Menopause Bloating: Causes, Relief and When to See a Littleton Gynecologist

As women reach middle age, menopause bloating is a frequent side effect that’s not often talked about. Sometimes mistaken for weight gain, menopause bloating is a temporary increase in abdominal size that can change throughout the day, while weight gain tends to be more gradual. Bloating during perimenopause (the years leading up to menopause) and menopause are caused by a combination of fluid retention, slower digestion and hormonal fluctuations.

“Women frequently report noticing a migration of where they carry weight, from the hips and thighs to the abdomen in perimenopause and menopause,” says Hillary Jarnagin, MD, an OB/GYN with AdventHealth Medical Group OB/GYN at Littleton. “When the increase in abdominal bloating combines with increased abdominal fat, the change can be both noticeable and bothersome to the women who experience it.”

Keep reading to learn more about menopause bloating, including its causes, how to find relief and expert tips from Dr. Jarnagin.

Causes of Menopause Bloating

Bloating is a common complaint during perimenopause and menopause. While the causes vary from person to person, your doctor can help identify the trigger. Unlike menopause bloating, which can be more persistent, perimenopause bloating often follows a cyclical pattern, worsening around menstruation. Dr. Jarnagin advises focusing on dietary modifications, hydration and regular exercise to help manage symptoms. “Incorporating probiotics, reducing processed foods and staying active can significantly improve bloating in both perimenopause and menopause,” she says.

Estrogen helps regulate fluid balance. As estrogen levels decline, digestion can slow, and some women may find they have new food sensitivities, particularly to gluten and dairy. Fluctuating and declining estrogen and progesterone levels can contribute to water retention and inflammation while also slowing digestion and the movement of food and air through the gastrointestinal system. These issues, in addition to the development of food sensitivities, can make abdominal bloating a frequent concern, beginning in perimenopause for many women.

How Bloating Causes Back Pain

One frequently asked question is whether bloating can lead to back pain. The answer is yes, though the connection isn’t always straightforward. Gas buildup in the digestive system can put pressure on surrounding organs, leading to discomfort that radiates to the lower back. Additionally, changes in weight distribution can alter posture and cause muscular strain.

“The shift to having more weight in the midsection can lead to increased strain on the lower back,” Dr. Jarnagin notes. “This is especially true if there is underlying pelvic floor dysfunction or if a woman experienced diastasis recti during pregnancy that was never resolved.”

Diastasis recti is when the abdominal muscles separate, compromising core strength and stability. This often translates to less back support and more pain. It also allows abdominal bloating to be more easily observed because the strong connective tissue, typically acting like an internal girdle, becomes weak, soft and stretched out.

Weakness or tightness in the pelvic floor muscles can disrupt core stability, leading to poor posture and extra strain on the lower back. Postural changes associated with bloating and weight redistribution can exacerbate back pain, particularly if the core muscles weaken. Maintaining a strong core through gentle strength training and yoga may help alleviate discomfort. For patients with diastasis recti and pelvic floor laxity, pelvic floor physical therapy or surgery may be needed to correct the condition.

Bloating During Pregnancy vs. Menopause Bloating

Bloating also occurs during pregnancy, though for different reasons. During pregnancy, high progesterone levels slow digestion, leading to gas buildup and bloating. As the uterus grows, it physically compresses the intestines, impairing the normal function of the gastrointestinal tract.

“In early pregnancy, I often recommend that patients avoid carbonation and gas-producing foods like beans, broccoli, cauliflower and Brussels sprouts to stave off bloating,” Dr. Jarnagin says. “As pregnancy progresses, being mindful of managing constipation with proper hydration, ingesting dietary fiber and exercise are important. During the latter half of the pregnancy, acid reflux becomes more of a concern than bloating, which is usually more common in the early part of the pregnancy.”

Managing bloating during pregnancy involves dietary changes, hydration and avoiding foods that trigger excessive gas production. Light exercise, such as walking and prenatal yoga, can promote digestion and reduce the discomfort of bloating. It's also important to identify and address constipation if it’s contributing to bloating.

Excessive Bloating in Early Pregnancy: When to See a Doctor

While mild bloating in early pregnancy is normal, excessive bloating accompanied by severe pain, nausea or changes in bowel habits may require medical attention. “If bloating is persistent and painful, it should be evaluated and addressed,” Dr. Jarnagin advises. “Be sure to raise these issues with your provider, who can evaluate your symptoms and recommend appropriate tests if necessary.”

Menopause Bloating Relief: What You Can Do at Home

Fortunately, there are several effective strategies for reducing menopause bloating at home. Adjusting your diet is key — reducing sodium, avoiding processed foods and identifying food sensitivities like dairy or gluten can significantly help relieve the problem. “Many women don’t realize that the foods they’ve eaten for years may suddenly become problematic in menopause,” Dr. Jarnagin says.

Hydration is also critical. Drinking at least eight glasses of water each day helps prevent water retention and supports digestion. Regular exercise, particularly low-impact activities like walking and yoga, can reduce bloating and promote gut motility. “Staying active is one of the simplest and most effective ways to alleviate bloating,” Dr. Jarnagin says.

Managing stress is another way to help menopause bloating. Elevated cortisol levels, often triggered by chronic stress, can contribute to bloating and weight gain. Meditation, deep breathing exercises and relaxing activities can help reduce stress-related bloating.

Probiotics and digestive enzymes are additional options for supporting gut health. Herbal teas such as peppermint, ginger and fennel may also ease bloating symptoms by calming the digestive system.

When to Be Concerned About Menopause Bloating

While bloating is a common and usually benign symptom, it’s important to be aware of potential red flags. Persistent, painful or sudden bloating should not be ignored. “If a woman has significant bloating alongside changes in digestive patterns, new food intolerances or unexplained weight changes, we start looking at other potential causes,” Dr. Jarnagin says.

In some cases, bloating may be a sign of more serious conditions. A pelvic ultrasound may be necessary to rule out ovarian masses, while a colonoscopy could identify conditions such as colon cancer or inflammatory bowel disease.

“I always recommend that women seek a medical evaluation if bloating is associated with pain, changes in appetite, weight loss or changes in bladder or bowel habits,” Dr. Jarnagin says. Early detection of digestive or gynecologic conditions can significantly improve treatment outcomes.

Helping You Take Control of Menopause Bloating

Menopause bloating is a common and manageable symptom. Understanding the causes and making simple lifestyle adjustments can provide the relief you’re seeking. However, if bloating is persistent, painful or accompanied by other concerning symptoms, it’s essential to seek medical advice.

At AdventHealth Medical Group OB/GYN at Littleton, we specialize in women’s health and menopause care. If you’re struggling with bloating or other menopause symptoms, our team is here to help. Call us at Call720-922-6240 to make an appointment so we can find a solution that works for you.