Menopause and Constipation
Natural solutions to get relief

It is possible that you never heard of the link between menopause and constipation before.

You may have been blessed with a great transit all of your life. Until now.

All of a sudden, your toilet habits seem to be stalling or grinding to a halt. Your skin is dry. And on the colonic side, things are definitely drying up too. Embarrassing complications of constipation may include urinary incontinence, making the situation worse.

Menopause and constipation

Or maybe you were constipated before, and menopause is worsening the problem quite a bit. Whatever your situation was before menopause, you need to get relief now.

In this article, we explain why menopause has a negative influence on transit. We also provide natural constipation solutions that will nourish and rebuild you instead of depleting you, depletion being the typical end-result of traditional drugs.


The link between menopause and constipation

In one study performed over 100 post-menopausal women, 37% were constipated, the condition expressing itself as:

  • Excessive straining when defecating (in 91.9% of constipated women)
  • A feeling of incomplete evacuation (in 83.8% of constipated women)
  • Hard or lumpy stools (in 81.1% of constipated women)
  • Less than three bowel movements per week (in 62.2% of constipated women)
  • The use of digital maneuvers to facilitate defecation (in 45.9% of constipated women).

We therefore see that a very strong link between menopause and constipation. And the cause is simple and well understood today : the fluctuation in your hormonal levels.

A healthy ratio between estrogens and progesterone maintains a healthy transit. We saw in a previous article that during pregnancy, the level of progesterone goes up, creating an imbalance in the ratio estrogen/protesterone, with progesterone dominating over estrogens.

Progesterone is the pregnancy hormone. It relaxes and slows down your digestive tract so that more nutrients can be absorbed in order to nourish the baby. You will remember from the introductory article that slowing down the progress of fecal matter in the colon causes over-dehydration of stools and constipation.

In menopause, the level of estrogens goes down. But the end-result is the same: progesterone dominating over estrogens, slowing down your transit, leading to menopause and constipation issues.

In addition, the fact that estrogens go down will "dry you up", making water less available to your mucosa, be it vaginal or digestive.

The causes of constipation during menopause are therefore two-fold :

  • The slowing down of intestinal and colonic motility;
  • The drying up of the digestive process, less digestive juices available to the digestive process means drier feces (bile in particular is our natural laxative)

The way we fix this situation is through nutrition and medicinal plants.


Nutrition for menopause and constipation

As you may have seen in other articles, I am not a huge fan of fibers. As a naturopath and herbalist running a busy clinic, I have observed that fibers actually tend to make matters worse in constipated people.

My nutritional advice revolve around vegetables and fruits, meats, fish and eggs, and good fats. My program is mostly inspired from the paleo movement, with a few variations.

Grains: depending upon the person and the situation, I may suggest the complete removal of grains from the diet. I particularly insist upon this point when there is inflammation of the joints or nerves, water retention, gastric reflux, thyroid problems or any auto-immune problems.

Dairies: In my experience, full-fat dairies are less problematic than grains if consumed in moderation. But they can clearly cause constipation in certain people. There are multiple studies(1bis)(2)(3) showing that dairy products cause constipation in children. I have observed that the same is true for adults. Whenever there is constipation, I ask my clients to go for a 1 or 2 months complete removal of dairies to see if it helps.

Note that the more the dairies are "refined", the less problematic they are. So milk and yogurts have to go first, with cheese being less problematic than milk and yogurts, and butter being less problematic than cheese. To be on the safe side, I ask my clients to go for a complete dairy removal for a certain period.

One thing I insist upon during menopause is what I call the good fats. This is a period of your life when you need lots of nourishment. Sexual hormones like estrogens and progesterone need fats as precursor, and you do not want to stop consuming those. Moreover, fats make your gallbladder secrete more bile, which acts as our natural laxative. If you have weight problems, keep in mind that they are very likely due to an overconsumption of carbohydrates rather than too much fat in your diet.

As a result, I tell my clients to liberally consume coconut oil, butter from pastured milk and olive oil. For cooking, I recommend coconut oil or palm kernel oil – those two are saturated and therefore stable when heated.

Eggs are very useful during menopause, especially the yolk which is rich in stable cholesterol, the main precursor of sexual hormones and vitamin D. I very often recommend two eggs for breakfast every day.

You should also consume fatty fishes such as salmon, mackerel, anchovies and sardines at least twice a weak.

Fruits and vegetables, particularly vegetables should represent a large portion of your plate, which should be composed of 1/4th of proteins (meat, fish) and 3/4th of vegetables.

