Put a bin in it

From shifting hormones to changing gut health, here's what could be behind your bloating.

- WORDS by KATY SUNNASSEE

Bloating is one of the most common gut complaints, especially in women over 40, and hormone fluctuations during perimenopause and menopause play a key role.

“Causes are typically multifactorial, involving a complex interplay between hormonal fluctuations, gastrointestinal function, dietary triggers, and stress,” says Dr Nirusha Kumaran, an expert in women’s health and longevity.

“During the perimenopausal and menopausal transition, shifts in key sex hormones - namely oestrogen, progesterone, and androgens - can significantly influence digestive health. Progesterone is known to slow gastrointestinal motility, which may result in delayed transit time and increased gas retention. Oestrogen supports the integrity of the gut lining and helps regulate microbiome composition, whilst androgens such as testosterone contribute to maintaining healthy bowel function. Lower androgen levels have been associated with increased prevalence of irritable bowel syndrome [IBS]-like symptoms.”

Stress further compounds these hormonal and digestive changes.

“Stress reduces the tone of your vagus nerve [the nerve responsible for rest and digestion] and suppresses the production of stomach acid and digestive enzymes, leading to inefficient digestion and bloating. Chronic stress also disrupts the gut-brain axis, potentially triggering gut microbiome imbalances and heightened visceral sensitivity, both of which are known contributors to bloating and IBS,” says Dr Kumaran.

Adding another layer of complexity, the gastrointestinal tract functions not only as a digestive organ but also as a major endocrine organ.

“It produces a variety of gut hormones, including glucagon-like peptide-1, serotonin, somatostatin, glucocorticoids and ghrelin. These hormones play a critical role in regulating gut motility, appetite, enzyme secretion, and nutrient absorption,” says Dr Kumaran.