Bloating in perimenopause: is it your hormones?

Bloating can show up in perimenopause, but research can’t yet say how much of it comes from hormones and how much from other things [1]. Bloating has many everyday causes, and the usual ones, like gas, certain foods and constipation, still apply in this phase [3][4]. If your stomach feels swollen often or the bloating is new for you, it’s worth a check with your doctor before you put it down to perimenopause.

I hear about bloating a lot from women in their 40s. Many say the same thing: “I eat the way I always have, and suddenly my stomach doesn’t agree.” Below I go through what we know, what else it can be and what is worth trying.

Is bloating a perimenopause symptom?

It’s not one of the classic signs. The NHS list of menopause and perimenopause symptoms is long, and it doesn’t include bloating [5]. Still, many people describe it, and researchers have studied gut symptoms around menopause for years.

A 2025 scoping review mapped 122 studies on gut symptoms in natural perimenopause and postmenopause. Bloating or gas came up in 46 of them, second only to constipation [1]. The authors point out that this shows what has been studied, not how common the symptoms are, and that studies disagree on whether gut symptoms change across the stages of menopause [1].

So the honest answer is: it may be connected, and you’re not imagining it, but the research doesn’t settle it yet.

How hormones might affect your gut

During perimenopause, your levels of estrogen and progesterone start to fall, and before menopause they can vary a lot from day to day [2]. These hormones don’t only act on your cycle.

Researchers think the changes may affect the gut in a few ways [1][6]:

• Speed. Progesterone may slow down the muscles in the gut wall, which can mean food and gas move more slowly
• Sensitivity. Sex hormones may change how sensitive the gut is, so the same amount of gas can feel like more
• Gut bacteria. Hormone changes may affect the gut microbiome, though the evidence is still thin [1]

Much of this research is early, and the authors of one review write that the underlying mechanisms remain poorly understood [6]. I find it useful as a way of understanding why the gut can change in this phase, not as proof.

There is a clue many women already know: bloating around your period. The NHS lists it as a common cause [3]. If your bloating follows your cycle, or gets worse as the cycle becomes irregular, that’s worth writing down.

Other common causes of bloating

Perimenopause doesn’t stop the usual causes. The most common one is gas in the gut, from swallowed air or from bacteria breaking down food in the large intestine [3][4]. Other causes include [3][4]:

• foods that produce more gas, like cabbage, beans, lentils and onions
• fizzy drinks
• eating fast, chewing gum or eating large meals late at night
• “light” products sweetened with sorbitol or xylitol [4]
• constipation
• a food intolerance, for example to lactose, or celiac disease

If you’ve been told you have IBS, bloating is often part of that picture too [3]. You can read more on my pages about bloating and IBS.

Bloating or weight around the waist?

These two get mixed up easily. Bloating usually comes and goes. A typical pattern is a flat stomach in the morning and a tight one by evening, or after certain meals.

Weight around the waist stays from day to day. It’s common in this phase: weight gain in perimenopause often happens around the stomach and upper body [5], and after menopause, the body stores more fat around the waist and inside the abdomen [2]. Often it’s both at once. I write more about that in perimenopause weight gain.

What you can try at home

The NHS and 1177 suggest simple steps for bloating [3][4]. They are a good place to start, whatever lies behind it:

• eat more slowly and keep your mouth closed when you chew, so you swallow less air
• cut down on fizzy drinks, chewing gum and hard candy
• avoid large meals late in the evening, and don’t slouch while you eat
• choose cooked vegetables over fried or grilled ones if raw or fried food makes you bloated [4]
• stay physically active every day [3][4]
• if you’re constipated, add soluble fiber, like oats or linseed [3]

A food and symptom diary for 2 to 4 weeks often shows more than any single change. Write down what you eat, when the bloating comes, how you slept, your stress level and where you are in your cycle. Bring it to your doctor, and to me if we meet.

How I work with bloating in perimenopause

At your first visit, we go through the whole picture: your digestion, cycle, sleep, stress, food and what you’ve already tried. The visit is 60 minutes, at Kommendörsgatan in Östermalm or online, in English or Swedish.

After the visit, you get a written plan. It can include advice on food and meal rhythm, Chinese and Western herbs, high-quality supplements and acupuncture, mainly Japanese style. If it makes sense, we add lab tests: functional testing alongside conventional tests. The results become a basis for your plan and for your conversations with your doctor.

I work in parallel with your doctor, whether or not you take HRT. You’ll find more about this phase on my perimenopause page, other signs in perimenopause symptoms, and all visit options on prices.

When to see a doctor

Contact your vårdcentral (local primary care clinic) or call 1177 (Sweden’s public health information service) if you have:

• bloating that has lasted more than two weeks [4]
• bloating most days, or bloating that doesn’t ease when you change what you eat [3]
• new stomach symptoms after 50, a lost appetite or changed bowel habits [4]
• weight loss you can’t explain, or blood in your stool [3]
• a lump or swelling in your stomach, a fever, or bloating with vomiting or stomach pain [3]

Bloating that doesn’t go away should be checked, because now and then it can be a sign of something more serious [3].

Call 112 if you have a swollen stomach with sudden, severe stomach pain, vomit blood or something that looks like coffee grounds, or have trouble breathing [3].

Sources

1. Shaw N, Abbott R, Pettinger C. The volume and characteristics of research on gastrointestinal symptoms in “natural” peri- and postmenopause: a scoping review. Women’s Health (London), 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12575958/
2. 1177. Klimakteriet (accessed 2026). https://www.1177.se/liv--halsa/sa-fungerar-kroppen/klimakteriet/
3. NHS. Bloating (accessed 2026). https://www.nhs.uk/conditions/bloating/
4. 1177. Gasbesvär (accessed 2026). https://www.1177.se/sjukdomar--besvar/mage-och-tarm/diarre-forstoppning-och-blod-i-avforingen/gasbesvar/
5. NHS. Symptoms of menopause and perimenopause (accessed 2026). https://www.nhs.uk/conditions/menopause/symptoms/
6. Li Z, Zheng Y, Shen F, Zhou X. Sex hormones and functional gastrointestinal disorders in menopausal women. Frontiers in Endocrinology, 2026. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2026.1679338/full