009: Why Am I So Bloated? Understanding Your Digestion During Perimenopause

You haven't changed what you eat or how you eat. But lately you've been feeling bloated — and you're not sure why.

Welcome to Nourish with Katrina — conversations on gut health, hormones, and ancestral nutrition for women 40 plus. I'm Katrina, and today we're talking about bloating.

If things in your body feel like they're shifting — your sleep, your weight, your mood, your digestion — you may be in perimenopause. Perimenopause is the natural transition leading up to menopause — defined as one full year without a period. It can begin as early as your late 30s and last ten years or more.

It affects far more than your reproductive system. And your digestive system is very much part of this transition — as natural as puberty, as pregnancy, as every hormonal shift that came before it.

Here's what's happening in your body.

Your hormones play a role in how your entire body functions — including your gut. Estrogen and progesterone are your two main reproductive hormones — but their job goes far beyond reproduction. They have always played an active role in how your digestive system moves and works. As these hormones shift during perimenopause, your digestive system shifts with them. This is your body responding to a new hormonal environment.

Here's what that looks like in practice.

First, food moves through your digestive system more slowly. Yes –– estrogen and progesterone help keep food moving through your digestive tract at a steady pace. As these hormones shift, that digestive movement changes pace. And, the longer food sits in your gut, the bacteria i nyour gut have more time to ferment and produce gas. More gas means more bloating.

Second, your gut bacteria are also shifting. Estrogen also influences the balance of your gut microbiome — the trillions of bacteria living in your digestive tract. As estrogen shifts, the balance of those bacteria changes too. For many women, this is associated with increased bloating and digestive sensitivity. Your gut is doing exactly what a responsive, living system does — it's moving with the change.

Third, stomach acid production may shift. Your stomach produces hydrochloric acid — and this acid does a lot of important work. It breaks down food, particularly protein, activates your digestive enzymes, and helps your body absorb key nutrients like B12, iron, magnesium, and zinc. As your body moves through this transition, acid production can change, which affects how efficiently food is broken down. Food may sit a little longer, ferment a little more, and produce more gas. It can also produce heartburn and reflux that feels like too much acid — but is often actually the opposite.

Several things can influence stomach acid production — and for many women it's a combination rather than any single cause. These include the natural changes in the cells that produce acid, hormonal shifts during perimenopause, a common bacterial infection called H. pylori that many people are unaware they have, and long-term use of acid-reducing medications.

Fourth, your digestive enzymes are changing. Your body produces enzymes throughout your digestive tract — in your saliva, your stomach, your pancreas, and your small intestine — and these are what actually break food down into forms your body can absorb. Proteins, carbohydrates, fats — each has its own enzyme family doing that work.

The cells and glands responsible for producing those enzymes change over time — and the hormonal shifts of perimenopause add to this. Foods that your body processed easily at 35 may now sit heavier or digest more slowly — because your digestive system is operating in a new hormonal context, and finding its new rhythm.

Fifth, cortisol becomes more easily triggered. Cortisol is your stress hormone and it directly affects digestive function. It's part of the fight-or-flight response: when your body perceives stress, it naturally redirects energy away from digestion and toward dealing with that stress. During perimenopause, as estrogen shifts, the nervous system becomes more sensitive to stress — making cortisol easier to trigger and slower to settle back down.

This means that eating while rushed, stressed, or running on poor sleep affects digestion more noticeably than it may have before.

And sixth, your gut is more responsive. Many women find their gut becomes more sensitive during perimenopause to certain foods, to stress, to sleep. Think of it as your body giving you clearer signals about what it needs. A UK study presented at The Menopause Society's 2025 Annual Meeting surveyed nearly 600 women aged 44 to 73 and found that 94% reported digestive changes, with 82% saying those changes either began or became more noticeable during perimenopause or menopause.

Here's how to support your body through this transition

These are practical ways to work with what your body is doing.

1. Notice what your body is responding to. Your gut can become more sensitive during perimenopause even when your diet hasn't changed. The most common triggers are foods high in fermentable carbohydrates — these are foods that gut bacteria break down in your digestive tract, producing gas as they do. Onions, garlic, beans, wheat, dairy, and certain fruits are the most common ones. Keeping a simple food and symptom diary for two weeks can show you a lot. You're looking for patterns.

One thing worth watching for: if your symptoms seem connected to fermented foods, aged cheeses, cured meats, or leftovers — histamine may be playing a role. More on that below.

2. Slow down when you eat. When you eat quickly, standing up, or while scrolling your phone, your nervous system is in alert mode — and in alert mode, digestive function is naturally reduced. Eating slowly, chewing thoroughly, and sitting down without screens gives your nervous system the signal it needs to shift into the relaxed state where digestion works at its best.

This matters more now because your enzyme production has shifted. The more you chew your food, the less work your stomach needs to do. It's a small practice that supports every single meal.

3. Move after meals. A 10-minute walk after eating is one of the simplest and most well-researched ways to ease bloating after a meal. It helps food and gas move through your digestive tract more efficiently, and it costs nothing.

