What’s the Link Between Menopause and Constipation?

If you’ve suddenly noticed you’re having more difficulty going to the bathroom, you may be wondering whether midlife hormonal shifts are to blame. While digestive issues have many possible causes, menopause and constipation can indeed go hand in hand. 

Unlike other well-known perimenopause symptoms, such as hot flashes or mood changes, you may not expect hormonal changes to make you so backed up.

You might feel hesitant to bring this symptom up with your clinician, but there’s no reason to be—constipation can be a common experience during the menopausal transition. The good news is that you can take plenty of steps to manage constipation at home. Plus, your clinician can suggest medications to speed things along. 

Read on for more about what’s happening in your body when your digestive system becomes sluggish, natural remedies for menopause constipation, and when to consult a healthcare professional (like a Midi clinician) for help getting relief.

Is Constipation a Symptom of Menopause?

Yes, constipation can be a symptom of perimenopause and menopause. Constipation is defined as having fewer than 3 bowel movements per week, with hard, difficult-to-pass stools. You may also find you have to strain to go to the bathroom or have the sensation that you didn’t completely empty your bowels.

Regardless of your age, it’s common to become constipated from time to time: Around 15% of the general population experiences constipation. Many factors can slow down your digestive system, including exercising less often, not drinking enough water, not consuming enough dietary fiber, or taking certain medications, among others.

But does menopause cause constipation directly? Fluctuations in the hormones estrogen and progesterone—which usually begin to decline sometime around your mid-40s—may also impact the digestive system. As a result, menopausal women are 2.9 times more likely to experience gastrointestinal (GI) symptoms, which might include heartburn, reflux, and trouble going to the bathroom. 

They are also more likely to have severe symptoms of IBS—a condition that can cause constipation as well as diarrhea, cramping, bloating, and gas—than premenopausal women.

How Menopause Hormones Affect Your Digestion

Declining levels of estrogen and progesterone during menopause may have an impact on your digestive health. But this doesn’t just happen during midlife; hormonal changes can affect your GI system at other times, too. For example, you may have been more likely to become constipated when menstruating or during pregnancy.

Why? Hormonal fluctuations could affect gut motility (those muscles that enable food to automatically move through the digestive tract), research suggests. Hormones can also alter your gut microbiota, the complex population of microorganisms living in the GI tract. 

As a result, your digestive system may start to move more slowly during the perimenopause years, causing less frequent bowel movements and possibly constipation. You might also experience fluid retention, bloating, and increased gas production, since those hormone shifts affect gut bacteria. 

Functional GI diseases and disorders of gut-brain interaction, such as IBS, are also highly prevalent during menopause, a 2026 review published in Frontiers in Endocrinology found.

But reproductive hormones may not be the only influence on midlife constipation. Anxiety, tension, and the stress hormone cortisol also seem to affect constipation and diarrhea severity during menopause, as noted in research published in the journal Menopause.

Constipation after menopause is also possible—in part because of those hormonal changes, but also because women may be taking more medications around this time that impact bowel movements. Plus, people may get even less physical activity as they age.

Other Causes of Constipation in Midlife

Shifting hormones might contribute to a slowed digestive system, but constipation during menopause can have a number of possible causes. 

If you’re suddenly having trouble with your bowel movements, it could be because:

• You’re dehydrated: Not drinking enough water can lead to harder, drier stools that are more difficult to pass. If you haven’t been staying hydrated enough—which might happen in part because it’s possible to lose some thirst sensitivity as you age—constipation can occur. 
• You’re taking certain medications: Many medications slow bowel movements and increase the risk of constipation, including iron pills, certain allergy medications, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, and selective serotonin reuptake inhibitors (SSRIs).
• You aren’t exercising as often: Not exercising regularly can contribute to constipation, and many women find that they have a harder time staying active as they age. In a 2023 study of Scottish national surveillance data, physical activity levels dropped from 40% among women ages 35 to 44 years old to 28% for the 55- to 64-year-old age group. 
• Your pelvic floor is changing: During perimenopause, the pelvic floor can start to experience a loss of muscle volume and strength. Constipation can be a symptom of pelvic floor dysfunction, and being chronically backed up may also worsen any existing pelvic floor issues.

