Perimenopause Bloating: Why Your Belly Won't Flatten (And What Actually Works)

You just ate a typical meal, but now you feel stuffed and uncomfortable. Your belly feels swollen, your waistband is suddenly too tight, and you’re gassy and maybe a little nauseous. 

If this sounds familiar, you’ve probably already experienced perimenopause bloating, an incredibly common symptom of perimenopause. On top of physical discomfort, you might also feel emotionally uneasy when your belly is bloated and sticking out. Try to remember that bloating is temporary and, above all, it isn’t a shortcoming.

In this article, we’ll cover why perimenopause bloating happens, and how to help reduce bloating and manage digestive symptoms long-term. 

Key Takeaways About Perimenopause Bloating

• Nearly 8 out of 10 women experience bloating in perimenopause—you're not alone
• It's not you, it's your hormones causing slower digestion and fluid retention
• Bloating is temporary and fluctuates throughout the day, unlike weight gain which is more persistent
• Changing your eating habits can help improve perimenopause bloating: try a digestion-friendly diet, eat slowly, chew fully, and sit up straight
• Most perimenopause bloating improves after menopause when hormones stabilize
• Hormone tracking can help you identify patterns and triggers

Is bloating a symptom of perimenopause? 

Yes, and that’s a fact. The lived experiences of perimenopausal people and the scientific evidence all show that perimenopause triggers an increase in digestion-related symptoms, including perimenopause bloating [1].

In fact, according to a new study presented at The Menopause Society’s 2025 Annual Meeting, a whopping 94% of women experience digestive health symptoms during perimenopause! And 77% experience perimenopause bloating [2].

Why is perimenopause bloating so common? Your digestive system is highly sensitive to hormone changes. Estrogen and progesterone, the two hormones that fluctuate wildly during perimenopause, play crucial roles in regulating digestion, gut bacteria, and fluid balance. When these hormones swing unpredictably, your digestive system struggles to keep up, resulting in symptoms like bloating, gas, and abdominal discomfort [3].

What is perimenopause bloating?

Symptoms of perimenopause bloating can vary from person to person, and include:

• Feeling tightness or pressure in your belly
• Feeling extremely full
• Having a swollen, protruding, or bigger belly than usual
• Passing more gas than usual
• Burping more than usual
• Abdominal discomfort
• Abdominal pain
• Nausea
• Clothing feeling too tight around the waist and belly
• Upper abdominal bloating (feeling full in your upper stomach)
• Lower abdominal bloating (feeling pressure below your belly button)

Perimenopause bloating changes throughout the day, and you may notice that you feel more bloated after eating. You may also feel more bloated around your period. Since bloating comes and goes, you generally won't have perimenopause bloating all the time, it tends to be worse at certain times and better at others.

Does Perimenopause Bloating Cause Visible Changes?

That depends: you may or may not notice an actual change in the size of your belly. 

Sometimes, bloating causes your belly to visibly swell and stick out more than usual, some women report looking "pregnant" or gaining several inches around their waist during bloating episodes. Other times, you might feel intensely bloated without seeing any visible changes in belly size. This is because bloating can involve:

• Gas accumulation: Trapped gas in your intestines creates pressure and discomfort but may not always cause visible swelling
• Fluid retention: Hormonal fluctuations cause your body to hold onto extra water, which can make your belly look puffy
• Intestinal distension: When digestion slows, food stays in your digestive tract longer, causing your intestines to stretch

The severity of visible bloating often depends on what you've eaten, where you are in your cycle, your stress levels, and individual factors like gut sensitivity.

What causes perimenopause bloating?

Like so many other perimenopause symptoms, perimenopause bloating is related to hormone changes.

Shifts in the levels of key hormones like estrogen and progesterone drive perimenopause. But these shifts don’t happen steadily: instead, hormone levels fluctuate wildly, leading to unpredictable jumps and drops.

