Bloating During Perimenopause: Why It Happens and How to Find Relief

By Ashley Nowe

Published:

bloating in perimenopause

Perimenopause can bring a host of unwelcome changes. Along with hot flashes and mood swings, many women experience bloating as a common perimenopause symptom. If you find your abdomen feeling puffy, tight, or uncomfortable during this transition, you’re not alone. This “hormonal bloating” can be frustrating, but understanding its causes and adopting a few practical strategies can help you feel better. In this guide, we’ll explore why bloating happens in perimenopause and share research-backed tips to reduce or prevent it, from diet and lifestyle tweaks to exercise and medical options.

Why Does Perimenopause Cause Bloating?

Hormones on a rollercoaster: The hormonal fluctuations of perimenopause are a major culprit behind bloating. During perimenopause (the several-year transition leading up to menopause), estrogen and progesterone levels swing dramatically. Estrogen in particular plays a role in regulating your body’s water balance. Rapid changes in estrogen can cause your body to hold on to more water, leading to that bloated, “puffy” feeling (Menopause Bloating: Causes, Treatment, and More). In fact, many women notice bloating tends to flare up at certain times of the month or perimenopause when estrogen spikes or falls. Researchers have also noted that shifting hormones may affect your gut microbiome and how food moves through your intestines, which can contribute to bloating (Menopause Bloating: Causes, Treatment, and More). The result is often water retention or slower digestion – a recipe for bloating.

Water retention vs. gas: Perimenopausal bloating usually boils down to either excess fluid or excess gas (sometimes both) in your system (Menopause bloating: Causes and relief) (Bloated and Gassy in Menopause: 6 ways to find relief). Water retention from hormonal changes can cause swelling in the belly (and sometimes in the hands or feet) as your tissues hold extra fluid. Gas retention can happen because perimenopause might slow down digestion (Bloated and Gassy in Menopause: 6 ways to find relief), allowing more time for food to ferment and produce gas, or because you’re swallowing more air. Many women in midlife report that their abdomen starts out flatter in the morning and becomes distended by evening – a sign of gas buildup throughout the day (Bloated and Gassy in Menopause: 6 ways to find relief). The hormonal stress of perimenopause can even indirectly cause more gas: cortisol released during stress can alter gut bacteria and trigger symptoms like bloating and constipation (Menopause Bloating – What are the Causes and Treatments? | OMC).

The good news is that bloating related to perimenopause is usually temporary and manageable. Bloating often occurs more frequently during perimenopause than after menopause (Menopause Bloating: Causes, Treatment, and More), and it tends to improve once your hormones settle into a postmenopausal pattern. In the meantime, you can take action with some lifestyle adjustments.

Dietary Changes to Reduce Bloating

What you eat (and how you eat) has a big impact on bloating. Simple dietary tweaks can help keep your digestion running smoothly and minimize that swollen feeling. Here are some nutrition strategies:

