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Menopause and Constipation: What’s the Connection?

Constipation is very common in menopause. While hormones are a primary factor, there are other causes strengthening the link between these conditions. Menopause is a transitional time for women that often begins between ages 45 and 55. It is the time beginning 12 months after a woman's last period and can last seven to 14 years. During this transition, women may experience a variety of symptoms

  • Posted on 27th May, 2022 15:00 PM
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Menopause is a transitional time for women that often begins between ages 45 and 55. It is the time beginning 12 months after a woman's last period and can last seven to 14 years. During this transition, women may experience a variety of symptoms associated with shifts in hormones. One of the more common symptoms of menopause is constipation.

Constipation is a condition in which you may have fewer than three bowel movements per week, stools that are hard, dry, or lumpy, stools that are difficult or painful to pass, or a feeling that not all stool has passed.

This article will discuss the connection between menopause and constipation, what else causes constipation, and tips for managing it.

Language Considerations

The word "women" is used here to refer to people who identify as women and have typical reproductive organs of a cisgender female. We recognize that some people who identify as women do not have the same anatomy as that depicted in this article.

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What’s the Connection Between Menopause and Constipation?

The menopausal transition affects each woman differently. During this time, the production of the female hormones estrogen and progesterone declines. Menopause can happen naturally with age or be caused by diseases, cancer treatments, or surgical removal of the ovaries.

No matter what triggers the menopausal transition, there is a change in levels of hormones in the body at this time. Since hormones act as chemical messengers in the body that help regulate many functions, the decline of estrogen and progesterone will cause changes, including constipation.

Changes During Menopause How It Leads to Constipation
Increased stress hormonesOne role of estrogen in the body is to help regulate cortisol, a stress hormone. When estrogen declines, levels of cortisol rise. Increased levels of cortisol in the body slows the digestion process, decreasing movement in the colon, which leads to constipation.
Drier, harder StoolsDeclining levels of progesterone can cause stools to stay in the colon longer. The longer the stool stays in the colon, the more they dry out, which leads to small, dry, hard stools that are difficult to pass.
Loss of muscle toneDecreases in estrogen can cause a decrease in muscle tone, including the muscle in the pelvic floor. A weakening pelvic floor can make it more difficult to fully pass stool. This problem can be further worsened when combined with chronic straining which further weakens pelvic floor muscles.
Increased joint and back painSome women will experience increased pain in the joints and back, which can limit a woman's mobility and prevent regular movement. Exercise helps to regulate digestion so this disruption can also contribute to constipation.

How to Treat Constipation

There are several ways to help improve constipation caused by hormonal changes during menopause.

Making Dietary Changes

Increasing dietary fiber can help the body better form and eliminate stools. This includes soluble and insoluble fiber, which have different functions, as follows:

  • Soluble fiber dissolves and creates a gel that attracts water. This helps to form stools that are softer so that they are easier to pass. Foods with soluble fiber include oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables.
  • Insoluble fiber is not dissolved in water and instead adds bulk to the stool so they are better formed and easier to eliminate fully. Foods with insoluble fiber include wheat bran, vegetables, and whole grains.

With increased dietary fiber, it's important to increase fluid intake as well.

Over-the-Counter Medications

There are many over-the-counter (OTC, without a prescription) medications used to treat constipation. These are called laxatives and they are short-term solutions that have different ways of working to relieve constipation. Types of OTC laxatives include:

  • Bulk-forming laxatives, such as fiber supplements, work similarly to adding dietary fiber. They help to form soft, bulky stools and make them easier to pass. It's important to increase water consumption when consuming bulk-forming laxatives, as constipation can worsen with increased fiber intake.
  • Osmotics are laxatives that work by drawing water into the colon to help stools pass. These can cause unpleasant side effects like nausea, bloating, cramping, and diarrhea.
  • Stool softeners work by adding moisture to the stool to help decrease straining. This class of laxative is a short-term solution that can cause electrolyte imbalances if use is prolonged.
  • Oral stimulants and rectal suppositories work by triggering contractions of the intestinal muscle to help eliminate stool.

Ensure Medications Are Right for You

As with all medications, it is important to speak with your healthcare provider first before starting medications for constipation to ensure they are safe for you to use, how to properly use them, and when to discontinue use.

