'I've been incredibly bloated since perimenopause - what's wrong with me?' Dr Amir Khan reveals the cause and how to prevent it

The most common symptoms of perimenopause are reportedly hot flushes, night sweats, mood swings, and poor sleep, but digestive changes actually affect more than 8 in 10 women at this life stage, according to a recent survey by The Menopause Society.

The survey found that bloating, constipation, and stomach pain were the top three issues, and almost every woman (94%) had experienced at least one of them in her life. So, it's fair to say that you're not alone if you've experienced changes to your digestive health after perimenopause.

Yet, it's often one of the symptoms swept under the rug, says Dr Amir Khan, a NHS GP and woman&home's own resident doctor. "Lots of women are surprised to learn that oestrogen and the gut are linked," he says.

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Why does bloating happen after perimenopause?

The doctor says that the digestive system becomes more sensitive "as oestrogen levels fluctuate and fall during perimenopause and menopause". The hormone plays a vital role in balancing our gut bacteria, keeping the gut lining strong, and reducing inflammation, so when we don't have enough of it, these benefits are limited.

"There's also a group of bacteria in our gut called oestrobolome, which breaks down oestrogen and brings it back to your bloodstream. During menopause, this bacteria becomes less plentiful and less efficient, meaning less oestrogen is recycled back into the blood via the gut," says Dr Khan.

"All of this means menopause affects your gut, but also your gut health affects the severity of your menopause symptoms, leading to bloating, constipation, and wind," he explains.

How to ease bloating after perimenopause

• Eat more fibre: High-fibre foods like fruits, vegetables, chia seeds, and nuts are great for gut health. They relieve bloating and constipation, and help keep bowel movements regular.
• Add more high-protein foods to your diet: Protein helps keep bloating at bay as well, the doctor says, as it helps produce stomach acids and enzymes. However, too much of it or eating protein supplements too quickly can have the opposite effect.
• Include more fermented foods in your diet: Fermented foods like sauerkraut and kimchi improve gut bacteria diversity, and help reduce inflammation, improving gut health and reducing bloating symptoms. Sprinkle some on a salad or add some to a sandwich at lunchtime.

One underrated high-fibre food to include is legumes, the doctor adds. "Legumes feed beneficial gut bacteria, helping to reduce inflammation, improve cholesterol, and stabilise blood sugars. Their low glycaemic index prevents energy spikes and crashes, too, supporting steady appetite and weight control. Eat them three to four times a week."

Uncomfortable symptoms may stop or become manageable after menopause for some, as hormones stabilise. However, the doctor also urges anyone with new bloating or irritable bowel syndrome (IBS) symptoms to speak to their doctor. "It can be a symptom of ovarian cancer, and they will most likely offer you a blood test and/or a scan," he says.

This advice initially appeared in the March 2026 issue of woman&home magazine. Subscribe today.