  • Balance your fiber intake: Eating plenty of fiber is great for digestion and overall gut health, but ramp it up gradually. High-fiber foods (vegetables, fruits, whole grains, legumes) feed the beneficial bacteria in your gut and act as “prebiotics,” which is good – except suddenly eating a lot more fiber than usual can cause gas in the short term. Aim for a consistent, moderate fiber intake and increase it slowly if you’re adding more produce or whole grains to your plate (How To Stop Menopause Bloating: 5 Experts Weigh In). Over time, a fiber-rich diet (including gut-friendly foods like oats, apples, avocado, and leafy greens) helps prevent constipation and creates a healthier gut microbiome, which can ease bloating once your system adjusts (How To Stop Menopause Bloating: 5 Experts Weigh In). Consider probiotic foods as well – yogurt, kefir, sauerkraut, kimchi and other fermented goodies can introduce beneficial bacteria to aid digestion and reduce bloating (Menopause bloating: Causes and relief).
  • Go easy on salt and processed foods: A high-sodium diet encourages your body to retain water, which can worsen bloating. During perimenopause, it’s wise to cut back on heavily salted, processed foods (think fast food, chips, canned soups) that can cause you to puff up (Menopause bloating: Causes and relief). Instead, choose fresh, whole foods when possible. Keeping an eye on sodium can help reduce water retention and the uncomfortable swelling it brings.
  • Stay hydrated: It may sound counterintuitive, but drinking enough water actually prevents bloating. Dehydration can lead to constipation (trapping gas and stool in your gut) and signals your body to hold on to water. By staying well-hydrated, you keep your digestive tract moving and signal your system that it can release excess fluid. In fact, once your body gets the water it needs, it will let go of the water it doesn’t need (Menopause Bloating – What are the Causes and Treatments? | OMC). Aim for about 8 glasses of water a day (more if you’re active). Proper hydration can reduce bloating and help flush out excess sodium.
  • Identify trigger foods: Some foods are notorious for causing gas or bloating, and you might become more sensitive to them during perimenopause. Common bloat triggers include beans, lentils, broccoli, cabbage, and other cruciferous vegetables, as well as carbonated drinks (the bubbles introduce gas), and dairy if you’re lactose intolerant (Menopause bloating: Causes and relief) (Menopause Bloating – What are the Causes and Treatments? | OMC). Fatty or fried foods can also cause that heavy, bloated feeling because they digest slowly (Menopause Bloating – What are the Causes and Treatments? | OMC). You don’t have to avoid all healthy veggies, but it can help to notice if certain foods consistently make you feel bloated. Try keeping a food diary to pinpoint your personal triggers. Simple swaps – like cutting down on fizzy drinks, or taking a lactase enzyme with dairy – may make a big difference.
  • Eat smaller, slower meals: How you eat is as important as what you eat. Eating large meals can stretch your digestive system and lead to more gas production, especially as metabolism slows during midlife (Menopause bloating: Causes and relief). You can prevent that overstuffed, gassy feeling by having smaller portions more frequently, rather than one big feast. Also, take your time when eating: gulping food or eating on the run causes you to swallow more air, which ends up as bloating. Sit down, chew thoroughly, and try not to rush. Mindful eating not only reduces swallowed air, it also aids digestion and may help you enjoy your food more. (Bonus: Eating slowly can prevent overeating, which helps with weight management during perimenopause.)
  • Include natural bloat-busters: Certain natural remedies can soothe your digestive tract. Herbal teas like peppermint, ginger, and chamomile are traditional favorites for relieving bloating and gas. Ginger, in particular, has research behind it for easing gastrointestinal discomfort; some women find that a daily ginger supplement or a cup of ginger tea relieves feelings of fullness and abdominal pressure (How To Stop Menopause Bloating: 5 Experts Weigh In). Peppermint and fennel are also known to relax GI muscles and dispel gas. These are gentle options to sip on when you’re feeling bloated. Just be cautious with peppermint if you have acid reflux, as it can aggravate heartburn in some people.

Lifestyle Changes for Bloating Relief

Beyond diet, your daily habits and routines play a significant role in managing bloating. Perimenopause is a great time to embrace lifestyle changes that not only reduce bloating but also improve your overall well-being. Here are some lifestyle tips:

