A woman sitting on a toilet and clutching her abdomen.
A change in hormone levels and certain medication can cause constipation in menopausal years.

Menopause and Constipation

Menopause is a natural transition period that every woman goes through, typically between the ages of 45 to 55. During this time, women can experience an array of uncomfortable symptoms, including constipation. Constipation is defined as being unable to have more than three bowel movements over the course of a week and having stools that are hard, dry or lumpy that are difficult to pass. Constipation can also cause a feeling of incomplete emptying. If symptoms last three months or longer, it is considered chronic constipation. So, let’s see what the deal is between menopause and constipation.

Symptoms of Constipation

Symptoms of constipation vary and may include:

  • Having fewer than three bowel movements a week.
  • Incomplete emptying of the bowels.
  • Straining to have a bowel movement.
  • Having stools that are small, hard or lumpy.
  • Feeling uncomfortable and sluggish.

Causes of Constipation During Menopause

Menopause occurs when a woman hasn’t had a period for at least one year. It’s characterized by a drop in female hormones, including estrogen and progesterone. These two hormones are responsible for various processes in the body, including digestion.

Let’s discuss how a drop in these two hormones may contribute to constipation during menopause.

1. A Drop in Estrogen

Estrogen is responsible for regulating the level of cortisol (the stress hormone) in the body. When estrogen drops during menopausal years, cortisol levels rise. This increase can slow down the digestive process, which increases the amount of time it takes to break down food. In turn, this decreases movement through the colon, ultimately leading to stools that are more difficult to pass.

2. A Drop in Progesterone

A drop in progesterone can cause the colon to slow down, which means that food waste sits for a longer period of time in the colon and dries out, making it more difficult to pass.

3. Pelvic Floor Issues

A drop in estrogen can cause decreased muscle tone throughout the body, including the muscles of the pelvic floor. Suffering from pelvic floor dysfunction can make it difficult to pass stool, especially if the stool is hard or dry. Unfortunately, constant straining when trying to pass stool can worsen pelvic floor dysfunction by weakening the muscles of the pelvic floor.

4. Joint and Back Pain Issues

As women age, they may experience increased pain in the joints of the body, which may limit their mobility and ability to engage in regular exercise. Staying active helps to regulate digestion, so inactivity can contribute to constipation.

5. Other Health Issues and Medication

In addition to the hormonal and body changes that occur during menopausal years that contribute to constipation, as women get older, they are more likely to need medication to control health conditions. Some medications are more likely to have constipation as a side effect, including:

  • Blood pressure medications, such as calcium channel blockers.
  • Thyroid medications.
  • Antidepressants, such as fluoxetine (Prozac) and amitriptyline (Elavil).
  • Opioids, such as oxycodone (OxyContin) and hydrocodone (Vicodin).
  • Sedatives.
  • Iron supplements.

Preventing and Treating Constipation During Menopause

If you are suffering from constipation during menopause, there are various ways to alleviate it, including:

Eating a Healthy, Fiber-Filled Diet

Ensure that you are eating lots of high-fiber foods and drinking enough water, as this can help to speed up digestion and relieve constipation. High fiber foods to consume:

  • Whole grains, including brown rice, as well as whole wheat breads, cereals and pastas.
  • Fruits, including apples, pears, strawberries, kiwis, bananas and raspberries.
  • Dried fruits, including prunes, figs and apricots.
  • Veggies, including broccoli, peas, carrots, beets, artichoke and brussels sprouts.
  • Beans and lentils.
  • Nuts and seeds, including almonds and chia seeds.
  • Oils, including flaxseed and olive.
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Making Simple Lifestyle Changes

Making some simple lifestyle changes, such as including daily exercise, can help to relieve constipation. You should aim for 30 minutes of exercise each day to keep yourself regular. You should incorporate aerobic, strength training and core exercises into your daily routine.

Aerobic exercise gets your heart pumping, improves blood circulation and relieves stress. Here are a few simple aerobic activities to try:

  • Brisk walking.
  • Running.
  • Swimming.
  • Biking.
  • Dancing.
  • Skating.

Strength training helps to build and maintain muscle mass, and core exercises, including Pilates and yoga, help to strengthen the abdominal and pelvic floor muscles. They can also help to regulate both bladder and bowel function.

Taking Medications as Needed

There are a variety of over-the-counter (OTC) medications available to help relieve constipation, including:

  • Stool softeners.
  • Laxatives (osmotic and bulk-forming).
  • Fiber supplements.
  • Glycerin suppositories.

If you start to take laxatives to relieve your constipation, use them with caution. If you use them regularly, your body may become dependent on them in order to have a bowel movement.

If OTC medications fail to provide relief, there are also many prescription medications available to relieve constipation, including:

  • Lactulose (Kristalose, Enulose).
  • Linaclotide (Linzess).
  • Lubiprostone (Amitiza).

Speaking with your doctor will help to determine which one is best for you.

Talk to Your Doctor

If your constipation doesn’t resolve itself with diet and lifestyle changes or with medications, it is important to speak with your doctor to rule out any underlying conditions that may be causing your constipation, including thyroid dysfunction and diabetes. Additionally, if you are experiencing pain, nausea, vomiting, bloating, inability to pass gas, blood in your stool or unintentional weight loss along with constipation, speak to your doctor to rule out serious underlying conditions, including bowel obstruction and colon cancer.

Constipation is common in women during their menopausal years. It is often attributed to the drop in estrogen and progesterone levels, and may be worsened by pelvic floor dysfunction or certain medications. Luckily, most cases of constipation during menopause can be relieved by diet and lifestyle changes. If you are unable to alleviate your constipation with diet and lifestyle changes, speak to your doctor, as there are a variety of OTC and prescription medications available to relieve your symptoms. Furthermore, your doctor will also be able to rule out any other underlying cause of your symptoms.