Gut Check: Navigating GI Issues in Perimenopause and Beyond

If you’re noticing more bloating, gas, or reflux than you used to, you’re not alone.

Digestive issues are a lesser-known but very real part of the perimenopausal and postmenopausal experience.

I’ve personally dealt with reflux for years, but since entering perimenopause, it has gotten significantly worse. On top of that, I’m currently taking Ozempic, which—while helpful for blood sugar and appetite regulation—can also contribute to digestive changes. If you're in the same boat, let’s break down what’s really going on, why it happens, and what you can do about it.

Why Does Perimenopause Wreck Your Gut?

Hormones—especially estrogen and progesterone—play a major role in digestion. When these hormones fluctuate (as they do wildly in perimenopause), the digestive system doesn’t always keep up smoothly.

• Estrogen drops can slow down digestion and reduce bile production, leading to constipation and bloating.

• Progesterone fluctuations can relax smooth muscle, including the esophagus, contributing to reflux.

• Increased cortisol from midlife stress impacts gut motility and can cause symptoms similar to IBS.

If you’re also using a medication like a GLP-1, it slows gastric emptying, meaning food stays in your stomach longer. This can increase:

• Nausea

• Reflux

• Gas and bloating

• Constipation

Common GI Symptoms in Perimenopause and Postmenopause

You might be experiencing:

• Bloating (especially after meals)

• Reflux or heartburn

• Nausea

• Constipation or diarrhea

• New food intolerances

• Gas or belching

• Feeling full too quickly

What You Can Do to Support Your Gut

Here are some strategies I use myself and often recommend to clients:

1. Eat Smaller, Slower Meals

Midlife digestion isn’t what it used to be. If you’re on Ozempic, large meals are even harder to tolerate.

• Eat slowly and chew thoroughly

• Try smaller portions spaced throughout the day

• Avoid drinking too much fluid during meals if reflux is an issue

2. Support Stomach Acid and Bile

It’s a myth that reflux is always caused by too much acid—many midlife women actually have low stomach acid.

• Try 1 tsp apple cider vinegar in water before meals (check with your provider)

• Consider digestive bitters or enzymes

• Magnesium or dandelion tea can support bile production

3. Balance the Gut Microbiome

Your gut bacteria influence both digestion and hormone metabolism.

• Add fermented foods like kimchi, sauerkraut, or kefir

• Slowly increase fiber intake (chia, flax, leafy greens)

• Try a high-quality probiotic

4. Move Your Body After Meals

Movement helps with digestion and blood sugar regulation.

• Take a gentle walk after eating

• Prioritize daily movement to keep things flowing

5. Manage Stress

Stress is a major gut disruptor—especially in perimenopause.

• Practice deep breathing, meditation, or journaling

• Try vagus nerve support: humming, cold rinses, or gargling

• Prioritize quality sleep

📝 Track Your Symptoms to Find Patterns

One of the most powerful tools during perimenopause and menopause is awareness. Keeping a GI symptom tracker can help you connect the dots between what you’re experiencing and possible root causes.

This isn’t just about food—your gut responds to hormones, stress, sleep, and medications, too.

✍️ What to Track Daily:

• Foods eaten: Include meals, snacks, drinks, and meal timing.

• Symptoms experienced: (e.g., reflux, bloating, nausea, gas, constipation, diarrhea)

• Sleep quality: Track how long you slept, whether you woke up during the night, and if sleep felt restful.

• Hormone fluctuations: Note your menstrual cycle phase (if still cycling), hot flashes, night sweats, or other signs of hormonal shifts.

• Stress levels: Rank your stress from 1–10 or briefly describe what was going on that day.

• Medications or supplements: Especially important if you’re using medications like Ozempic, NSAIDs, magnesium, probiotics, etc.

🗓️ Example Entry:

Date: August 13

Breakfast: Eggs + avocado + coffee

Lunch: Chicken salad + kombucha

Dinner: Grilled salmon, sweet potato, broccoli

Snacks: Protein shake

Symptoms: Mild reflux after lunch, gassy in the evening

Sleep: 6 hours, woke up twice

Hormones: Mid-luteal phase (PMS symptoms)

Stress: 7/10 — work deadline

Medications: Ozempic (0.5 mg), magnesium glycinate before bed

After a couple of weeks, you may start to see trends.Does bloating show up more during PMS? Does reflux worsen after certain meals or on high-stress days? This kind of insight allows you to make empowered, informed adjustments.

Remember: you’re not chasing perfection—you’re building awareness.

My Honest Take

GI symptoms during perimenopause can feel frustrating, confusing, and even embarrassing—but you’re not alone, and you’re not broken.

This phase of life brings real physiological shifts that deserve understanding, not shame. Some days are better than others, but the key is listening to your body and adjusting with care—not restriction or fear.

💬 Ready for Support?

I help midlife women navigate gut health, hormones, and everything in between. If this resonates with you, I’d love to talk.

📞 Book a free consult📲 Follow @rekindlewithkim🌐 Visit www.rekindlewithkim.com

You don’t have to do this alone.