If you have gut inflammation, it is best to avoid raw vegetables as the fibers can be very abrasive to your gut. Gently steaming them is, in that case, a better way to go.

I will provide more details in my upcoming “anti-constipation nutritional program” ebook.

In addition to those nutritional advice, I recommend that you read the following articles :


Supplements for menopause and constipation

Magnesium

There is a good chance that you would benefit from magnesium supplementation. Most of the population around the globe today is magnesium deficient. And a lack of magnesium triggers a malfunctioning of our muscles, gut muscles included. If your gut muscles are not tonic enough, feces will not move fast enough in your bowel causing constipation.

You particularly need magnesium if you are chronically stressed (menopause and constipation may in itself be a source of stress) or if you consume lots of carbohydrates in your diet, sugars included, since insulin production requires magnesium.

You should read the following article, and include magnesium supplementation as part of your daily routine:

Vitamin C

The same can be said of vitamin C. An apple today contains just 5% of the vitamin C it used to contain in the 1950’s. If you regularly consume fruits and vegetables, even organic ones, chances are they have been grown on semi-depleted soils. It is becoming harder and harder to get our daily needs through foods.

Second, the government has set a daily requirement that is ridiculously low. If you want to avoid scurvy, then 150 mg of vitamin C a day may be enough. If you want to buffer oxidative stress, help your immune system, and make sure you make enough collagen to repair damaged skin and tissues, you need a lot more.

One study has shown that vitamin C associated with hesperidin (a flavonoid found in citrus fruits) can improve hot flashes during menopause(7).

You should read the following article, and include vitamin C supplementation as part of your daily routine:

There are other supplements I may recommend during my consultations, like vitamin D. Those two however are the main ones that can help with constipation issues.


Medicinal plants for menopause and constipation

1. The liver: deeply involved in menopause and constipation

Your priority when you go through menopause and constipation is to take good care of your liver. This is very important. Here is why:

  • Your liver makes the essential precursors to sexual hormones (estrogens, progesterone)
  • Your liver maintains hormone levels in your blood and recycles any excess from your blood

Therefore, the liver is the organ that is the most involved in hormonal regulations.

The problem is, most of us today are liver-deficient. Stress robs the liver from its vital energy. Moreover, the liver being the recycling plant of the body, it is constantly solicited by an excess of foods, pollutants, cosmetics (what you put on your skin goes to your liver via blood capillaries), pesticides and preservatives in your food, medication, the list goes on and on. The liver is tired most of the time.

Here are two herbal protocols you should try if you are chronically constipated. Pick one of the two and try it. Do it for a month, it will help your liver clean-up, detoxify, get healthier and secrete more bile, our natural laxative.

Here is a suggested dosage, read the full article for more information regarding how to use those plants.

  • Yellow dock (Rumex crispus): 20 drops of tincture, twice a day
  • Dandelion (Taraxacum officinale): 30 drops of tincture, twice a day

2. Taking care of your hormones

Menopause and constipation often go hand in hand due to the decrease in the production of certain hormones like estrogens. Medicinal plants can rebalance hormonal levels just enough to help you go through this special period of your life.

There are many different herbs that can be used during menopause. Here are some of my favorites. Consider taking the following liquid extracts, found in quality online stores such as Mountain Rose Herbs:

  • Dong Quai (Angelica sinensis), which acts as a hormonal regulator. Take 10 drops of a quality tincture, twice a day.
  • American Ginseng (Panax quinquefolium), which acts as an overall tonic for people lacking energy and fluids. Take 15 drops of a quality tincture of the cultivated roots, twice a day. Do not buy a tincture of wild roots as the plant is endangered.
  • Red clover (Trifolium pratense), a very useful plant to calm the symptoms of menopause(5), either as a tincture (flower extract) or as a tea of the flower heads.

Putting it all together, you can order 4 bottles of herbal tinctures, and take the following mix twice a day in a little water :

  • Yellow dock (Rumex crispus): 20 drops
  • Dong Quai (Angelica sinensis): 10 drops
  • American Ginseng (Panax quinquefolium): 15 drops
  • Red clover flower extract (Trifolium pretense) : 20 drops

There are a lot more herbal combinations that can be used, with different plants such as Black Cohosh (Cimicifuga racemosa), licorice (Glycyrrhiza glabra), etc.

I recommend different mixes in my clinic based on the person and her constitution. Not knowing you, I am suggesting a generic formulation that should be a very good starting point.


Exercise for menopause and constipation

You may have reduced your physical activity due to hot flashes and an overall low energy level.