Signs Your Constipation Is Related to Menopause

So in your case, is constipation a sign of menopause—or something else entirely? The truth is that it can be tricky to pinpoint exactly what’s causing a digestive slow-down. It’s also possible that multiple factors are contributing to your constipation, such as menopause-related changes combined with reduced fluid intake or lack of exercise.

In general, constipation during menopause may be accompanied by other GI symptoms, such as bloating, gas, fluid retention, and abdominal discomfort. You might also notice that you’re experiencing more heartburn and acid reflux than usual—this is because declining estrogen levels can weaken the lower esophageal sphincter. Diarrhea is less common than constipation during the menopause transition, but some women do find that their stools are looser and more watery during this time.

Track your symptoms and when they occur. (For example, is your constipation worse when you’re also having more sleep issues or vasomotor symptoms like hot flashes?) Sharing this info with your Midi clinician can help them determine the best treatments for you. 

How to Relieve Constipation During Menopause

If you’re wondering how to relieve constipation during menopause, know that simple lifestyle changes can often make a big difference. To support your digestive system:

• Increase your fiber intake: Dietary fiber adds much-needed bulk to your stool, helping it retain fluids that keep it soft. Aim for around 25 to 34 grams per day from fiber-rich foods such as whole grains, fruits, vegetables, and legumes. If your clinician recommends it, a fiber supplement such as Midi’s Daily Fiber+ may also give you a boost.  
• Drink plenty of water: Adults generally need between 11.5 and 15.5 cups of total fluids per day, which can come from water as well as other beverages and water-packed foods. When you’re well-hydrated, your stool is softer and you might also experience less gas.
• Stay active: Physical activity helps stool move more easily through your digestive system. Aim for at least 150 minutes of moderate aerobic activity each week, plus at least 2 days of resistance or strength training.
• Maintain good bathroom habits: Go to the bathroom when you feel the urge (don’t hold it in!) and try to stick to a consistent routine to make bowel movements more predictable, such as going 15 minutes after a meal.
• Ask your clinician about natural remedies: Some women find that over-the-counter (OTC) supplements like prune, magnesium, or probiotics help soften stools and keep their digestive systems humming along. A gentle OTC laxative or stool softener may also help.

Can Hormone Therapy Help with Constipation?

Evidence on how hormone replacement therapy (HRT, now commonly referred to as menopause hormone therapy, or MHT) might impact constipation has been mixed. This type of medication treats menopause symptoms brought on by fluctuating hormone levels, and there are several forms of HRT available.

In theory, since declining levels of female reproductive hormones could slow down the digestive system and potentially contribute to constipation, increasing levels of those hormones throughout the body would improve it. But research hasn’t always shown this, although studies are limited. 

In a 2024 study that looked at the effects of HRT on gastroparesis—a condition that causes food to move through the digestive system more slowly and can include constipation as a side effect—HRT actually increased the chances of women developing the condition over time. 

However, an earlier study of postmenopausal women found that progesterone (one standard part of HRT) had a significant overall effect on colonic transit, improving the time it took for bowel movements to empty. Taking progesterone and estrogen together as a combination therapy did not have an effect on transit compared with a placebo.

Another 2023 study suggested that HRT may have a more beneficial impact on gut health. Researchers observed women with inflammatory bowel disease (IBD) who had received HRT, and they found that postmenopausal women who had received HRT experienced an improvement in their symptoms compared with those who had not taken this form of medication.

The bottom line? More research is needed to determine how, exactly, HRT might influence constipation. Regardless, HRT isn’t a stand-alone constipation treatment—rather, it’s the gold-standard solution for symptoms like hot flashes, osteopenia, and vaginal and urinary symptoms. A healthcare professional, such as a Midi clinician, can recommend other options that help address digestive systems directly.

