Perimenopause & Your Gut: Why Everything Feels Different—and How to Settle It Down

You wake up a little puffy, your jeans feel argumentative, and your gut seems to be running on a different schedule than the rest of your day. Perimenopause has a way of nudging digestion off its usual rhythm. Hormones like estrogen and progesterone don’t just influence cycles; they also whisper to the nerves and muscles that move food along. When those signals wobble, you can feel slower or faster transit, more gas, and a louder “pain volume.” None of this means you’re doing anything wrong. It means your body is busy adapting.

Let’s name what’s going on so it feels less mysterious. When stool is harder and less frequent, that’s constipation; when it’s looser or more urgent, that’s diarrhea; when both trade places, that’s the classic perimenopause plot twist. If belly pain tends to ride along with changes in your bathroom habits, you may meet criteria for IBS—irritable bowel syndrome. IBS is a pattern, not a personal failing. The win comes from small, steady tweaks that teach your gut a calmer beat.

Before we talk food, a quick safety sidebar. If you notice blood in the stool, black/tarry stools, fever, unexplained weight loss, waking up at night with pain or diarrhea, new symptoms after age 50, or pain that’s severe and persistent—check in with your doctor promptly. It’s always better to ask than to worry.

So where do you start when the internet is shouting about five different miracle diets? Start simple. Give yourself two quiet weeks of noticing. Jot down what you eat, how you slept, your stress level, and what your gut did. Patterns will peek through: “When I sleep badly, I bloat more.” “Coffee on an empty stomach is a bit bossy.” “Tomato sauce is fine, but garlic is too loud.” This isn’t a surveillance project; it’s a conversation with your body.

From there, think “gentle renovations,” not a teardown. Most women feel better by nudging fibre up slowly and eating on a reliable rhythm. Fibre isn’t one thing—it’s a friendly crowd. The kind that tends to calm an unpredictable gut is the gel-forming, soluble type. Oats, peeled apples or pears, cooked carrots or zucchini, potatoes and rice all play nicely for many people. If you want a quick helper, a small daily dose of psyllium or partially hydrolyzed guar gum (PHGG) often smooths out both constipation and diarrhea. Go slow, sip water, and let your gut catch up.

What about FODMAPs—the carbs that can be gas-prone? A short, time-limited low-FODMAP phase can give you breathing room, but it works best as a structured experiment with reintroductions, not a forever plan. The goal isn’t to shrink your menu; it’s to discover your personal “yes, sometimes, not today” list. Many of my clients realize they tolerate more than they feared once they sleep better and spread meals out a bit.

Speaking of meals, imagine your day as three steady anchors and a small snack if you need it. A plate that calms the nervous system looks ordinary on purpose: a quarter plate of protein, half of produce (cooked veggies are often kinder at the start), and a quarter of comfortable carbs like oats, rice, potatoes, or quinoa, plus a drizzle of olive oil or a handful of nuts or seeds. Perimenopause can make caffeine and alcohol feel louder; rather than cutting them forever, run a one-week trial where you dial them back and see what happens. Data beats guesswork.

Supplements can be helpful, but they shouldn’t become a second job. Many people find enteric-coated peppermint oil takes the edge off cramping. A probiotic can be worth a 4–8 week trial; keep it if you notice clear benefits, and let it go if you don’t. If constipation is part of your story, magnesium citrate at night can be useful—just check your medications and kidney health first.

Here’s the part we often skip: the nervous system. Hot flashes, night sweats, and life load make your “alarm system” a little hair-trigger. Ten minutes of something rhythmic—walking, gentle cycling, yoga flows, a short breathing practice—turns the volume knob down. Protecting sleep helps just as much as food tweaks. Cool your room, ease into bed with something low-stimulus, and let tomorrow’s to-dos live on paper, not in your head. If anxiety and gut symptoms travel together, brief programs like gut-directed hypnotherapy or cognitive behavioural strategies can be surprisingly effective; they’re not “in your head,” they’re tools for the gut–brain highway.

A week that works might look like this: oatmeal cooked in milk or soy milk with chia and stewed blueberries for breakfast; a simple rice bowl with salmon, cucumber, and carrots at lunch; baked potatoes with cottage cheese and chives alongside sautéed zucchini for dinner. Another day swaps in sourdough eggs and spinach, quinoa-chicken salad with lemon and parsley, and tofu stir-fry with rice noodles. It’s not fancy; it’s kind.

You don’t need perfection to feel better. You need a rhythm your body can trust.

If you want a plan shaped to your symptoms, schedule, and preferences, book a nutrition consultation. We’ll build a calm, realistic roadmap that actually fits your life.