Menopause and Constipation: What’s the Connection?

Menopause is a transitional time for females that often begins between ages 45 and 55. It is the time beginning 12 months after a last period and can last seven to 14 years. During this transition, people may experience a variety of symptoms associated with shifts in hormones. One of the more common symptoms of menopause is constipation.

Constipation is a condition in which you may have fewer than three bowel movements per week, stools that are hard, dry, or lumpy, stools that are difficult or painful to pass, or a feeling that not all stool has passed.

This article will discuss the connection between menopause and constipation, what else causes constipation, and tips for managing it.

What’s the Connection Between Menopause and Constipation?

The menopausal transition affects each person differently. During this time, the production of the female hormones estrogen and progesterone declines. Menopause can happen naturally with age or be caused by diseases, cancer treatments, or surgical removal of the ovaries.

No matter what triggers the menopausal transition, there is a change in levels of hormones in the body at this time. Since hormones act as chemical messengers in the body that help regulate many functions, the decline of estrogen and progesterone will cause changes, including constipation.

How to Treat Constipation

There are several ways to help improve constipation caused by hormonal changes during menopause.

Making Dietary Changes

Increasing dietary fiber can help the body better form and eliminate stools. This includes soluble and insoluble fiber, which have different functions, as follows:

• Soluble fiber dissolves and creates a gel that attracts water. This helps to form stools that are softer so that they are easier to pass. Foods with soluble fiber include oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables.
• Insoluble fiber is not dissolved in water and instead adds bulk to the stool so they are better formed and easier to eliminate fully. Foods with insoluble fiber include wheat bran, vegetables, and whole grains.

With increased dietary fiber, it's important to increase fluid intake as well.

Over-the-Counter Medications

There are many over-the-counter (OTC, without a prescription) medications used to treat constipation. These are called laxatives and they are short-term solutions that have different ways of working to relieve constipation. Types of OTC laxatives include:

• Bulk-forming laxatives, such as fiber supplements, work similarly to adding dietary fiber. They help to form soft, bulky stools and make them easier to pass. It's important to increase water consumption when consuming bulk-forming laxatives, as constipation can worsen with increased fiber intake.
• Osmotics are laxatives that work by drawing water into the colon to help stools pass. These can cause unpleasant side effects like nausea, bloating, cramping, and diarrhea.
• Stool softeners work by adding moisture to the stool to help decrease straining. This class of laxative is a short-term solution that can cause electrolyte imbalances if use is prolonged.
• Oral stimulants and rectal suppositories work by triggering contractions of the intestinal muscle to help eliminate stool.

Exercise

Daily exercise can help with constipation. The Centers for Disease Control and Prevention (CDC) recommends at least 30 minutes per day of exercise to keep the body strong and healthy. Various types are recommended, including:

• Cardio training can help improve blood circulation to the abdominal area and relieve stress, which helps to regulate your bowel movement.
• Strength training can help with building and maintaining muscle mass that tends to decrease with menopause.
• Core exercises such as yoga and pilates are recommended to help strengthen and tone abdominal and pelvic floor muscles, which are important for digestion, bladder, and bowel functions.

Home Remedies

In addition to increasing dietary fiber, fluids, regular exercise, and OTC medications, there are additional home remedies that are thought to help relieve constipation. Be sure to speak with your healthcare provider before trying these solutions:

• Probiotics
• Coffee or tea
• Prunes, figs, and raisins
• Herbal laxatives or supplements
• Biofeedback
• Acupressure
• Enemas
• Bowel retraining
  
• Abdominal massage

Other Causes of Constipation

Other potential causes of constipation include diet, various medications, dehydration, and a lack of physical activity.

Diet

Diets with foods low in fiber and high in processed foods can cause or worsen constipation. These foods include:

• Chips
• Meat
• Fast food
• Prepared foods, such as some frozen meals and snack foods
• Processed foods, such as hot dogs or some microwavable dinners

To prevent constipation, eat a fiber-rich diet that includes:

• Whole grains, such as whole wheat bread and pasta, oatmeal, and bran flake cereals
• Legumes, such as lentils, black beans, kidney beans, soybeans, and chickpeas
• Fruits, such as berries, apples with the skin on, oranges, and pears
• Vegetables, such as carrots, broccoli, peas, and collard greens
• Nuts, such as almonds, peanuts, and pecans

Medication

As people age, they may take more medications. Many of these common medications may contribute to constipation, including:

• Blood pressure medications such as calcium channel blockers
• Opioids such as OxyContin (oxycodone) and Vicodin (hydrocodone)
• Anticholinergics such as Ditropan (oxybutynin) and Benadryl (diphenhydramine)
• Antidepressants such as Prozac (fluoxetine) or Elavil (amitriptyline)
• Iron supplements
• Sedatives

Check the package for possible side effects and if they include constipation.

Dehydration

Dehydration is a risk factor for constipation. Dehydration can be caused by inadequate fluid intake or fluid loss. Further, when you do not drink enough water and other fluids, the colon will remove even more water from the stool in an effort to conserve water in the body. This causes stool to be hard, dry, and more difficult to pass.

Lack of Movement

Research indicates that physical inactivity, such as sitting or lying down for prolonged periods of time, can cause constipation. Sitting can compress the abdominal cavity and slow digestion. Poor posture causes muscles in the core and pelvic floor to weaken, which can also contribute to more difficulty passing stool.

When to See a Healthcare Provider

If you're experiencing constipation and diet and lifestyle modifications don't provide relief, you may want to see your healthcare provider to rule out more serious problems. It's important to see a healthcare provider if you notice:

• Changes in your bowel habits
• Blood in your stool
• Serious stomach pain
• Unintentional weight loss
  

Summary

Constipation is a very common symptom experienced during the menopausal transition. While hormones may be working to make bowel movements more sluggish and difficult, there are ways to treat constipation. Laxatives and other over-the-counter supplements can offer short-term relief, while dietary and lifestyle changes can help improve quality of life and contribute to easier, more regular bowel movements.