Why Some Women Develop New Food Sensitivities During Perimenopause
Some women begin experiencing bloating, reflux, nausea, or digestive discomfort after eating foods they had tolerated for years. The alluring explanation is a new food intolerance, but often it’s more complicated and far more interesting than that.
The Food May Be the Same, but the Body Is Not
The term “perimenopause” is used for the period of time when hormone levels are not declining consistently. While a perimenopause test kit can test for some hormones, testing hormones by itself is oftentimes of little use as levels fluctuate significantly during the transition. Usually better clinical context is provided by symptoms, menstrual changes, age, and medical history.
The digestive system is also influenced by hormonal activity. Ovarian hormones can affect motility and visceral sensitivity, with the presence of both estrogen and progesterone receptors in the gastrointestinal tract. In more practical terms, digestion may change over time even if the meal itself doesn’t.
Having different reactions to food does not necessarily indicate a different allergy. Gas, abdominal pain and nausea may be caused by shifts in metabolism, side effects of drugs, an underlying gastrointestinal disorder becoming more apparent or a real food allergy.
Sometimes the Problem Is Digestive Timing
The speed at which food moves through the digestive tract also matters, and hormonal changes can impact this. Gut motility is slowed by progesterone, and changes in ovarian hormones have also been correlated with gastrointestinal symptom changes.
Consequently, familiar foods might become suspect. The combination of a full meal, fermentable carbs or coffee can be more gassy and uncomfortable when reflux is already a problem. A study with women who have IBS also indicates that sex hormones can affect the sensitivity and communication between the gut and the brain. This is not to say that perimenopause causes IBS, but with a digestive disorder, symptoms may worsen.
The Gut Microbiome May Be Rearranging the Furniture
The gut microbiome also changes over time, and new studies are exploring how the menopause transition could influence the microbiome. Gut bacteria are also involved in the metabolism of estrogen, suggesting a bi-directional relationship.
This may be relevant to food sensitivity since gut bacteria have the role of breaking down myriad compounds that can only be broken down by several digestive enzymes in the human body. If the environment of the intestines changes, the fermentation pattern and the creation of gas could change as well. At present, the science is still in its infancy, and there is no clear evidence that this microbiome shift in menopause is the direct cause of any specific food intolerance.
Histamine Is an Interesting Suspect
Histamine has become a common topic in discussions about perimenopause because it often comes up when wine, fermented foods or aged products begin to produce symptoms. Histamine intolerance is typically characterised as a lack of the ability to efficiently metabolise dietary histamine, but can have a wide range of symptoms that overlap with many other conditions.
There is some biological interest in how estrogens are associated with histamine, but there is little clinical data. So far, attributing all of the negative reactions to Parmesan and Pinot Noir to hormones is a bit ahead of the science.
Stress and Sleep Can Quietly Change the Menu
Perimenopause is difficult to study because many factors change at the same time. Many factors can affect digestion, including sleep disturbances, psychological stress, medication, changes in routine and hormonal changes. Research suggests that stress affects both digestive function and the perception of gastrointestinal symptoms.
A suddenly intolerable food could be just half the problem. Keeping a food diary, along with notes on sleep, stress, menstrual cycle, medications and symptoms, can help identify patterns that aren’t obvious from a list of foods to avoid.
FAQ: Food Sensitivities During Perimenopause
Can food sensitivities first appear during perimenopause?
At this time, new digestive reactions can also occur, but not necessarily an allergy or permanent intolerance. Foods that were previously okay may seem difficult to eat.
Are these reactions permanent?
Not necessarily. Symptoms may change as hormones change and with other factors; however, if the symptoms are persistent, it’s important to see a doctor, not just dismiss them as perimenopause.
Should suspected foods be completely eliminated?
Nutrition can be unnecessarily complicated if there is a large-scale restriction without a specific reason. A symptom diary and professional evaluation can help identify a pattern of symptoms that is related to food.
When Familiar Foods Start Playing by New Rules
One of the more surprising aspects in perimenopause is that the food may be only the tip of the iceberg. Hormonal fluctuations intersect with movement through the gut, sensitivity of the intestines, stress, sleep, and maybe even shifts in the microbiome, leading to a change in how a typical meal is felt.
Sometimes a real intolerance develops, which should be properly investigated. The gastrointestinal tract may just be reacting to its new hormonal environment. The useful question is therefore not only which food caused the reaction, but what else changed around the same time.
