“Bloating” is an umbrella term used to describe discomfort in the abdominal area related to:
- Water retention, which can be felt in other parts of your body, such as hands, feet, and face
- Trapped air in the abdomen, which makes your stomach feel full and swollen
For most of us, this isn’t anything new as we’ve (unfortunately) become BFFs with bloating over the years, especially during the pre-menstrual / PMS phase of our cycle, something 95% of us experience during our lifetime. Bloating often shows up to the party alongside a slew of other related symptoms, such as bowel discomfort, changes in bowel patterns (constipation and diarrhea), and abdominal pain.
Why do we bloat?
During perimenopause (or the transition period between the onset of your first symptoms and the onset of menopause), bloating can be traced back to hormone fluctuations — specifically estrogen and progesterone. Here’s why:
After we ovulate but before we begin our period, we’re in what’s called the “luteal phase.” At first, estrogen drops, but then it begins to rise and stays there. With more estrogen, we get more water retention. And with more water retention, we get bloat.
But estrogen isn’t the only fluctuating hormone. Progesterone rises, too, which affects the amount of time it takes food to move through our colon (aka GI transit time). When things slow down, it can cause constipation and, you guessed it, bloating.
While the science behind GI issues occurring pre-menopause into perimenopause is well established, it’s unfortunately less so when it comes to menopause. However, there is emerging science indicating that, during perimenopause and menopause, lower estrogen levels may result in decreased bile production, which is a substance that keeps the intestines lubricated. Less lubrication leads to harder and drier stool, which leads to constipation, which leads to…you can fill in the blank here. (*sigh*)
Outside of hormones, other causes of bloat and ancillary GI symptoms include:
- Nutrition: specifically insufficient protein and electrolyte imbalances
- Diet sensitivities: including celiac/gluten sensitivity and dairy intolerance
- Culprit foods & drinks: including chewing gum (which causes you to swallow air), carbonated beverages, and indigestible carbs found in sugar-free foods (e.g., sorbitol, mannitol, and xylitol)
- Irritable Bowel Syndrome (IBS): a condition that affects the large intestine, with symptoms such as cramping, bloating, gas, diarrhea, constipation, and abdominal pain
- Ovarian cancer or liver disease: yes, bloating can sometimes indicate a more serious problem like fluid in the abdominal cavity, which can be caused by liver disease or ovarian cancer — but to be clear, usually these conditions are not the reason for bloating
More often than not, bloating is transient, meaning it comes and goes
For transient bloating, it’s very unlikely that the cause is something more serious, such as ovarian cysts/cancer or fibroids. However, if any of the below apply to you, that’s a sign to consult your healthcare provider (or Elektra):
- Ongoing, chronic bloating
- Persistent or severe abdominal pain
- Ongoing diarrhea
- Bloody stool
- Changes in the color or frequency of stool
- Unintended weight loss
- Chest discomfort
- Loss of appetite or feeling full quickly
Dr. Anna Barbieri, MD
Pro tip #1
Not sure what specific foods are affecting you? Take stock of what you’re eating by keeping a food diary (here’s a great one from Harvard Health). Track what you eat and any symptoms. By doing this, you can better assess recurring patterns and problematic foods. You can also bring this along to your doctor’s appointment to be well prepared. Here’s a comprehensive guide to get you started.