What does this have to do with your bloating? Here’s how perimenopause hormone shifts and fluctuations cause perimenopause bloating:

1. Slower Digestion

Estrogen and progesterone regulate digestion (specifically gastric motility, which is the way your muscles move food through your digestive tract). Hormone fluctuations slow down your digestion, leading to bloating and gassiness [3].

How it works: Progesterone, in particular, relaxes smooth muscle tissue throughout your body including in your digestive tract. When progesterone levels spike or fluctuate unpredictably during perimenopause, your intestinal muscles contract less efficiently, causing food to move more slowly through your system. This gives bacteria more time to ferment food, producing excess gas and bloating [1,3].

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2. Gut Microbiome Changes

Perimenopause hormone changes alter the makeup of your gut microbiome (the population of friendly microorganisms in your gut that aid in digestion and support overall well-being) [4]. This impacts how your body reacts to different foods, and may lead to digestive symptoms like bloating.

What happens: Research shows that declining estrogen levels during perimenopause reduce the diversity of beneficial gut bacteria. This imbalance, called dysbiosis, can make you more sensitive to foods you previously tolerated well and increase gas production, inflammation, and bloating [4].

3. Increased Fluid Retention

Estrogen and progesterone help regulate how your body retains and eliminates fluids [5]. During perimenopause, hormone fluctuations can make you retain more fluid, which can cause bloating.

Why this matters: When estrogen levels spike (which happens frequently during perimenopause), your body holds onto more sodium and water. This fluid retention doesn't just affect your belly, you might also notice swollen hands, feet, or breasts, but abdominal fluid retention is particularly noticeable and uncomfortable [5].

4. Increased Stress and Cortisol

Stress rises during perimenopause for many reasons, managing symptoms, sleep disruptions, life transitions, and hormonal effects on mood. That increased stress can impact your gut and make you digest more slowly, leading to bloating [6].

The gut-brain connection: Stress triggers the release of cortisol and other stress hormones that directly affect your digestive system. Chronic stress can alter gut motility, increase intestinal permeability ("leaky gut"), and worsen inflammation—all of which contribute to bloating and digestive discomfort [6].

5. Related Perimenopause Digestive Symptoms

Perimenopause causes lots of other digestive and gastrointestinal symptoms that can make bloating worse, like:

• Gassiness and flatulence
• Constipation (slowed digestion means slower bowel movements)
• Nausea and indigestion
• Stomach pain and cramping
• Acid reflux and heartburn
• Changes in bowel habits [2]

All of these symptoms are interconnected, constipation makes bloating worse, gas causes abdominal pain, and nausea can change your eating patterns in ways that trigger more bloating.

Medications That Can Worsen Bloating

Bloating can also be a side effect of certain medications commonly prescribed to help manage perimenopause symptoms, including:

• Hormone replacement therapy (HRT) (HRT): Particularly in the first few months of treatment as your body adjusts [15]
• Hormonal birth control: Can cause fluid retention and slow digestion
• Some antidepressants: Especially SSRIs, which can affect gut motility
• Calcium supplements: Can cause constipation and bloating if not taken properly

If you suspect your medication is worsening bloating, talk to your doctor about alternatives or adjustments, never stop prescribed medication without medical guidance.

Is It Perimenopause Bloating or Perimenopause Weight Gain?

This is one of the most common questions women have during perimenopause, and for good reason, both can make your belly look and feel bigger. 

Weight gain is a common and natural part of the transition to menopause. Like bloating, it’s also related to hormones: perimenopause hormone changes slow your metabolism, making it easier to gain weight, while decreasing estrogen levels send that weight to your belly [7,8].

How can you tell the difference between perimenopause bloating and perimenopause weight gain? Duration:

• Perimenopause bloating comes in bursts: Changes to your belly like swelling and tightness happen throughout the day, but your belly relaxes back down to usual size.
• Perimenopause weight gain brings more persistent changes: Your belly size doesn’t fluctuate over the course of the day, and changes occur more gradually.

