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Causes

• Many hormonal changes and imbalances occur during perimenopause. Production of both estrogen and progesterone begin to decrease. Lower hormone levels trigger the release of the hormone cortisol, known as the stress hormone. The release of stomach acid is slowed, and the contents of the stomach are moved more slowly through the digestive system, resulting in digestive discomfort.
  
  

Considerations

• There are other causes for digestive problems besides hormone imbalances. Other possible causes include stress, environmental toxins, genetics and eating habits. Risk factors that may make you more susceptible to digestive disturbances include smoking, drinking alcohol excessively and inactivity.
  
  

Symptoms

• Women experience a variety of digestive problems during this transitional time. The most common symptoms are bloating, diarrhea and constipation. You may also experience cramps, gas and a false urge to have a bowel movement. Some women experience hoarseness and too much mucous in the throat, which may or may not trigger heartburn.
  
  

Lifestyle Changes

• Changes in lifestyle may offer relief of symptoms. A healthy diet is more important than ever. Include plenty of fresh fruits, vegetables and whole grains, and limit your intake of fatty foods. Drink plenty of water. Avoid alcohol and caffeine. If you haven't been exercising regularly, it's time to get started including some form of exercise in your daily routine, such as walking or riding a bike. If you are suffering from gas and bloating, limit gas-producing foods such as beans and cabbage. Stress reduction techniques such as yoga and meditation can help ease symptoms. Discuss treatment options with your doctor.
  
  

Alternative Treatments

• Since many digestive problems during perimenopause are caused by hormonal imbalances, look for supplements that bring a natural balance to hormone levels. Black cohosh is an herb that contains estrogenic components, which may help to treat hormonal imbalance. Macafem is a non-estrogenic herb that may help stimulate hormone production. Some women find ginger helpful in settling indigestion. Herbal medicines may offer relief to some, but none to others.
  
  

Warning

• Be alert to changes in your symptoms such as blood in your stools, increased pain or sudden weight loss. These symptoms may have a different cause. Talk to your doctor if you experience troubling symptoms, or if you don't obtain relief from digestive problems from lifestyle changes.