Gut-Brain Connection & Menopause

Janelle asks: “I feel the gut-brain connection is more prominent at my age now at 42 (or I have become more aware of it). Does it get heightened during PMS, perimenopause, and pre-menopause?“

Val Schonberg (Registered Dietitian Nutritionist and NAMS-certified menopause practitioner): Hi, Janelle! Yes, fluctuating hormones and the presence or absence of estrogen, that occurs before or during the menstrual cycle (remember puberty) and during the transition to menopause influences the gut-brain connection. The gut-brain connection refers to a bidirectional communication between the “gut” (your digestive system) and the brain. Complex and intricate neurological and physiological factors influence this connection, and in the past decade this has become a hot area of nutritional and psychological research. Scientists continue to reveal information about this two-way highway and the consequential impact of emotions, stress, and hormones on gut function, as well as the influence of the food we eat (and the resulting trillions of microorganisms that exist in the gut) on mood, anxiety, stress, and brain function. Although we know that this complex connection impacts women at all stages of life, the research is still evolving as it relates to the shift in hormones during menopause.

You may become aware of this connection when you experience symptoms such as bloating, gas, constipation and/or diarrhea, but also when feeling anxious, moody, fatigue, or suffering with headaches or “brain fog.” More extreme symptoms such as persistent migraines, “urgent diarrhea” or “functional constipation,” could be related to signs of other health concerns and should be discussed with a qualified physician, such as a gastroenterologist or your gynecologist. Additionally, it is recommended if you are suffering from disabling feelings of depression or unmanaged anxiety to visit with a licensed psychologist.

Like hormones, stress and diet also impact the health of the gut-brain connection. Consequently, as women approach their mid-40’s, additional stress such as career changes, kids leaving for college, divorce, aging parents, downsizing, etc. may increase. At the same time, women may unintentionally or intentionally be skipping meals, cooking less at home, and eating out more or more frequently and diet quality may suffer. Nutrition research in this area is relatively new and emerging. We are learning that a diet rich in plant foods and fiber (whole grains, vegetables, fruit, nuts, beans, and legumes), supports a more healthy, diverse microbiome (the name for those trillions of microorganisms) and is associated with improvements in digestion as well as overall physical and mental health. The habitual intake of fermented foods, such as yogurt (with live and active cultures), sauerkraut, and kefir may also help maintain a healthy gut. Negative influences on the gut microbiome that may affect health and disease risk include chronic over consumption of ultra-processed foods (sodas, packaged snacks, energy drinks, energy bars, etc.), diets high in fat and animal protein, as well as yo-yo dieting or going on and off diets, and certain medications.