18 Expert Tips to Support Gut Health During Perimenopause

Written by MJ Feeke, Nutritional Therapist

MJ is a BANT Registered Nutritionist, Nutritional Therapist, Health Coach, Chef, and Certified Breathwork Facilitator with over 25 years of experience in the food industry and over 20 years as a small business owner. She is dedicated to educating and empowering others through nutrition and wellness.

Navigating perimenopause can feel like a rollercoaster, with fluctuating hormones, changing moods, and unexpected digestive issues. If bloating, constipation, or indigestion have crept in alongside your hot flushes, you're not alone. Hormonal shifts during perimenopause can have a big impact on gut health, but the good news is, you can take steps to restore balance.

1. Know your why

Understanding why gut health matters during perimenopause is the first step. As estrogen and progesterone decline, digestive function can slow, gut lining integrity can weaken, and inflammation can rise. Supporting your gut means better nutrient absorption, more stable moods, fewer bloating episodes, and even improved hormone detoxification. Write down how you want to feel during this phase: energized, relaxed, calm, confident. Let that intention guide your daily choices.

2. Start your day with a gut-friendly routine

A warm glass of water with lemon, gentle stretching, a mindful breath, and a fiber-rich breakfast, such as oats with flaxseeds and berries, can help set the tone for digestive ease throughout the day. This kind of morning rhythm supports bowel regularity, calms the nervous system, and nourishes your microbiome.

No time for a full routine?

Even just five minutes for a calming breath and warm water can help stimulate digestion. Small habits, done consistently, matter more than perfection.

3. Dress comfortably (even at the table)

Tight waistbands and restrictive clothing can compress your midsection, making bloating and indigestion worse. Wearing looser, more comfortable clothes, especially during meals, can allow your digestive organs space to do their job, and help you feel more relaxed and in tune with your body.

4. Make mealtimes mindful

Rushed eating leads to poor digestion, more bloating, and missed signals of fullness. Before you eat, take 3 deep breaths. Sit down, put away your phone, and chew slowly. Notice textures, smells, and flavors. Mindful eating activates your parasympathetic, rest-and-digest, nervous system, improving nutrient absorption and calming inflammation.

5. Set realistic nutrition goals

You don’t need to overhaul everything overnight. Start by adding, not restricting. Consider adding one extra portion of veg to your meals. Swap white bread for whole grain. Include fermented foods like kimchi, kefir, or sauerkraut 3 times a week. Small shifts done consistently support gut resilience over time.

6. Stay accountable to your well-being

Tracking symptoms like bloating, constipation, or food sensitivities in a simple journal can help you identify patterns. If you’re working with a practitioner, share your food and mood log regularly. Accountability helps you stay connected to your goals and understand what’s truly supporting your body.

7. Reward yourself with rest and nourishment

Supporting your gut doesn’t have to feel like punishment. Celebrate the small wins, like remembering to slow down at lunch or choosing a home-cooked meal over a processed one. Your reward can be anything that feels nourishing, such as a bath, a walk in nature, or a cozy early night. These are just as essential to gut health as food.

8. Connect with others in the same phase

You’re not alone; millions of women are navigating these changes too. Whether it’s a friend, an online group, or a coach, sharing your experience can lighten the load and offer practical support.

No support network?

You can still validate your experience. Be your own best advocate, and seek professional guidance if you need tailored support.

9. Don’t underestimate the power of rest

Poor sleep disrupts digestion and hormone balance. Aim for 7 to 9 hours per night, and if you struggle, create a wind-down ritual. Reduce screens after 8 PM, try magnesium-rich foods like pumpkin seeds, or consider natural sleep aids like valerian or tart cherry juice. Your gut heals while you rest; give it the time it needs.

10. Try a gut-nourishing class

Movement supports digestion, especially in low-impact activities like yoga, Pilates, or walking. Consider joining a weekly class that combines movement with breathwork or mindfulness. These can help reduce cortisol, ease bloating, and support your gut-brain connection.

11. Track your gut health progress

Use a journal or app to track: Bowel movements (frequency, consistency, foods that support or aggravate symptoms, energy levels, mood. This helps you connect the dots and build a picture of what works for you.

