Navigating Nausea and Digestive Quirks in Menopause

The Breakfast Battle

Breakfast used to be my absolute favorite meal. I would have to eat within 30 minutes of waking up to avoid feeling nauseous. But wait! Perimenopause comes along, and my body has decided that breakfast is now a high-stakes game. For the past 2-3 years, I’ve been struggling with the menopausal version of morning sickness. The thought of food early in the morning makes me sick, and although I sometimes try to force myself to eat something, most of the time, I have to wait until at least 2 hours after I wake up. Because this is so distressing to me, I dove into the research to find out if this is common during menopause, and it’s not, or at least I can’t find any studies on nausea in menopause. Instead, it was lumped in with gastrointestinal issues (GI). I also found exciting studies on the effect of menopause on the gut microbiome and how it can wreak havoc on your GI system. So if GI issues are on your list of “didn’t know this is menopause-related” stuff, this article will help you understand more about it. 

The Hormonal Tango

To better understand why menopause can create havoc on your GI system, I’ll give you a brief overview of what’s happening hormonally. Estrogen and Progesterone have very distinct effects on the GI system, with progesterone slowing digestion and estrogen speeding up digestion. This hormonal tango often causes women to go from constipation to diarrhea, depending on where their hormone levels are. You may have already experienced this during your regular menstrual cycles (period diarrhea is a real thing).

Unfortunately, during menopause, hormone levels can be all over the place, which means these changes can come quicker than a switchback on a steep road. Turns out that the decrease in estrogen seems to be linked to an increase in GI issues, such as constipation, gassiness, and bloating.  

The Gut Microbiome: A Hidden Player

The gut microbiome is our backstage star. Recent studies reveal menopause is associated with lower gut microbiome diversity, which is not a good thing. We want our microbiome to be as diverse as possible. The more diversity, the better, in life and in microbiome ;)  There are over 100 trillion bacteria, most of them in the intestines. Think of this bacteria as an intestinal medicine cabinet capable of protecting us from damaging organisms. Those millions of bacteria produce neurotransmitters relaying messages from the intestines to the brain, causing the body to react in different ways. They help the body support essential functions and health challenges, such as digestion, metabolism, mental health, nervous system, stress, hypertension, cholesterol reduction, and GI distress. 

Menopause-specific benefits of pro- and prebiotics

Vaginal health 

Recent studies evaluating the efficacy of probiotics for postmenopausal women show that they can be beneficial in the prevention and treatment of two frequently occurring vaginal infections in postmenopausal women, bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC).  This is a well-researched application of probiotic supplementation in the menopausal population and is considered a viable non-pharmaceutical option for vaginal health. 

Bone health

Osteoporosis is one of the highest risk factors for menopausal women. Some studies evaluating the benefit of probiotics demonstrated increased serum calcium levels and reduced bone loss, leading to better bone health. A recent literature review suggested that supplementation with probiotics could increase lumbar BMD. Hopefully, there will be more research on this in the future. 

Warning! Regulation of probiotics varies between regions and is focused on the legitimacy of claims rather than the efficacy and safety of those products. Because of their classification as food/health supplements, they do not have to go through clinical trials as medical drugs do. This allows companies to label their products "probiotic" even if they don't meet the scientific definition of the term. Be sure to research probiotic supplements before purchasing. The best way to consume probiotics is through naturally probiotic foods that can be added to your diet. 

Best probiotic food choices:

Listen to Your Body

Fellow menopausers, listen to your bodies! Just because a symptom isn’t common doesn’t mean it’s irrelevant. If a new symptom joins the menopausal party, don’t dismiss it. Talk to your healthcare provider about it and don’t let them ignore you. The reality is that if you’re in your mid-to-late forties, the change in hormones during this transition could be the leading player and should at least be a topic of conversation. I experience unexpected twists all the time. No prior GI issues, no other explanations – just the menopausal roller coaster doing its fast spins and loops.

In my case, I’ve learned to go with the flow (pun intended). When nausea tiptoes in, I skip the hot meal and opt for crunchy cereal with cold milk. It’s less off-putting to me. My recommendation is to be more flexible in your approach to daily life during this unpredictable time. Instead of fighting it, try to find solutions that work now, even if they must change tomorrow (again). You’ve got this!

Are you experiencing or have experienced any symptoms during menopause that you didn’t know about? Please share. You can email me at [email protected].