  • Keep moving, gently: Regular physical activity helps your digestion work better and keeps bloating at bay. You don’t have to run marathons – even mild exercise has benefits. Movement encourages gas to pass through your system rather than trapping it. In fact, scientific research shows that light physical activity can speed up the clearance of intestinal gas and ease bloating symptoms (Menopause Bloating – What are the Causes and Treatments? | OMC) (Menopause Bloating – What are the Causes and Treatments? | OMC). Try to incorporate movement into each day: a gentle walk, a leisurely bike ride, or a relaxing yoga session can all stimulate your digestive tract. One simple trick is taking a 10-minute walk after dinner – this can aid digestion, reduce gas buildup, and even improve your sleep quality (How To Stop Menopause Bloating: 5 Experts Weigh In). The key is consistency: regular exercise (in any form) will help regulate your bowel habits and prevent the sluggishness that contributes to bloating.
  • Manage stress and emotions: Stress isn’t just mental – it has physical effects, especially on your gut. Midlife can be a stressful time (balancing work, family, and the changes of perimenopause), and high stress levels can worsen bloating. When you’re anxious or tense, your body releases cortisol and adrenaline, which can disrupt digestion. For some people, stress slows digestion down, leading to constipation and bloating; for others, it might speed things up, causing cramping or diarrhea (Menopause Bloating – What are the Causes and Treatments? | OMC). Stress and anxiety can also alter your breathing pattern (think shallow, rapid breaths or gulping air when nervous), meaning you swallow more air and end up bloated (How To Stop Menopause Bloating: 5 Experts Weigh In). Finding healthy ways to cope with stress will help keep your digestive system in balance. Consider relaxation techniques like deep breathing exercises, meditation, or gentle yoga. Even a few minutes a day of mindful breathing or progressive muscle relaxation can calm your nervous system. Prioritize self-care: take short breaks during busy days, get outside in nature if you can, or engage in hobbies that help you unwind. Some women benefit from talking with a therapist or joining a support group to navigate the emotional ups and downs of perimenopause. Reducing stress isn’t always easy, but it can significantly ease hormonal bloating and improve your quality of life (How To Stop Menopause Bloating: 5 Experts Weigh In).
  • Quit smoking (and moderate alcohol): If you smoke, know that it could be contributing to your bloating (on top of all the other health harms). Smoking can cause you to swallow excess air and can irritate your stomach, leading to more gas and discomfort (Menopause Bloating: Causes, Treatment, and More). Quitting smoking is one of the best things you can do for your health in midlife. Alcohol can be another bloating trigger – it dehydrates you and can throw off your fluid balance, causing water retention or constipation. It also might disrupt your gut microbiome. You don’t need to give up a glass of wine if you enjoy it, but try to drink alcohol in moderation and be mindful if you notice a pattern between cocktail night and next-day bloat. And of course, drink plenty of water to stay hydrated if you do have alcohol.
  • Wear comfortable clothing: This is a small thing that can make a difference. On days when you’re bloated, super-tight waistbands or belts can make you feel much worse by pressing on your swollen abdomen. Opt for breathable, comfy clothes when you can. This doesn’t reduce bloating per se, but it can certainly improve your comfort level and stress level (no one feels good with their pants digging in during a bloat!).

By making these lifestyle adjustments – moving more, stressing less, and avoiding habits that introduce excess air or irritants – you set the stage for a calmer digestive system.

Exercise: Strength Training and Core Support

Exercise deserves special mention because it offers a one-two punch against perimenopausal bloating. The right kind of exercise can help reduce bloating and also combat that infamous “meno belly” weight gain that often accompanies midlife. In particular, resistance training (strength training) and core-focused exercises are highly beneficial during perimenopause.

Build muscle to beat bloat: Strength training involves working your muscles against resistance (like lifting weights, using resistance bands, or bodyweight exercises like squats and push-ups). How does this help bloating? For one, building lean muscle revs up your metabolism, which can counteract the natural slowdown in metabolism during perimenopause. A healthier metabolism helps manage weight gain around the abdomen, so you’re less likely to confuse bloating with ongoing belly fat. Muscle tissue also helps regulate blood sugar and insulin, potentially reducing cravings and energy crashes that can lead to bloating (like those caused by overeating sweets or refined carbs). From a fluid balance perspective, having more muscle mass can improve circulation and lymphatic drainage, possibly helping your body release water retention more efficiently. The bottom line: exercise regularly, combining cardio with strength training for the best results. Experts recommend working out several times a week and mixing aerobic activities with strength-building ones (Menopause Bloating: Causes, Treatment, and More). Even just 20–30 minutes of strength exercises a couple of times a week can make a difference over time.