12. Plan meals ahead of time

Meal planning reduces the chance of skipping meals or relying on ultra-processed convenience foods that disrupt gut health. Batch-cook simple meals like soups, stews, or veggie-loaded frittatas. Stock your fridge with snacks like boiled eggs, hummus, and carrot sticks, or natural yogurt and berries. Your gut loves regular, balanced meals.

13. Prioritize consistency over motivation

You won’t always feel motivated, but you can commit to being consistent. Eat a variety of fiber-rich foods most days, keep hydrated, and make time to rest.

The key to better gut health isn’t one perfect day; it’s the sum of small, consistent choices over time

14. Be kind to yourself

Perimenopause is a transformation, not a decline. If your digestion has changed, it's not your fault. Be curious, not critical. Thank your body for what it’s doing, keeping you alive and adapting daily. This kindness matters. Stress and negative self-talk directly impact gut health via the gut-brain axis.

15. Keep things enjoyable

Gut-friendly eating doesn’t mean boring. Get creative with herbs, spices, textures, and global cuisines. Try new recipes, like lentil dahl, gut-soothing soups, or probiotic-rich smoothies. When meals are satisfying, you're more likely to stick with nourishing habits long-term.

16. Don’t give up on feeling good

It might take time to find what works best for your gut during this life phase, but don’t give up. You deserve to feel comfortable, strong, and well. Stick with it. Your gut microbiome responds to consistent care, and real healing is possible.

17. Visualize calm digestion

Take a moment each day to imagine your digestion flowing smoothly, your food breaking down with ease, your body absorbing all the goodness, your gut feeling light and peaceful. This mental practice signals safety to your nervous system, improving your digestive response.

18. Work with a professional

If you're struggling with persistent bloating, IBS symptoms, constipation, or food sensitivities, working with a nutritional therapist can provide targeted support.

A professional can help you to identify trigger foods, restore gut lining integrity, rebalance your microbiome, support hormonal detox pathways, and suggest individualized protocols and supplements. You don’t have to do this alone. There’s expert help available to guide you.

Frequently asked questions

Why does perimenopause affect digestion?

Hormonal fluctuations, particularly declining estrogen and progesterone, can slow gut motility, increase bloating, and alter the gut microbiome. Stress and poor sleep also impact digestion during this life phase.

What foods support gut health in perimenopause?

Focus on fiber-rich vegetables, fermented foods such as yogurt, kimchi, and kefir, healthy fats like olive oil and avocado, and prebiotic-rich foods like garlic, onions, and leeks.

Can probiotics help?

Yes, probiotics can help rebalance gut bacteria, reduce bloating, and support immune function. Look for multi-strain formulas with lactobacillus and bifidobacterium species, or try probiotic foods.

How does stress affect gut health?

Chronic stress activates the fight-or-flight response, impairing digestion, reducing stomach acid, and increasing inflammation. Stress management is essential for gut health; consider breathwork, yoga, or mindfulness.

Is constipation common in perimenopause?

Yes, slower transit time and declining muscle tone in the bowel can lead to constipation. Increase fiber, hydrate, move your body, and consider magnesium citrate if needed.

Should I consider stool testing during perimenopause?

Yes, comprehensive stool testing can provide valuable insights into your gut health, including the balance of beneficial bacteria, the presence of pathogens or parasites, levels of inflammation, and how well you're digesting food. This information can help tailor a personalized nutrition and supplement plan to support your gut and overall well-being during perimenopause.

Let's work together to support your gut health naturally

If you're ready to feel better in your body, reduce bloating, and reclaim your energy, I’m here to help. Let's create a personalized gut health plan tailored to your perimenopausal needs, so you can thrive, not just survive.

Book your free gut health discovery call today and take the first step toward feeling good again.

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Read more from MJ Feeke

MJ Feeke, Nutritional Therapist

MJ is a leader in the wellness world who understands the transformative power of positive nutrition and lifestyle medicine. As a busy working woman, mom, wife, and daughter, she deeply relates to the challenges of managing stress and life load, especially for midlife women. MJ is passionate about empowering individuals to reclaim their health and live their best lives.