Exercise

Daily exercise can help with constipation. The Centers for Disease Control and Prevention (CDC) recommends at least 30 minutes per day of exercise to keep the body strong and healthy. Various types are recommended, including:

  • Cardio training can help improve blood circulation to the abdominal area and relieve stress, which helps to regulate your bowel movement.
  • Strength training can help with building and maintaining muscle mass that tends to decrease with menopause.
  • Core exercises such as yoga and pilates are recommended to help strengthen and tone abdominal and pelvic floor muscles, which are important for digestion, bladder, and bowel functions.

Home Remedies

In addition to increasing dietary fiber, fluids, regular exercise, and OTC medications, there are additional home remedies that are thought to help relieve constipation. Be sure to speak with your healthcare provider before trying these solutions:

Additional Causes of Constipation in Women

Other potential causes of constipation include diet, various medications, dehydration, and a lack of physical activity.

Diet

Diets with foods low in fiber and high in processed foods can cause or worsen constipation. These foods include:

  • Chips
  • Meat
  • Fast food
  • Prepared foods, such as some frozen meals and snack foods
  • Processed foods, such as hot dogs or some microwavable dinners

To prevent constipation, eat a fiber-rich diet that includes:

  • Whole grains, such as whole wheat bread and pasta, oatmeal, and bran flake cereals
  • Legumes, such as lentils, black beans, kidney beans, soybeans, and chickpeas
  • Fruits, such as berries, apples with the skin on, oranges, and pears
  • Vegetables, such as carrots, broccoli, peas, and collard greens
  • Nuts, such as almonds, peanuts, and pecans

How Much Fiber Do I Need?

Most women do not get enough fiber. Here is your recommended daily fiber intake based on age:

  • For women ages 19–30: 28 grams of fiber per day
  • For women ages 31–50: 25 grams of fiber per day
  • For women ages 51 and older: 22 grams of fiber per day

Medication

As women age, they may take more medications. Many of these common medications may contribute to constipation, including:

  • Blood pressure medications such as calcium channel blockers
  • Opioids such as OxyContin (oxycodone) and Vicodin (hydrocodone)
  • Anticholinergics such as Ditropan (oxybutynin) and Benadryl (diphenhydramine)
  • Antidepressants such as Prozac (fluoxetine) or Elavil (amitriptyline)
  • Iron supplements
  • Sedatives

Check the package for possible side effects and if they include constipation.

Dehydration

Dehydration is a risk factor for constipation. Dehydration can be caused by inadequate fluid intake or fluid loss. Further, when you do not drink enough water and other fluids, the colon will remove even more water from the stool in an effort to conserve water in the body. This causes stool to be hard, dry, and more difficult to pass.

Lack of Movement

Research indicates that physical inactivity, such as sitting or lying down for prolonged periods of time, can cause constipation. Sitting can compress the abdominal cavity and slow digestion. Poor posture causes muscles in the core and pelvic floor to weaken, which can also contribute to more difficulty passing stool.

When to See a Healthcare Provider

If you're experiencing constipation and diet and lifestyle modifications don't provide relief, you may want to see your healthcare provider to rule out more serious problems. It's important to see a healthcare provider if you notice:

Summary

Constipation is a very common symptom experienced by women who are going through the menopausal transition. While hormones may be working to make bowel movements more sluggish and difficult, there are ways to treat constipation. Laxatives and other over-the-counter supplements can offer short-term relief, while dietary and lifestyle changes can help improve quality of life and contribute to easier, more regular bowel movements.

A Word From Verywell

If you are experiencing constipation as a result of your menopausal transition, you're not alone. Approximately 38% of women will experience changes to their bowel functions as hormones fluctuate during this time.

Dietary and lifestyle changes can ease some discomfort, however, it's important to speak with your healthcare team if you are going to try any OTC medications or supplements at home. See your healthcare provider immediately if you notice any alarming changes, extreme pain and discomfort, or blood in your stool.

Frequently Asked Questions

  • Is constipation part of perimenopause?

    Constipation is a common symptom of perimenopause, the years leading up to menopause. This is due to the shift in hormones that women experience that may slow down the digestive tract.

  • Does constipation get worse as you get older?

    Constipation doesn't necessarily get worse as you get older, but it does become more common. This could be a result of poor diet, not getting enough exercise, dehydration, or using laxatives too often. Medical conditions and medications may also contribute to constipation.

  • How long is too long to be constipated?

    This depends on what is considered regular for you. Bowel habits vary from person to person. Some may go three times a day, while others go three times per week. The length of time that is too long to be constipated is determined by what is regular or irregular for that individual.

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