Focus on your core: Core exercises target the muscles of your abdomen, lower back, and pelvis. While core workouts won’t magically empty gas from your intestines, a strong core can improve your posture and support your abdominal organs better. Good posture can prevent that slouched belly press that makes bloating feel worse. Core strength (from exercises like planks, Pilates, or yoga poses) may also help your gut transit by gently massaging the intestines and improving motility. Think of activities like yoga twists or Pilates sequences – many women report these can relieve bloating by helping gas move along. Additionally, toning your midsection muscles can help tighten your belly so that even when you do bloat, you might not feel as protruded or uncomfortable. One menopause expert notes that strength training and core exercises can help tone the midsection, while activities like walking and yoga also reduce stress (which plays a big role in belly discomfort) (Struggling with Menopause Bloating? Here’s What’s Causing It …). As a bonus, having a strong core and better balance will improve your overall fitness and can reduce back pain, which is a win-win as you age.

Keep it enjoyable: If you’re new to exercise or returning after a break, start small and choose activities you enjoy. You might try a strength training class tailored for midlife women or follow along with beginner-friendly videos at home. Pilates and yoga are excellent for core work and have the added benefit of stress reduction. Remember, even gentle exercise counts – consistency is more important than intensity. Over time, your body will become more efficient at handling digestion and stress, making bloating episodes less frequent.

Medical Options and When to Consult a Provider

Most of the time, bloating during perimenopause can be managed with the lifestyle and dietary changes described above. However, if you’re still struggling or the bloating is severe, there are additional steps you can consider in consultation with a healthcare provider:

  • Over-the-counter relief: For occasional bloating that’s primarily gas-related, an OTC anti-gas medication like simethicone (Gas-X) might help break up gas bubbles. There are also anti-bloat supplements (containing enzymes like alpha-galactosidase for gas from beans, or lactase for dairy) that some women use. Be sure to discuss with a pharmacist or doctor which option is appropriate (Menopause Bloating: Causes, Treatment, and More). If constipation is part of the problem, a gentle fiber supplement or stool softener could be recommended to keep things moving.
  • Water pills (diuretics): If you tend to retain fluid and feel puffy all over, a doctor might prescribe a diuretic medication to help your body release excess water (Menopause Bloating: Causes, Treatment, and More). This is usually for more persistent edema rather than mild cyclical bloating. Diuretics can have side effects and aren’t for everyday use, so they’re only used in certain cases under medical supervision.
  • Hormone treatments: Some women find that regulating hormones can ease perimenopausal symptoms. Low-dose birth control pills are sometimes used during perimenopause to even out hormonal fluctuations, which may help reduce bloating and other PMS-like symptoms for those still getting periods (Menopause Bloating: Causes, Treatment, and More). Another option is menopausal hormone therapy (MHT, also called HRT) once you’re in menopause, to replace declining hormones. However, when it comes to bloating, hormone therapy is not a magic cure. In fact, higher levels of estrogen from HRT can sometimes cause bloating as a side effect (Menopause Bloating – What are the Causes and Treatments? | OMC) (How To Stop Menopause Bloating: 5 Experts Weigh In). Every woman reacts differently: a steady dose of hormones might relieve bloating for some, but others might bloat more. If you are considering HRT or birth control for midlife symptoms, discuss the pros and cons with your provider – and mention the bloating issue. They can help tailor the treatment (for example, adjusting estrogen dose or using progesterone) to minimize unwanted side effects (How To Stop Menopause Bloating: 5 Experts Weigh In). The decision to use hormone therapy should factor in all your symptoms and health risks, not just bloating.
  • When to see your provider: Bloating during perimenopause is often “normal” if it comes and goes. But listen to your body. If your bloating is prolonged, very painful, or different than usual, it’s important to consult a healthcare provider. Bloating that lasts for weeks on end or is accompanied by alarming symptoms could signal something else that needs medical attention (Menopause Bloating: Causes, Treatment, and More). For instance, persistent bloating with abdominal pain, noticeable abdominal swelling, loss of appetite, or feeling full quickly can (rarely) be a sign of ovarian cancer – so don’t ignore ongoing bloating (Menopause Bloating: Causes, Treatment, and More). Other conditions like fibroids, IBS (irritable bowel syndrome), acid reflux, or celiac disease can also cause bloating and may flare up during midlife (Menopause Bloating: Causes, Treatment, and More). It’s wise to rule out these issues if your bloating is severe. See your doctor if you have red-flag symptoms such as bloating with diarrhea or constipation that doesn’t resolve, frequent vomiting, blood in your stool, or intense heartburn (How To Stop Menopause Bloating: 5 Experts Weigh In). Essentially, if something feels off or you’re worried, get it checked out. Your provider can run tests or exams to make sure everything is okay, and they may offer targeted treatments (for example, IBS management, or diets like low-FODMAP for sensitive guts) to help you find relief.