Important note: You can experience both simultaneously! Many perimenopausal women are dealing with gradual weight gain AND periodic bloating, making it challenging to distinguish between the two. Tracking your symptoms and measurements at consistent times (like first thing in the morning) can help you identify patterns.

When Will Perimenopause Bloating Stop?

Perimenopause bloating tends to ease once you've reached official menopause (you reach official menopause when you've gone 12 consecutive months without a period). Bloating is generally less common after menopause, since hormone levels are more stable once you're beyond the perimenopause fluctuations [1].

The timeline: Perimenopause typically lasts 4-7 years, though it can be shorter or longer. During this time, bloating may be intermittent, you might have weeks or months with frequent bloating, followed by periods where it improves.

After menopause: Once your hormones stabilize at lower levels post-menopause, most women experience significant improvement in bloating and other digestive symptoms. However, some women continue to experience occasional bloating, especially if they:

• Take hormone replacement therapy (which can cause temporary bloating)
• Have developed food sensitivities during perimenopause
• Have underlying digestive conditions like IBS that were worsened by perimenopause

How Long Does Perimenopause Bloating Last?

During an episode: Individual bloating episodes typically last anywhere from a few hours to a full day. Many women notice bloating builds throughout the day, peaking in the late afternoon or evening, then improving overnight.

Pattern frequency: Some women experience bloating daily, while others only have it certain times of the month (often around their period or during ovulation when hormones fluctuate most dramatically).

Overall duration: As mentioned above, bloating is most common throughout the 4-7 years of perimenopause transition, though severity and frequency vary significantly from woman to woman.

When to See a Doctor About Perimenopause Bloating?

Perimenopause bloating is frustrating, uncomfortable, and sometimes painful, but it generally isn’t cause for concern and your belly will return to usual size. 

However, contact your doctor about perimenopause bloating if:

• Touching your stomach hurts (could indicate inflammation or other issues)
• Swelling and bloating doesn't go down after 24 hours or persists for days
• You have bloody stool (requires immediate evaluation)
• You're severely constipated (no bowel movement for several days)
• You have persistent diarrhea (especially if accompanied by weight loss)
• You experience sudden, unexplained weight loss (10+ pounds without trying)
• You have a hard time doing daily activities due to bloating (severe impact on quality of life)
• Bloating is accompanied by severe pain that doesn't improve with over-the-counter remedies
• You experience bloating with vomiting that won't stop
• You notice yellowing of skin or eyes (could indicate liver issues)
• You have a family history of ovarian cancer (bloating can be a symptom, though rarely)

How to Help With Perimenopause Bloating

Perimenopause bloating can be anything from frustrating, to uncomfortable, to even painful. The good news is, there are ways to help ease perimenopause bloating in the moment, and manage bloating long-term.

Here’s a list of actionable strategies you can try for help with perimenopause bloating: 

Immediate Relief Strategies

Massage your belly gently: To release trapped gas when you're having perimenopause bloating, try gently massaging your belly from right to left, following the path of your colon [9]. Start at your lower right abdomen, move up toward your ribs, across to your left side, then down toward your lower left abdomen. This encourages gas to move through your digestive tract toward elimination.

Make your diet more digestion-friendly: Cut down on foods known to cause bloating and gas, like dairy, gluten, and beans. Talk to your doctor about a low FODMAP diet, which minimizes your consumption of a certain type of hard-to-digest carbs, and may be particularly helpful for improving perimenopause bloating [10]. 

Try over-the-counter remedies:

• Simethicone (Gas-X): Helps break up gas bubbles
• Activated charcoal: May absorb excess gas (take away from other medications)
• Probiotics: Can help balance gut bacteria, though effects take time
• Digestive enzymes: Help break down hard-to-digest foods

Use heat: A heating pad or warm compress on your abdomen can relax digestive muscles and relieve bloating discomfort.

