Constipated & Over 40? It’s Probably Your Hormones (Not Your Fiber)

Let’s talk about the kind of thing nobody likes to talk about—but every woman over 40 has dealt with: constipation. And I’m not talking about skipping a day or two. I’m talking about that bloated, stuck, dry, nothing’s-moving situation that makes you feel sluggish, foggy, and honestly, kind of miserable.

Here’s what most doctors will say: “Drink more water. Eat more fiber. Exercise.” Sure, those are good basics—but for women in perimenopause or menopause, they’re not enough. Why? Because constipation at this stage of life is often a hormone issue, not a hydration problem.

The Hormone–Gut Connection You’ve Probably Never Heard About

You’ve heard me say it before: your hormones rule everything. And your gut is no exception.

Let’s start with progesterone. This hormone naturally relaxes smooth muscle—including your intestines. When progesterone levels dip (which starts happening in your late 30s and tanks by your 50s), your gut can lose its natural rhythm. Things slow down. Transit time gets longer. You feel bloated, backed up, and uncomfortable.

Estrogen? It keeps your colon hydrated. So when estrogen drops—or swings like a hormonal pendulum in perimenopause—stools get dry, hard, and tough to pass. Estrogen fluctuations can even cause your gut to flip-flop between constipation and diarrhea. Fun, right?

Then there’s cortisol—your stress hormone. Chronic stress raises cortisol, which dampens digestive juices and paralyzes gut motility. So if you’re feeling stressed, tired, wired, and constipated? Cortisol’s probably in the mix.

And don’t forget thyroid hormones. Your thyroid sets the pace for your metabolism, including gut movement. Low or sluggish thyroid function is a major (but often missed) reason women struggle with stubborn constipation in midlife.

Tried Everything and Still Constipated? It’s Time to Look at Your Hormones

If you’ve already cleaned up your diet, hydrated like crazy, cut caffeine, and walked every day—and you’re still bloated and backed up—it’s time to get serious about hormonal support.

Here’s how functional medicine helps women get things moving again:

Hormonal Solutions for Midlife Constipation

1. Bioidentical Progesterone
Taken at night, bioidentical progesterone helps calm the nervous system, supports sleep, and encourages parasympathetic activity (the “rest and digest” mode your gut depends on). It’s especially helpful if your constipation comes with anxiety, poor sleep, or PMS-like symptoms.

2. Bioidentical Estrogen (Estradiol)
This isn’t just for hot flashes. Estradiol helps retain moisture in the colon and reduce gut inflammation—especially when used as a patch or cream. If your stools are dry and painful to pass, estrogen might be your missing piece.

3. Thyroid Support (T3/T4 Combo)
Even subclinical hypothyroidism can stop your gut in its tracks. A full thyroid panel (not just TSH!) can reveal if you’d benefit from thyroid hormone therapy to reboot your metabolism and bowel motility.

Prevention Still Matters, Too

Hormonal support is key, but don’t ditch the basics. For smoother digestion:

• Drink plenty of water

• Eat whole-food fiber (not just powders)

• Move your body daily

• Respond when your body says go (no more holding it in!)

• Reduce alcohol, caffeine, and processed food

But if you’ve already done the basics and you’re still stuck? Hormones are likely the root.

Ready to Stop Struggling with Constipation?

If you’re tired of being bloated, uncomfortable, and just “dealing with it,” it’s time to get your hormones back in sync. Bioidentical hormone therapy (BHRT) can be the missing link that transforms your digestion, energy, and overall comfort.

👉 Book a consult now at getmerva.com
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