Constipation is the opposite of diarrhea - it's when stool tends to stick around longer than necessary. Often it's drier, lumpier, and harder than normal, and may be difficult to pass.
Constipation often comes along with abdominal pain and bloating. And can be common in people with certain gut issues, like irritable bowel syndrome (IBS).
About 14-24% of adults experience constipation. Constipation becomes chronic when it happens at least three times per week for three months. Constipation can be caused by diet or stress, and even changes to our daily routine. And it can often appear at menopause or post menopause.
Menopause is earmarked by a drop in female hormones such as estrogen and progesterone. These hormones affect many areas of the body, including the digestive tract. As a result of this hormone drop, some postmenopausal women experience constipation. However, changes in bowel routine can begin even before menopause, during perimenopause.
Sometimes the culprit is a medical condition or medications. And sometimes there can be a structural problem with the gut. Many times the cause is unknown.
If you want to chat about your gut health and how it may be affecting your menopause symptoms, click here to schedule a free call with me.
Whether you know why or not, there are some things you can do if you get constipated.
1 - Eat more fibre
You've probably heard to eat more prunes (and figs and dates) if you get constipated. Why is that? It comes down to fibre.
Dietary fibre is a type of plant-based carbohydrate that we can’t digest and absorb. Unlike cows, humans don’t have the digestive enzymes to break it down. And that’s a good thing!
Even though we can’t digest it ourselves, fibre is very important for our gut health for two reasons. First, fibre helps to push things through our system (and out the other end). Second, fibre is an important food for feeding the friendly microbes in our gut. There are two kinds of fibre: soluble and insoluble.
Soluble fibre dissolves in water to make a gel-like consistency. It can soften and bulk up the stool; this is the kind of fibre that you want to focus on for helping with constipation. Soluble fibre is found in legumes (beans, peas, lentils), fruit (apples, bananas, berries, citrus, pears, etc.), vegetables (broccoli, carrots, spinach, etc.), and grains like oats.
Psyllium is a soluble non-fermenting fibre from corn husks. It’s been shown to help soften stools and produce a laxative effect.
Insoluble fibre, on the other hand, holds onto water and can help to push things through the gut and get things moving. It's the kind found in the skins and seeds of fruits and vegetables like asparagus, broccoli, celery, zucchini, as well as the skins of apples, pears, and potatoes.
It’s recommended that adults consume between 20-35 grams of fibre per day.
If you are going to increase your fibre intake, make sure to do it gradually. Radically changing your diet can make things worse!
And, it’s also very important to combine increased fibre intake with my next point to drink more fluids.
NOTE: There is conflicting evidence on how fibre affects constipation. In some cases, less insoluble fibre may be better, especially if you have certain digestive issues. So, make sure you’re monitoring how your diet affects your gut health and act accordingly. And don’t be afraid to see your healthcare provider when necessary.
2 - Drink more fluids
Since constipated stools are hard and dry, drinking more fluids can help keep everything hydrated and moist. This is especially true when trying to maintain a healthy gut every day, rather than when trying to deal with the problem of constipation after it has started.
This is even more important if you are experiencing hot flushes, as this dehydrates you further! In addition, too little progesterone can cause your colon to slow down. The longer food waste remains in your colon, the dryer it gets. Stool also tends to be dryer when estrogen and progesterone levels are low.
Some postmenopausal women also have weakened pelvic floor muscles. This can make it difficult to eliminate stool, especially when it is hard and dry.
Your fluids don't only have to be water - watery foods like soups, and some fruits and vegetables can also contribute to your fluid intake.
Always ensure you're well hydrated, and drinking according to thirst; this is recommended for gut health as well as overall health.
3 - Probiotics
Probiotics are beneficial microbes that come in fermented foods and supplements. They have a number of effects on gut health and constipation. They affect gut transit time (how fast food goes through us), increase the number of bowel movements per week, and help to soften stools to make them easier to pass.
Probiotic foods (and drinks) include fermented vegetables (like sauerkraut and kimchi), miso, kefir, and kombucha.
More research is needed when it comes to recommending a specific probiotic supplement or strain. If you’re going to take supplements, make sure to read the label to ensure that it’s safe for you. And take it as directed.
4 - Lifestyle
Some studies show a gut benefit from regular exercise. Ideally, aim to exercise for at least 30 minutes most days.
In terms of stress, when we’re stressed, it often affects our digestive system. The connection between our gut and our brain is so strong, researchers have coined the term “gut-brain axis.”
Cortisol is a hormone associated with stress. Estrogen is responsible for many things including keeping cortisol levels low. When estrogen declines, cortisol levels rise. This can slow down the digestive process, lengthening the amount of time it takes for food to break down. This can make stool more difficult to pass. By better managing stress, we can help to reduce emotional and physical issues (like gut issues) that may result from stress. Try things like meditation, deep breathing, and exercise.
And last but not least - make sure to go when you need to go! Don’t hold it in because that can make things worse.
1. Optimal digestion is so important for overall health. Constipation is a common problem in menopausal women.
2. Increasing our fibre and water intake - especially if you’re experiencing hot flushes, and boosting our friendly gut microbes are key things we can do to help things move along.
3. Low estrogen can slow down the digestive process, lengthening the amount of time it takes for food to break down. This can make stool more difficult to pass.
4. Too little progesterone can also cause your colon to slow down.
5. As women age, they may also need medications which have constipation listed as a possible complication. These medications include:
Navigating through menopause can sometimes be a frustrating and challenging journey, and talking about these things can be difficult. I am going through some of these things myself, and have clients that do as well. Why not take some time to have a chat about how you could relieve some of your symptoms? Click below to schedule a call with me.
Click below to listen to a podcast episode I was interviewed for, about building resilience and my journey to being a Health Coach