October is Menopause Awareness Month, and on 18 October, World Menopause Day puts midlife health on the agenda around the world. The conversation has come a long way: hot flushes, sleep and brain fog are finally being talked about at work, on the school run and over dinner. Your gut, though, still tends to get left off the list. If your digestion has felt different since your periods started changing, you are not imagining it, and you are completely entitled to bring it up.
Menopause is usually discussed through hot flushes, sleep and mood, but research suggests the gut may change during this transition too. Changes in bowel habit, bloating and tummy discomfort are worth writing down and raising with your GP, especially as this year's World Menopause Day theme is chronic pain in midlife.
Why World Menopause Day matters for your gut
World Menopause Day is run every year by the International Menopause Society, and the theme for 2026 is chronic pain in midlife [1]. Pain in midlife is often thought of as joints, backs and headaches. But tummy discomfort, bloating and changes in how often you go are common everyday complaints, and they are easy to dismiss as just one of those things.
That matters, because being heard is still not a given. When the government asked women in England about their healthcare experiences, 84% of respondents said there had been times when they were not listened to by healthcare professionals [2]. Awareness months exist partly to close that gap, and your gut deserves a place in the conversation. If you want the wider picture first, our guide to gut health and menopause covers the basics.
What research suggests happens to the gut during menopause
Oestrogen and progesterone do not only act on the reproductive system. Receptors for these hormones are found along the digestive tract, and changes in sex hormones may influence how quickly the gut moves and how sensitive it feels, which could contribute to changes in digestive symptoms for some women [3]. The relationship is complex, with several mechanisms likely at play rather than one simple hormonal switch [3]. During perimenopause, hormonal changes can coincide with changes in gut function, and some women notice their digestion behaving differently, from constipation to changes in their bowel pattern.
The gut microbiome may shift as well. In a US study that sequenced stool samples from 2,300 people, postmenopausal women tended towards lower gut microbiome diversity than premenopausal women, with a makeup slightly more similar to men's [4]. The same researchers reported changes in the estrobolome, the collection of bacterial genes thought to help process oestrogen in the gut [4]. This is an observational study, so it cannot show cause and effect, but it adds to a growing body of evidence that menopause and the gut may be more connected than many of us were told. The evidence is still developing, though. A 2025 scoping review of research on gut symptoms in peri and postmenopause found important gaps, including inconsistent ways of defining menopausal stages and measuring symptoms [5]. Not every woman will notice changes, and that is normal too.
| What you might notice | What may be involved | Worth noting down |
|---|---|---|
| Going less often, or harder stools | Hormonal change may influence how quickly the gut moves [3] | How often you go and what it looks like |
| Bloating that comes and goes | Changes in gut sensitivity are thought to play a part [3] | Time of day and what you ate |
| Looser stools at times | Hormone fluctuations may affect gut movement [3] | Whether it clusters on certain days |
| Tummy discomfort | Many possible causes, so worth discussing with your GP | How long it lasts and how often |
See a GP if:
- you have been bloated for 3 weeks or more
- you keep getting bloated
- bloating comes with weight loss, blood in your poo or a change in bowel habit that does not settle
Do not wait for an awareness month to get these checked [7].
How to bring your gut into your menopause appointment
NICE guidance on menopause asks clinicians to take an individualised approach to care [6], which means your own symptoms, described clearly, really do count. A few things may help them land.
Write it down before you go. Two to four weeks of simple notes on how often you go, what it looks like, bloating and discomfort gives your GP something concrete to work with. The Bristol Stool Chart is a useful shared language.
Lead with the change. Saying that your bowel habit is different from what is normal for you is often more useful than guessing at a cause.
Ask directly. It is reasonable to ask whether your gut symptoms could be connected to menopause, and what else might explain them.
Most midlife gut changes are everyday ones, and noticing them early simply means you go into appointments with better information. You might also find why perimenopause bloating happens a helpful read before you book, and gut health after 40 covers the wider changes.
Use Menopause Awareness Month as your starting point. For the rest of October, keep a short daily note of your bowel habits, bloating and energy alongside any other symptoms, so you have a clear picture to take to your GP. Gutsi, a gut health tracker, tracks consistency, frequency and hydration every day, passively, which can help you see patterns over time and capture information to take to your clinician.
References
- International Menopause Society. (2026). President's newsletter, April 2026: World Menopause Day 2026 theme announced as Chronic Pain in Midlife. https://www.imsociety.org/?p=4180
- Department of Health and Social Care. (2021). Results of the Women's Health: Let's talk about it survey. https://www.gov.uk/government/calls-for-evidence/womens-health-strategy-call-for-evidence/outcome/results-of-the-womens-health-lets-talk-about-it-survey
- Mulak, A., Taché, Y., & Larauche, M. (2014). Sex hormones in the modulation of irritable bowel syndrome. World Journal of Gastroenterology, 20(10), 2433-2448. https://doi.org/10.3748/wjg.v20.i10.2433
- Peters, B. A., Lin, J., Qi, Q., et al. (2022). Menopause is associated with an altered gut microbiome and estrobolome, with implications for adverse cardiometabolic risk in the Hispanic Community Health Study/Study of Latinos. mSystems, 7(3), e0027322. https://doi.org/10.1128/msystems.00273-22 (Observational study.)
- Shaw, N., Pettinger, C., et al. (2025). The volume and characteristics of research on gastrointestinal symptoms in natural peri and postmenopause: a scoping review. Women's Health, 21, 17455057251387470. https://pmc.ncbi.nlm.nih.gov/articles/PMC12575958/
- National Institute for Health and Care Excellence. (2015, updated 2024). Menopause: identification and management (NG23). https://www.nice.org.uk/guidance/ng23
- NHS. Bloating. https://www.nhs.uk/conditions/bloating/
Gutsi provides lifestyle and wellness insights only. It is not intended to diagnose, treat, cure or prevent any disease, and should not be used as a substitute for professional medical advice.
