What Causes Perimenopause Constipation-and What to Do About It
“Perimenopause Constipation” was written by Su-Nui Escobar, DCN, RDN, FAND, in collaboration with soon to be Registered Dietitians Vicky Rojas Alessandra Sparks.
Evidence suggests that constipation is common during perimenopause and hormones might be the ones to blame!
While we often think of constipation as being unable to do more than three bowel movements within a week, there are other symptoms. Having stools that are difficult to pass, or hard and dry are also considered constipation (1). If you are experiencing any of these symptoms, keep reading to learn about why this happens and most important: how to fix it!
How Hormonal Changes Cause Perimenopausal Constipation
Estrogen and progesterone change once women enter into perimenopause. These hormones contribute to the proper functioning of intestinal transit (2). Thus a change in these hormones can cause unwanted changes in the gastrointestinal tract, including constipation.
Other hormonal imbalances during perimenopause can also contribute to constipation. For example, some imbalances in the hormones that maintain the body’s fluid balance can cause constipation by retaining fluids. This will cause the food bolus to compact and dry out. A dry bolus will take longer to travel through the intestine (3).
The Surprising Relation Between Constipation and Depression
An article published in the Journal Gastroenterology shows that a hormone imbalance can cause constipation. Specifically a shortage of serotonin -the happiness hormone- in the gut can cause this uncomfortable condition.
The same shortage of serotonin shortage in the brain can also lead to depression.
The good news is that the treatment that raises serotonin levels in the gut and brain could also help constipation (4).
There is also the behavioral aspect of depression. When we are unwell emotionally, our eating habits can change. Eating more, less, skipping meals, or eating unhealthy foods can make it difficult to maintain a normal intestinal transit, leading to constipation.
How to Get Rid of Constipation in Perimenopause ?
Despite having a multifactorial cause, similar lifestyle changes can improve constipation while alleviating other unwanted symptoms of perimenopause.
Increase your Fiber Intake
Fiber is essential if you struggle with constipation. According to the 2020-2025 Dietary Guidelines for Americans, fiber’s daily requirement for women aged 50 or younger is 25 grams. Women aged 51 or older need 21 grams (5).
There are plenty of high fiber foods that could be helpful to naturally avoid and relieve constipation. However, to prevent any gastrointestinal issues, such as gas or bloating, it is recommended to gradually increase fiber consumption.
Fruits and Vegetables
Fruits and vegetables can help you to form softer, bulkier stools. Eating them raw with skin will provide you with larger amounts of insoluble fiber. This type of fiber can help you pass the stools faster.
Also, while any fruit and vegetable will be helpful as we are going for quantity, some of the best for constipation are:
- Strawberries, blackberries, kiwi, prunes, papaya, peaches, apricots, plums, raisins, rhubarb, apples, pears, and pineapples.
- Artichoke, celery, eggplants, zucchini, corn, potatoes with their skin, broccoli, green leafy vegetables such as spinach, lettuce, kale, and arugula.
It is well known that the fiber in whole grains can help with constipation. Whole with bread (make sure to read the labels to ensure one that is high in fiber), whole wheat pasta, cereals high in fiber, oats, buckwheat, quinoa, and brown rice are good examples of whole grains.
Other Foods That Help With Constipation
- Avocado, flax seeds, nuts, and olive oil are good sources of fatty acids that can help you speed up your intestinal transit.
Smart tip: It will always be necessary to increase its consumption progressively to accustom the body to avoid gas or bloating problems.
Water, Water and More Water
Remember that dehydration can be one of the usual causes of constipation. How much water you need per day? The recommendation is that you drink between 2 and 3 liters of water daily, especially if you are increasing your fiber intake or if you practice physical activity on a more regular basis.
If you struggle to drink enough water daily, add slices of fruits, herbs, or vegetables. Imagine drinking the type water you will find at a nice spa at your home! Here is a list of infused water ideas.
Juices, broths, tea, infusions, and refreshing drinks also count toward your daily water intake.
Moving more can help you pass the stools faster. It also reduces the amount of water reabsorbed in your intestines reducing the chance of you having hard stools. For relieving constipation, simple short walks a few times a day can help.
Aerobic exercise- such as running, jogging, biking, and dancing- can help further by stimulating the natural contractions your body needs to pass the stool.
Another type of movement that is very helpful for constipation is yoga. As your body twists in the different positions, the muscles in your intestines work more efficiently to pass stools faster.
Last, moving can help reduce stress and depression, helping your gastrointestinal (GI) system to work better.
Be cautious if you are tented to use laxatives
While laxatives are a great way to quickly fix constipation in the short run, using them for prolonged periods can can damage the intestinal walls and spontaneously make their function more challenging (8).
Perimenopause constipation can be treated if you change your lifestyle habits. No need to suffer this uncomfortable condition.
Take care of yourself inside out!
Thank you Vicky Rojas and Alessandra Sparks for your wonderful contribution to this blog.
Constipation. (2020, November 17). Retrieved February 14, 2021, from https://medlineplus.gov/constipation.html
Diaz, S. (2020, October 01). Constipation. Retrieved February 12, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK513291/#:~:text=Having%20hard%20and%20painful%20stools,that%20cause%20rectal%20outlet%20obstruction
Glander, A. (2020, July 22). 23 infused Water ideas that will make you forget about soda. Retrieved February 14, 2021, from https://www.tasteofhome.com/collection/infused-water-ideas/
Home: Dietary guidelines for Americans. (n.d.). Retrieved February 14, 2021, from https://www.dietaryguidelines.gov/
Israelyan, N., Del Colle, A., Li, Z., Park, Y., Xing, A., Jacobsen, J. P., . . . Margolis, K. G. (2019). Effects of serotonin AND SLOW-RELEASE 5-Hydroxytryptophan on gastrointestinal Motility in a mouse model of depression. Gastroenterology, 157(2). doi:10.1053/j.gastro.2019.04.022
Publishing, H. (n.d.). Coming to terms with constipation. Retrieved February 14, 2021, from https://www.health.harvard.edu/digestive-health/coming-to-terms-with-constipation
Tack J;Müller-Lissner S;Stanghellini V;Boeckxstaens G;Kamm MA;Simren M;Galmiche JP;Fried M;. (n.d.). Diagnosis and treatment of chronic CONSTIPATION–A European perspective. Retrieved February 12, 2021, from https://pubmed.ncbi.nlm.nih.gov/21605282/
Yoga for CONSTIPATION: 8 poses for quick relief. (n.d.). Retrieved February 14, 2021, from https://www.medicalnewstoday.com/articles/327086