Why Your Gut Changes in Perimenopause — and How to Support It Naturally

When your hormones shift, your gut feels it first.

If you’ve noticed more bloating, food sensitivities, or unpredictable digestion as you move through your 40s — you’re not imagining it.

Hormonal changes during perimenopause can have a powerful ripple effect on your gut, mood, and metabolism.

At Hābu Health, I often see women who feel like their digestion suddenly “changed overnight.”

The truth is, your gut and your hormones are deeply connected — and when one goes out of balance, the other follows.

The hormone–gut connection

During perimenopause, levels of oestrogen and progesterone begin to fluctuate. These hormones don’t just influence your reproductive cycle — they also affect:

• The speed of your digestion

• The balance of your gut bacteria

• The strength of your gut lining

• Your body’s response to stress and inflammation

As oestrogen drops, beneficial gut bacteria that help metabolise hormones can decline.

Progesterone changes may slow bowel movements, leading to bloating or constipation.

And increased cortisol (your stress hormone) can make your gut more sensitive, triggering symptoms like reflux, nausea, or IBS-like discomfort.

Common gut changes in perimenopause

Many women in perimenopause experience:

• Bloating or distention after meals

• Irregular bowel movements

• New or worsening food intolerances

• Nausea or sluggish digestion

• Cravings or unstable blood sugar

• Histamine sensitivity or skin reactions

If you’ve said, “I used to eat that fine, now I can’t,” it’s often linked to hormone shifts affecting your gut lining and microbiome balance.

The gut–hormone feedback loop

Your gut helps process and eliminate excess hormones — especially oestrogen.

When your gut is sluggish or inflamed, oestrogen can be recirculated in the body, worsening symptoms like:

• Breast tenderness

• Heavy periods

• Mood changes

• Weight gain or fluid retention

This is why I call the gut the “silent hormone regulator.”

Supporting gut health can make perimenopause smoother and calmer from the inside out.

How to support your gut naturally during perimenopause

1. Eat for hormone balance

Focus on whole foods rich in fibre, colourful vegetables, and healthy fats (like olive oil, avocado, flax, and nuts). These nourish your microbiome and support oestrogen clearance.

2. Support your liver

Your liver helps process both hormones and toxins. Herbal support (such as St Mary’s Thistle and Dandelion root) combined with clean hydration can make a world of difference.

3. Calm your nervous system

Your gut has its own nervous system — the “second brain.”

Stress, anxiety, or lack of rest can disrupt digestion, so gentle practices like breathwork, magnesium, and herbal nervines (Withania, Passionflower, Chamomile) are key.

4. Consider a tailored herbal plan

Certain herbs can reduce inflammation, support digestion, and rebalance hormones.

In clinic, I often use Rehmannia, Sage, and Shatavari alongside digestive herbs to support calm and resilience.

5. Listen to your body

Perimenopause is a time to slow down and tune in. When you honour your gut’s cues — hunger, fullness, bloating — you begin to rebuild trust in your body again.

When to seek support

If your bloating, fatigue, or mood swings are affecting your quality of life, it’s time to look deeper.

Together, we can identify your unique gut–hormone patterns and design a plan that restores balance naturally — no fad diets or harsh cleanses, just evidence-based, nurturing care.

The next step

Book your Perimenopause Consultation

Let’s explore what your body needs to find balance again.

Appointments are available online Australia-wide.

Book Now

Written by Karyn Campbell, Naturopath and Herbalist at Hābu Health. Karyn helps women 40+ navigate perimenopause with natural, evidence-based care that restores balance to hormones, gut, and mind.