Menopause and Constipation

By Dr. Vik, MBBS, MRCP(GB), PhD

Menopause and constipation

As women get older, a number of different hormonal changes occur within their bodies.

While some women may find relief in not having their periods any more, in most cases menopause is accompanied by a great deal of stress and anxiety.

Changes in mood, an increase in body weight, vaginal dryness and an alteration in bowel habit are just some of the symptoms menopausal women may experience.

In the changes in bowel habits, constipation is a common and well recognized problem. There are a number of different reasons for this. In this article we will briefly discuss the link between menopause and constipation.

The Link Between Menopause and

Constipation

A person is considered constipated when they have less than 3 bowel movements a week, or when stool is dry, hard and difficult to pass.

Studies conducted in post-menopausal women have demonstrated constipation symptoms, including excessive straining when attempting to have a bowel movement, passing hard stools and the feeling of incomplete evacuation of the bowel.

There are a number of different causes that connect menopause and constipation, as described below.

1. Change in mood

A large majority of women who go through menopause tend to experience an alteration in their mood. Depression, anxiety and even panic attacks may occur.

Change in mood is often accompanied by a change in diet. This can mean an increase in ‘comfort eating’. 

Comfort eating involves the consumption of foods that tends to be high in sugar, giving a great deal of pleasure and satisfaction following consumption. For example, ice cream and chocolate are common comfort foods. 

Junk foods have very low fiber content, and high consumption usually leads to constipation. 

Furthermore, the high sugar content can eventually lead to obesity, which is yet another recognized cause of constipation. Constipation may be easily dealt with by taking a daily magnesium supplement. 

Most people don’t get enough magnesium in their diet. Therefore, taking a magnesium supplement may result in numerous health benefits, including constipation relief.

Magnesium is an osmotic mineral which draws water into the colon. This moistens stool, making it soft, slippery and easy to pass. 

Just make sure when taking a magnesium supplement to stay properly hydrated, drinking 6 to 8 glasses of water a day.

2. Alteration in hormone levels

When women have normal periods, there is a perfect balance of hormones, including estrogen, progesterone and cortisol, which helps break down sugar, burn fat and maintain adequate metabolism. 

Once menopause takes place, estrogen levels drop and cortisol levels rise. As a result, there is inadequate metabolism of sugars and fats, primarily due to an alteration in normal food digestion.

This can result in increased gas production, and over time, constipation. This is because partly digested food takes longer to pass through the intestine. 

In addition to this, the relative rise in progesterone levels can cause increased digestive transit time, meaning it takes longer for food to pass through the bowel loops. 

A large amount of water that is present within the stools therefore gets absorbed resulting in hard and lumpy stools.

Hormone replacement therapy

Some women may commence hormone replacement therapy if prescribed by their doctor.

The consumption of healthy oils can increase hormone production. This is because hormones are produced within the body from fat that we consume in our diet.

Magnesium

Once again, a magnesium supplement can help to speed food through the colon. 

1. Magnesium aids in digestion

2. Magnesium is a relaxant mineral that may help to restore proper muscle function to a tense colon. 

However, these options are not necessarily feasible for all patients. In such a situation, the use a laxative may be helpful, especially fiber laxatives that are not habit forming.

Second, a change in one’s diet and an increase in fluid intake may prove quite beneficial.

3. The use of supplements and drugs

Iron supplements

In a small proportion of postmenopausal women, low hemoglobin may be a problem. One of the reasons for this is low levels of iron in the body.

This condition is known as iron deficiency anaemia. The treatment for iron deficiency anaemia is a prescription for iron medication. A common side effect of iron medicine is constipation, which can bring difficulties during menopause.

To prevent constipation caused by an iron supplement, try spreading the dose of iron to 3 or 4 times a day. Patients may require additional measures as well.

Calcium supplements

Another supplement that can cause constipation is calcium. Postmenopausal women are at risk of thinning of the bones (a condition called osteoporosis) which is primarily due to a reduction in the level of estrogen in their body.

One of the treatments of osteoporosis is to take a calcium supplement.

Regular intake of calcium can cause constipation and patients may have to stop taking this treatment in order to restore normal bowel movements.

Of course, here as well, laxatives or a magnesium supplement can be extremely beneficial.

Unabsorbed calcium finds its way to the colon. Since calcium tends to tighten up muscles, its effect on the colon is to tighten the colon muscle, thus hindering peristalsis, the wave-like contractions of the colon that move stool along.

Magnesium is the mineral that loosens muscles. When a magnesium supplement is taken along with calcium, it helps to balance out the effect of calcium, restoring normal peristalsis.

Medications

It is not uncommon for postmenopausal women to also use a number of different over-the-counter drugs to keep them healthy and prevent backaches and joint pain. These pain relievers can sometimes cause constipation.

In patients who have high blood pressure, the use of drugs such as clonidine is associated with the development of constipation as a side effect.

The treatment of constipation in such patients is rather simple. Stop taking the medication, or as your doctor or pharmacist to recommend one that doesn’t cause constipation.

However, if the medication is essential, consider increasing water intake, plus a magnesium supplement.

Unlike most laxatives, a magnesium supplement is non-habit forming, it may be taken daily for as long as desired.

Those with kidney disease should not take a magnesium supplement unless advised to do so by their doctor.

Conclusion

Menopause and constipation are linked together by a number of different factors. Each of these factors has a bearing on patient well-being and must be treated safely and effectively.

Some cases can be dealt with through simple lifestyle modifications and by staying hydrated.

The use of a magnesium supplement in managing constipation in women undergoing menopause (or postmenopausal women) has been proven to be effective.

(Return from Menopause and Constipation to Causes of Constipation)