Long-Term Management Strategies

Eat slowly, sit up straight, and have smaller meals more frequently: Your body has a harder time digesting when you eat too quickly and you’re hunched over. Eating slowly and chewing fully while sitting up straight improves digestion, which is extra useful when digestion slows down in perimenopause. Try eating smaller, more frequent meals, too, and see how your digestive symptoms respond.

Make your diet more digestion-friendly:

Cut down on foods known to cause bloating and gas, like:

• Dairy products (if lactose intolerant)
• Gluten-containing foods (wheat, barley, rye)
• Beans and legumes (or soak them properly before cooking)
• Cruciferous vegetables (broccoli, cauliflower, cabbage, Brussels sprouts)
• Onions and garlic
• Artificial sweeteners (sorbitol, xylitol, mannitol)
• High-fat or fried foods (slow digestion further)

Add bloat-fighting foods:

• Cucumber (natural diuretic)
• Ginger (aids digestion and reduces inflammation) [13]
• Fennel (traditional remedy for gas and bloating)
• Asparagus (helps reduce water retention)
• Bananas (potassium helps balance sodium)
• Yogurt with live cultures (supports gut bacteria)
• Papaya and pineapple (contain digestive enzymes)

Talk to your doctor about a low FODMAP diet, which minimizes your consumption of certain types of hard-to-digest carbs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols), and may be particularly helpful for improving perimenopause bloating [10]. The low FODMAP diet is typically followed for 2-6 weeks to identify trigger foods, then those foods are gradually reintroduced.

Cut down on gum and carbonated drinks: Chewing gum can make you swallow air, which can lead to built-up gas in your gut. Fizzy drinks (soda, sparkling water, beer) introduce carbon dioxide directly into your digestive system, making gas build up. In turn, too much gas in the gut causes bloating.

Get good sleep: Quality sleep supports gut function, which can help ease digestive symptoms like bloating and gas [11]. Aim for 7-9 hours per night. Poor sleep disrupts the gut-brain axis and can worsen digestive issues.

Exercise regularly: Regular exercise supports digestion and a healthy gut microbiome, and can help manage perimenopause bloating and other symptoms [12]. Exercise can even ease symptoms when you’re feeling bloated [9].

Try natural remedies for digestion support: Ginger and peppermint may boost digestion and gut function to reduce perimenopause bloating, stomach cramps, and other digestive symptoms [13,14]. Try slowly sipping tea, eating crystallized ginger, or sucking on a peppermint chew or lozenge.

Consider probiotics and prebiotics: Probiotics introduce beneficial bacteria, while prebiotics feed the good bacteria you already have. Look for supplements containing: Lactobacillus strains, Bifidobacterium strains, At least 10 billion CFUs (colony-forming units).

Track your hormones to understand your symptoms: Hormone tracking with at-home testing like the Oova perimenopause kit can help you understand how perimenopause bloating and other symptoms may be related to your shifting hormones. When you understand your body, you can take control of your perimenopause care.

Be kind to yourself: Don’t blame yourself for perimenopause changes to your body, whether that’s bloating, weight gain, belly fat, and more. You’re not doing anything wrong, and none of this is a question of will power, it’s biology.

Does Hormone Replacement Therapy Help or Worsen Bloating?

The relationship between HRT and bloating is complex:

HRT may worsen bloating initially because:

• Introducing hormones can temporarily disrupt digestion as your body adjusts
• Estrogen can cause fluid retention
• Bloating is a common side effect, especially in the first 2-3 months [15]

HRT may help bloating long-term because:

• Stabilizing hormone levels can improve digestive function
• Reducing hormone fluctuations may ease gut microbiome disruption
• Many women find overall symptom improvement outweighs temporary bloating

If HRT is causing bloating:

• Wait 2-3 months to see if your body adjusts
• Ask about lowering your dose
• Try transdermal estrogen (patches, gels) instead of oral forms
• Switch to a different formulation
• Take medication with food to minimize digestive upset

Always discuss side effects with your doctor before making changes to HRT.

