—And What You Can Do About It

Did you know that menopause affects nearly every organ in your body? As we go through perimenopause and menopause, changes in hormones like estrogen and progesterone ripple through organs and systems like our liver, gut, nerves, heart, blood vessels, muscles, brain and even skin. As these organs and tissues change and age, they have a reduced ability to function, to their job and absorb and metabolise nutrients. These shifts aren’t just about periods stopping—they impact how we digest food, manage weight, and feel overall. As you will see in a moment, particularly gut health, is an important area to consider in managing menopause symptoms and/or weight (Peters et al, 2022). 

Let’s break it down:

Key Changes to Your Body During Menopause:

All organs are covered in estrogen receptors- so as estrogen changes and declines these organs age, change in size and function:

Liver and Gallbladder:
Your liver can shrink by up to 40% during menopause! This greatly reduces its function and it can easily become overwhelmed and contribute to the dreaded midlife weight gain. The gallbladder lowers production of bile and storage, which can be part of the reason many midlife women start to feeling bloated. Since the liver and gallbladder change in structure and function during this time, supporting their health is essential.

Heart:
The heart muscle and blood vessels age and stiffen during menopause, and potassium as well as aerobic exercise become essential to optimise function.

Muscles and Skin:
Declining hormone levels mean muscles lose tone and size, while your skin (the largest organ in your body that is packed with estrogen receptors) can become thinner and drier and less able to absorb Vitamin D. Both declining muscle mass and low Vitamin D levels directly affect bone density which is a huge concern as we age. Loss of muscle and bone density are big contributors to mortality.

Gut Health and digestive organs:

The Gut microbiome is considered one of the largest organs in our body so we need to consider it when wanting to manage hormones, periods, menopause and long term health goals. When hormones fluctuate and change, then decline later in Perimenopause and into Menopause they directly affect our gut and the billions of microbes living there (our microbiome). 

When estrogen and progesterone decline:

• Digestive issues like bloating, constipation, or urgency become more common. IBS increases 4x in Western countries.
• Estrogen has a role in helping the gut epithelium or lining to turn over cells regularly. The lining of a woman’s gut is thinner and contains more estrogen receptors than a man’s. The tiny microvilli that line our digestive system change as estrogen declines, causing ‘gaps’, meaning that the gut lining can thin, leading to conditions like “leaky gut” or also called intestinal (hyper)permeability.
• Your pancreas produces fewer digestive enzymes, making it harder to absorb nutrients.

Gut Microbiome and Symptoms:
Gut health isn’t just about digestion—it’s tied to so many menopause symptoms! Poor gut health can worsen:

• Brain fog, depression, anxiety, and insomnia.
• Hot flushes, sore joints, and weight changes.

Gut-Brain Connection:
Your gut and brain are closely linked (this is called the gut-brain axis). Researchers have found that improving gut health can help restore energy levels and improve mood—a game-changer for menopause!

Why Gut Health Matters Now More Than Ever

Modern diets, especially low in fibre, have weakened our gut microbiomes over generations. This is a problem because 70% of our energy comes from our gut!

What can you do? Focus on eating gut-friendly, fibre-rich foods, stay hydrated, and don’t forget to move your body regularly to support digestion.

With the gut microbiome being linked to bone density, brain health, moods, nutrient absorption, heart health, better metabolic health and insulin sensitivity- taking care of your gut is going to lead to not only symptom reduction but most importantly better long-term health outcomes in Menopause.

Tracking your cycles in perimenopause is important so you have insight into which stage of perimenopause you might be in (early peri cycles are still regular, then can start to shorten or lengthen in mid-peri, in end stages of peri cycles can become more sporadic and periods can be skipped for several months). This can empower you to track your moods and other perimenopause symptoms and seek help early if you see they are related to your periods or cycles.

Here is a link about my evidence-based GUT RESET.

-Aline McCarthy