Bottom line: don’t hesitate to seek medical advice for bloating if you need it. While it’s a common part of perimenopause, you shouldn’t suffer in silence or assume you just have to live with it. There may be additional remedies or treatments to help you feel better.

Frequently Asked Questions About Perimenopausal Bloating

Is bloating a sign of menopause? Yes, bloating can be a sign of the menopause transition. Many women experience bloating as a perimenopause symptom due to hormonal fluctuations (Menopause Bloating: Causes, Treatment, and More). In fact, gastrointestinal changes like bloating are part of the wide array of symptoms caused by shifting hormones. That said, bloating alone doesn’t prove you’re in menopause – it can also come from diet, stress, or other factors. But if you’re in your forties or fifties and noticing more frequent bloating along with cycle changes, it could well be related to perimenopause.

How long does perimenopause bloating last? It varies. Bloating in perimenopause often comes and goes in short episodes – for example, you might bloat for a few hours or days around hormone surges, and then it subsides. Many women report that their belly can bloat up during the day and then flatten out by the next morning. The important thing is that true bloating is usually temporary (your abdomen’s size fluctuates throughout the day), unlike permanent weight gain (Menopause Bloating: Causes, Treatment, and More). Perimenopausal bloating can be an off-and-on annoyance for several months or years while your hormones are in flux. The good news is it generally does not last forever. Once you reach menopause (no periods for 12 months) and your hormones stabilize at a lower level, the hormonal bloating often improves or disappears (Menopause Bloating: Causes, Treatment, and More). Every woman is different – some might only have occasional bloating, while others feel puffy for longer stretches. If your bloating is persistent and not easing up at all, consider talking with your doctor to look for other causes or solutions.

Is perimenopausal bloating hormonal? In large part, yes. The hormonal changes of perimenopause are a primary driver of bloating in midlife. Fluctuating estrogen levels can lead to water retention, meaning your body holds extra fluid and causes bloating (Menopause Bloating: Causes, Treatment, and More). Changes in progesterone can affect muscle tone in the gut and sometimes slow digestion, leading to more gas. Additionally, the interplay of hormones can influence your gut bacteria and how food moves through your system, which can make you bloated (Menopause Bloating: Causes, Treatment, and More). This is why we often call it “hormonal bloating.” However, hormones aren’t the only factor. Lifestyle factors often mix in – for example, stress hormones (cortisol) can contribute to bloat, and dietary habits (what you eat and how you eat) can cause bloating too. In summary, perimenopausal bloating is largely hormonal in origin, but managing diet, exercise, and stress is key to fighting the bloat.

What can I do to relieve menopause bloating? The first steps are usually lifestyle changes: adjust your diet to avoid common bloat triggers (excess salt, fried foods, carbonated drinks, too much sugar), eat smaller high-fiber meals, drink plenty of water, and stay physically active to aid digestion. Stress management is also important – techniques like yoga, meditation, or simple deep breathing can help. Many women find relief with these approaches over time. You can also consider over-the-counter remedies for short-term help (like anti-gas medication or digestive enzymes for certain foods). If these measures aren’t enough, consult your healthcare provider. They may check for other causes or discuss medical options like probiotics, supplements, or hormonal treatments tailored to you. Remember, you might need a bit of trial and error to find what works best for your body, but with persistence you can significantly reduce perimenopausal bloating and feel more like yourself again.

Sources:

Gennev – Bloated and Gassy in Menopause: 6 Ways to Find Relief (Bloated and Gassy in Menopause: 6 ways to find relief)