Perimenopause Bloating: The Bottom Line

Perimenopause bloating can make your belly feel extremely full, swollen, and tight, and can be uncomfortable and even painful. You may or may not see temporary visible changes in belly size, but the discomfort is very real.

Nearly 80% of perimenopausal women experience bloating, making it one of the most common digestive symptoms of this transition. The good news? It's usually temporary and tends to improve significantly after menopause when your hormones stabilize.

To ease perimenopause bloating symptoms and manage bloating long term, try:

• Gently massaging your belly from right to left to release gas
• Eating a digestion-friendly diet low in bloat-triggering foods
• Staying well-hydrated with 8-10 glasses of water daily
• Exercising regularly to support gut motility
• Eating slowly, chewing thoroughly, and sitting up straight
• Trying natural remedies for digestion support like ginger tea and peppermint
• Managing stress through relaxation techniques
• Tracking your hormones to identify patterns

Remember that perimenopause bloating isn't a shortcoming or a sign that you're doing something wrong, it's a symptom of the biological changes your body is going through. Be kind to yourself, and talk to your doctor about how to support your digestive health and overall well-being in perimenopause and beyond.

Ready to understand the hormonal patterns behind your bloating? Track your perimenopause hormones with the Oova kit and take control of your symptoms with data-driven insights.

Common Questions About Perimenopause Bloating

Why is my stomach bloated all the time during perimenopause?

Constant bloating during perimenopause is usually due to hormonal fluctuations causing persistent slowed digestion, fluid retention, and gut microbiome changes. However, if bloating is truly constant (doesn't improve at all, even overnight or first thing in the morning), you should see your doctor to rule out other conditions like IBS, SIBO, food intolerances, or ovarian issues. Most perimenopause bloating comes and goes rather than being constant.

Can perimenopause cause upper abdominal bloating?

Yes, perimenopause can cause bloating in both the upper and lower abdomen. Upper abdominal bloating (feeling full in your stomach area) is often related to slowed gastric emptying—when your stomach takes longer to empty food into your intestines. This is caused by hormone-related changes in digestive motility. Lower abdominal bloating is more commonly related to intestinal gas, constipation, and fluid retention.

Why do I look pregnant during perimenopause?

The combination of bloating, fluid retention, weight redistribution to the belly area, and potential visceral fat accumulation can create a "pregnant" appearance during perimenopause. This is incredibly common and is sometimes called "meno-belly" or "menopause belly." The appearance is usually most pronounced in the evening after a day of eating and fluid accumulation, and typically improves overnight.

Does drinking more water help with perimenopause bloating?

Yes! While it seems counterintuitive, drinking adequate water (8-10 glasses daily) actually helps reduce bloating. When you're dehydrated, your body holds onto water, causing fluid retention and bloating. Proper hydration helps flush excess sodium, prevents constipation, and supports healthy digestion. Just avoid drinking large amounts during meals, which can dilute digestive enzymes, drink water between meals instead.

Can perimenopause bloating cause weight gain on the scale?

Bloating itself is primarily gas and fluid retention, which can cause temporary weight fluctuations of 2-5 pounds. However, the hormonal changes causing bloating also contribute to actual weight gain through slowed metabolism, increased belly fat storage, and reduced muscle mass. So while bloating doesn't directly cause fat gain, the underlying hormonal changes drive both bloating AND weight gain simultaneously.

What foods should I avoid to reduce perimenopause bloating?

The most common bloating triggers are: dairy (if lactose intolerant), gluten, beans and legumes, cruciferous vegetables (broccoli, cauliflower), onions and garlic, carbonated drinks, artificial sweeteners, high-fat fried foods, and processed foods high in sodium. However, trigger foods vary by individual. Keep a food diary to identify your personal triggers, and consider trying a low FODMAP elimination diet under medical guidance.