The Hormone-Gut Cycle

What you need to know about digestion issues, how they relate to the menopausal transition and what to do to improve gut health.

Part I of a 2-part series on gut health and menopause

Among the most common menopausal symptoms women complain about, hot flashes, fatigue and brain-fog get top billing. However, often women will dismiss gastrointestinal issues as a problem related to their hormone fluctuations.

But gut issues are one of the side effects when we have too much cortisol in our system and cortisol rises during perimenopause. 

Here’s why.

To explain, we must first examine the Autonomic Nervous System (ANS). The ANS controls all key functions of the body, such as heart rate, digestion, body temperature, metabolism, and our stress response. It is made up of two systems: the Sympathetic Nervous System (SNS); and the Parasympathetic Nervous System (PSNS).  One system will charge us up while the other will calm us down. SNS is the fight, flight or freeze response, and PSNS is the rest, digest and recovery response. 

Now let’s look briefly at hormones and the relationship to the ANS. Stress and its effect on the body play a major role in both our physiological and psychological health and well-being. The menopause transition, as natural and as normal as it is, is still a stress on the body. As a result, baseline cortisol levels may be higher. This elevated cortisol level has an impact on the production of progesterone. 

What is cortisol?

Cortisol plays a role in just about every function of the body - brain function, bones, muscles, heart, lungs, blood, and regulating energy. Disruptions to cortisol will wreak havoc in various ways on all systems - respiratory, circulatory, endocrine, and digestion. Cortisol, as well as adrenaline, are stress hormones produced by the adrenal gland, a gland that rests on the top of the kidneys. Stress hormones serve as the body’s built-in safety system for survival. Remember the fight or flight response? Cortisol spikes when we go into a higher sympathetic drive. Menopause is automatically associated with a rise in sympathetic nerve activity (SNA).

The rationale for this rise is not entirely well known but is largely attributed to fluctuation in estrogen levels as we age, which impact the central nervous system.  Menopause anxiety, in general, can also cause a rise in SNA because of the underlying stresses on the body that occur during menopausal transition such as sleep deficiency, moodiness, irritability, fluid retention, and inflammation, to name a few. 

When there is too much cortisol in our system the following perimenopause symptoms can be experienced:

• headaches

• muscle aches

• feeling “wired and tired” (Dr. Stacy Sims)

• belly fat and increased fat storage

• inability to lose weight

• susceptible to colds

• sugary and savory food cravings

• gut issues 

• drop in libido

• insomnia

• painful periods, and

• anxiety and depression

Each of these symptoms will be further explored in later articles. For now, I will focus on gut issues. But before that, let’s introduce the progesterone - cortisol relationship. Actually, it is more of a progesterone - cortisol - estrogen conundrum. 

The hormone progesterone is the precursor to cortisol, meaning that progesterone is needed to produce cortisol in the body, causing progesterone levels to decrease when cortisol levels rise. Stress and its resulting high cortisol in a woman’s life can lead to progesterone deficiency. 

Progesterone deficiency causes estrogen dominance in the body. Estrogen and progesterone are two hormones that counteract each other out to regulate the body and to achieve homeostasis. A deficiency or excess in one will cause the opposite effect in the other and this imbalance introduces a variety of symptoms. As well, estrogen regulates the production of cortisol, so when it is imbalanced cortisol function will be significantly impacted. Remember, cortisol regulates all of the body’s functioning systems including the digestive system and metabolism. 

Now let’s talk about gastrointestinal issues as it relates to hormones. With the hormone fluctuations occurring during perimenopause and the resulting elevated levels of cortisol,women are six times more like­ly to expe­ri­ence symp­toms includ­ing stom­ach pain, gas, bloat­ing and diar­rhea or con­sti­pa­tion - all related to IBS - than men.

Gut issues that arise during the menopausal transition are caused by two factors: the female hormonal makeup, discussed earlier, and the structural makeup of the female anatomy. Due to the loca­tion of a wom­an’s uterus and ovaries, the path of the colon is longer and more com­plex. This structural difference causes female diges­tive organs to be sluggish and emp­ty far slower. Coupled with the estrogen-progesterone-cortisol factors, we can now better understand why gut-related health is problematic for women and should not be ignored during perimenopause.

A malfunctioning gut if left unchecked, can manifest into full blown irritable bowel syndrome (IBS) or worse - Crohn’s disease, cardiovascular disease, and even some form of cancers. That is because there are trillions of microbes in the gut that are performing millions of intricate and complex functions to keep us healthy and when imbalanced, can trigger a host of diseases.

But it is not all doom and gloom. There are a number of natural remedies readily available to tackle gut issues and get the microbiome back on track while also addressing stress and weight gain associated with perimenopause. Knowing what remedies work and why is all part of being empowered as a menopausal woman. 

In Part II of this article, we will look at five (5) of those remedies to consider incorporating into your daily practice.

*This article is an accumulation of information gathered from many sources and is for information purposes only. It does not constitute medical advice nor does it replace professional medical diagnosis. Always consult with your family doctor or a healthcare professional about your menopause symptoms, digestive health and any prolonged abdominal pain you may be suffering from.