When to See a Clinician About Menopausal Constipation

You can often manage constipation at home with lifestyle changes or OTC remedies, such as stool softeners or fiber supplements. That said, you can always reach out to your clinician for reassurance about digestive concerns. 

Certain signs definitely warrant a visit with your clinician, including:

• You have blood in your stool.
• You’ve noticed that you’re suddenly losing weight without trying.
• You feel fatigued all the time and are also constipated.
• You frequently feel bloated.
• You’ve tried lifestyle changes and OTC remedies, but your constipation isn’t improving.
• You also have abdominal pain.
• Your constipation came on suddenly and isn’t typical for you.

Your clinician can rule out any possible medical issues that might be contributing to your constipation, plus recommend effective treatments to help you go to the bathroom more easily.

How Midi Can Help with Menopause and Constipation

Working with a menopause-trained clinician, such as one at Midi, can be especially helpful when navigating digestive changes during perimenopause and menopause. Midi clinicians can evaluate your GI symptoms in the context of the entire menopause transition and come up with a personalized treatment plan that’s appropriate for you.

At your visit, which is often covered by insurance, your Midi clinician can discuss a number of possible options to help relieve constipation, which might include:

• lifestyle guidance
• OTC medications that may be helpful
• supplements
• HRT, when appropriate

Key Takeaways

• Constipation means having 3 or fewer bowel movements per week, with firm, hard-to-pass stools. It’s a common digestive issue: Around 15% of the general population experiences constipation from time to time.
• Fluctuating hormones during perimenopause may contribute to constipation. Menopausal women are 2.9 times more likely to experience abnormal GI symptoms like heartburn, reflux, and trouble going to the bathroom, research has found. 
• While hormones are one possible culprit, you can also become constipated in midlife because you’re not drinking enough water, not eating enough fiber, or not getting enough exercise, as well as due to medications you’re taking. 
• More evidence is needed to determine how hormone replacement therapy (HRT) might impact constipation, though some studies suggest progesterone may actually help speed your digestive system up.
• If you’re experiencing menopause and constipation, the good news is there’s plenty you can do to manage symptoms, including drinking enough water, eating more fiber, exercising, and maintaining a consistent routine. Certain supplements may help too, but get your clinician’s OK first.
• Always let your clinician know if you notice any red flags, such as blood in your stool, digestive changes that come on suddenly and are new for you, or constipation along with abdominal pain, fatigue, or bloating. 

Frequently Asked Questions (FAQs)

Why am I suddenly constipated all the time in midlife?

Fluctuating levels of progesterone and estrogen starting in your mid-40s may trigger a slower digestive system and constipation for some women. But it’s also possible to become constipated in midlife because you’re not drinking enough water or getting enough fiber in your diets, as well as if you’ve started to exercise less often.

What is the simplest trick to empty your bowels?

Sitting in a squatting position on the toilet, meaning your knees are elevated above your hips, may help make bowel movements easier and possibly ease constipation, a 2025 review in BMC Public Health found. But if constipation is a recurring problem, you’ll also want to try lifestyle changes (drinking more water, getting enough fiber, exercising) and asking your clinician about supplements or OTC medications, such as stool softeners or laxatives, to help speed things along.

How long does menopause-related constipation last?

It’s unclear: Little research has been done on the duration of menopause constipation specifically. But in general, menopause symptoms can last around 7 years on average—so it’s worth speaking with your clinician about ways to manage constipation if it’s ongoing.

Can menopause cause both constipation and bloating?

Yes, hormonal changes can impact gut bacteria, which may cause bloating, fluid retention, or increased gas production. Menopause may also contribute to more severe IBS symptoms, a condition that may feature both constipation and bloating. 

Is constipation a sign of perimenopause?

It’s definitely possible. Research has found that some of the most prevalent signs of perimenopause are irregular periods, hot flashes, pain during sex, frequent urination, vaginal dryness, and heart palpitations. But many women also report constipation, which may be caused by fluctuating hormones that affect gut microbiota and gut motility, the muscles that move food through the digestive tract.