4. Introduce fibre gradually. Fibre feeds the beneficial bacteria in your gut and helps keep things moving through your digestive tract — both of which support easier digestion. Your gut does best when fibre is added slowly rather than all at once. Cooked vegetables are generally easier to digest than raw ones — the cooking process softens the plant fibres and reduces the work your gut needs to do. Raw and fermented vegetables can contribute to bloating for some women during this transition, so pay attention to how your body responds to them.

5. Sleep and stress are part of this too. How well you sleep and how much stress you carry both directly affect how your digestive system functions — they are fully part of the same picture. A consistent sleep schedule, limiting screens before bed, and eating your last meal at least two to three hours before you sleep all help. Finding a way to wind down that works for you supports the kind of deep rest that your nervous system — and your digestion — depend on. And if life feels particularly full right now, even small daily practices like a short walk, slow breathing, or quiet time without a screen can help bring cortisol back down.

And here's a little extra support:

Your body is doing a lot right now. These are some simple things that can help your digestive system along during this transition.

Probiotics. Probiotics are live bacteria that support the balance of your gut microbiome. The research shows that the strain matters — different strains do different jobs. Two strains that have shown up consistently in studies for reducing bloating are Lactobacillus plantarum 299v and Bifidobacterium infantis 35624. Look for these names on the label rather than just picking up any probiotic off the shelf. Give them at least four weeks — they work gradually, not overnight.

Digestive enzymes. Your body produces enzymes to break down the food you eat — proteins, carbohydrates, and fats each have their own. As your body moves through this transition, enzyme production can shift, and a supplement can give your digestion a helpful hand. Different enzymes target different foods, so matching the enzyme to what you're noticing is the most useful approach.

One thing worth knowing: raw dairy is often better tolerated than pasteurised dairy because it still contains the natural enzymes that help break it down — enzymes that the pasteurization process removes.

Histamine and DAO enzymes. Histamine is a chemical your body produces naturally — it's involved in immune responses, digestion, and communication between cells. It's also found in certain foods, particularly those that are aged, fermented, or left over, because histamine builds up as food sits.

Your body normally breaks down dietary histamine using an enzyme called DAO. Estrogen directly affects how well DAO works — and as estrogen shifts during perimenopause, some women find their body handles histamine differently than it used to. Foods they've eaten comfortably for years can start producing a response.

Keeping a simple food journal and noting how you feel after eating can help you spot patterns you might otherwise miss. If aged cheeses, cured meats, smoked fish, or leftovers seem to bring on bloating, discomfort, or headaches — histamine may be part of your picture.

Magnesium. Magnesium helps keep things moving through your digestive tract. If you've noticed things feeling a little slow or sluggish, magnesium citrate or magnesium glycinate taken in the evening is worth trying. Start with a low dose — citrate in particular can be quite effective, so a little goes a long way.

Ginger — as food or tea. Ginger is a traditional remedy with real research behind it for easing bloating. It helps food move out of your stomach more efficiently and eases cramping in your digestive tract. Fresh ginger in meals, ginger tea after eating, or a few slices steeped in hot water before a meal all work well. Start with a small amount and see how you go.

And, in addition to all of these things we've covered, here are a few other things worth knowing about:

These are some other things that can contribute to digestive changes and are worth being aware of.

H. pylori — a bacterial infection in the stomach lining that is more common than most people realise. It can affect how well your stomach produces acid and breaks down food. A simple breath, stool, or blood test can identify it.

Thyroid function — thyroid changes become more common during and after perimenopause, and thyroid function directly affects how efficiently food moves through your digestive system.

Celiac disease — if wheat consistently seems to trigger your bloating, this is worth looking into. It's identified with a simple blood test.

SIBO — this stands for small intestinal bacterial overgrowth. If your bloating seems to get worse rather than better when you eat more fibre or fermented foods, SIBO may be worth knowing about. In this case, more fibre and probiotics can sometimes make things feel heavier rather than easier.

Here's your takeaways:

Perimenopause is a biological transition — as natural as every hormonal shift that came before it. Your digestive system is part of that transition. The changes you're noticing make complete biological sense.

Your hormones, your gut bacteria, your enzyme production, your stress responses — they are all shifting at the same time. The food on your plate may be exactly the same as it's always been. How your body works with it is evolving.

Slow down at meals, pay attention to how your body responds to different foods, move after eating, sleep well, and where it feels right, give your digestive system a little extra support.

Your body is intelligent and always seeking balance. And it will show you what it needs — through how it feels after a meal, how it responds to stress, how it settles when you slow down.

Ready to take this further?

Digestion is one piece of a larger picture. When your body is absorbing nutrients well, everything else — your energy, your hormones, your overall health — has a better foundation to build on. And knowing which foods to build your meals around during this season of life is one of the most useful things you can do for your body right now.

The free Protein Guide for Women 40+ is a good place to start. It's practical and specific to this season of life. You'll find it at nourishwithkatrina.com/protein-guide — the link is also in the show notes.

Get the free Protein Guide →