But there is a clear link between constipation and inactivity(6). Certain physical movements, especially those related to the lower trunk and legs, can improve the activity of the colon. Slowing down your physical activity may have been one of the aggravating factors.

Increase exercises that get your lower trunk and legs moving, especially after lunch or dinner:

  • Walking is one of the best exercises;
  • Swimming is great, and very gentle on your muscles and joints.

If you have to live with menopause and constipation, you will have to establish a routine where you practice those exercises several times a week, say swimming once or twice a week, and walking one hour the days you don’t swim.


Hypothyroidism

I wanted to briefly talk about hypothyroidism here because in my experience, that is a condition that seems to appear more and more during menopause.

Sometimes menopause triggers hypothyroidism, a condition where your thyroid gland is under-functioning. When your thyroid does not produce enough hormones, you will feel tired, you will put on weight, you will be constipated, and you may feel depressed.

As you can see, those are also some of the typical symptoms of menopause. So menopause can hide an hypothyroidism condition.

Some studies have shown that the auto-immune form of hypothyroidism can be triggered by changes in oestrogen levels. May be you have suffered from thyroid imbalances in the past without even noticing it. May be you always had a low energy level and you learned to live with it. Menopause, with its hormonal changes, can make the situation worse and therefore make it more noticeable to you.

In any case, if you do suffer from a low level of energy, low sex drive, you have put on weight and you are constipated, ask your doctor to run thyroid blood tests. Menopause is a good moment to do a blood check-up anyway. Those thyroid tests are quite standard, they measure different levels of hormones (TSH, T3, T4) in order to determine if indeed your thyroid is under-functioning.

One word of advice: the acceptable range for what constitutes hypothyroidism is fairly wide in the medical world. So your doctor may tell you that your tests are fine. Do take a look at those tests and see if you fall in the middle of the range (ok), or if you fall more toward the upper or lower limits (not ok). If you do (for instance your TSH is close to the upper limit), your thyroid may need help. Once your thyroid goes back to normal, your menopause and constipation problem is likely to disappear.


Conclusion

Even though menopause and constipation often go hand in hand, you don’t need to feel powerless in front of that situation. There are multiple natural approaches that will bring relief to you, rebalancing your hormonal levels and bringing back fluids and tone to your digestive tract.

Nutrition and exercise can help. But so do supplements like magnesium, which in itself is often sufficient to make a big difference in the transit of a magnesium-deficient person.

Medicinal plants that are gentle and nourishing will also help you go back to a normal transit.

Those 3 approaches, nutrition, supplements and plants, are usually quite affordable and easy to implement.

The hardest one to put in place is usually nutrition, because you do need time to acquire quality ingredients and prepare your meals in an optimal way. But in the long run, it is the approach that pays off the most to severe the tie beween menopause and constipation.


References for "Menopause and Constipation"

(1) de Oliveira SC, Pinto-Neto AM, Góes JR, Conde DM, Santos-Sá D, Costa-Paiva L. [Prevalence and factors associated with intestinal constipation in postmenopausal women]. Arq Gastroenterol. 2005 Jan-Mar;42(1):24-9.

(1bis) Iacono G, Cavataio F, Montalto G, Florena A, Tumminello M, Soresi M, Notarbartolo A, Carroccio A. "Intolerance of cow's milk and chronic constipation in children." N Engl J Med. 1998 Oct 15;339(16):1100-4.

(2) Daher S, Tahan S, Solé D, Naspitz CK, Da Silva Patrício FR, Neto UF, De Morais MB. "Cow's milk protein intolerance and chronic constipation in children". Pediatr Allergy Immunol. 2001 Dec;12(6):339-42.

(3) Irastorza I, Ibañez B, Delgado-Sanzonetti L, Maruri N, Vitoria JC. "Cow's-milk-free diet as a therapeutic option in childhood chronic constipation". J Pediatr Gastroenterol Nutr. 2010 Aug;51(2):171-6.

(4) Smith CJ. Non-hormonal control of vasomotor flushing in menopausal patients. Chic Med 1964;67:193-195.

(5) Panay N. Taking an integrated approach: managing women with phytoestrogens. Climacteric. 2011 Dec;14 Suppl 2:2-7.

(6) Simrén M. "Physical activity and the gastrointestinal tract". Eur J Gastroenterol Hepatol. 2002 Oct;14(10):1053-6.

(7) Philp HA. Hot flashes--a review of the literature on alternative and complementary treatment approaches. Altern Med Rev. 2003 Aug;8(3):284-302. Review.


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