Navigating midlife changes: The unspoken issue of constipation

As women enter the stages of perimenopause and menopause, their bodies undergo a variety of changes. While hot flashes and mood swings are commonly discussed, there's another, less glamorous issue that many women face silently: constipation. It might not make for polite dinner conversation, but understanding and addressing constipation can significantly improve quality of life.

Constipation is more than just an occasional inconvenience for many women; it's a chronic condition that affects a significant portion of the population. According to a comprehensive review of multiple studies, the prevalence of chronic idiopathic constipation (CIC) is around 14% in the general population, with women being particularly affected. In fact, women are twice as likely as men to suffer from this condition.

Why are women more prone to constipation, especially as they age? Hormonal changes play a crucial role. The decline in estrogen and progesterone during perimenopause and menopause can slow down the digestive system, leading to less frequent and more difficult bowel movements. Additionally, conditions such as obstructive defecation, which is common in middle-aged women, can exacerbate the problem.

Constipation might seem like a minor issue, but its impact on daily life can be profound. Studies have shown that it significantly impairs health-related quality of life, affecting both physical comfort and mental well-being. Women with chronic constipation report higher levels of stress, anxiety, and depression. It's not just about the physical discomfort; the constant worry about bowel movements can be mentally exhausting.

Moreover, severe constipation has been linked to increased risks of cardiovascular disease and colorectal cancer. This is particularly concerning for post-menopausal women, who already face higher risks for these conditions.

Constipation can feel like a silent and persistent nuisance, particularly for women navigating the middle years of life. This condition demands a proactive approach to ensure digestive well-being. Thankfully, there’s a wealth of natural remedies and lifestyle adjustments that can help alleviate this issue. Here’s a guide to managing constipation with strategies rooted in recent scientific findings and time-tested wisdom.

Embrace fibre wisely: quality over quantity

Fibre is frequently hailed as a digestive aid, but the type and amount matter. A study reviewing the efficacy of low-fibre diets revealed that, contrary to popular belief, reducing fibre intake might sometimes benefit individuals with severe constipation or irritable bowel syndrome (IBS). However, this doesn’t mean fibre should be shunned altogether. Instead, focus on high-quality sources of fibre that can enhance bowel function without overwhelming the digestive system.

Incorporate soluble fibres like those found in oats, apples, and citrus fruits, which can help maintain regularity without the harsh effects of insoluble fibres that might exacerbate discomfort. For a gentler approach, consider adding kiwifruit to your diet. Kiwifruit isn’t just a tasty treat—it's a powerful ally in the fight against constipation. Studies have shown that kiwifruit significantly enhances stool consistency and increases the frequency of bowel movements. This tropical fruit is rich in dietary fibre and contains actinidin, an enzyme that promotes digestion. By integrating just a few kiwifruits into your diet each week, you can improve stool softness and bulk, making bowel movements easier and more regular. 

Harness the power of flaxseed

Flaxseed is another natural marvel that’s gained recognition for its laxative properties. With its rich fibre content and beneficial fats, flaxseed acts as a gentle stool softener and helps increase bowel movement frequency. Incorporate ground flaxseed into your diet by adding it to smoothies, yoghurt, or salads. Not only does it support digestive health, but it also offers additional benefits such as heart health and hormonal support. 

Watch your fat intake

While dietary fats are essential, excessive consumption—especially of saturated fats—can contribute to constipation. High-fat diets have been shown to delay colonic transit and negatively impact bowel regularity. To maintain balance, limit saturated fats and opt for healthier fats found in avocados, nuts, and olive oil. These fats support overall health and can aid in preventing constipation.

Broccoli sprouts: The antioxidant ally

Incorporating antioxidant-rich foods like broccoli sprouts into your diet can be surprisingly effective in improving bowel function. These sprouts contain sulforaphane, a compound known for its ability to combat oxidative stress and support intestinal health. Adding a small daily serving of raw broccoli sprouts can enhance your body’s natural antioxidant defences, which may, in turn, improve bowel regularity and overall digestive health.

Consider natural laxatives

For those seeking additional relief, natural laxatives like dried plums (prunes) and fig paste can be powerful allies. Dried plums are not only palatable but also highly effective for alleviating mild to moderate constipation. They contain sorbitol and fibre, which promote bowel movement and increase stool frequency. Similarly, fig paste has been shown to enhance colonic transit time and reduce abdominal discomfort.

Keep hydrated

Don’t underestimate the power of hydration. Drinking plenty of water is crucial for maintaining stool consistency and promoting regular bowel movements. Aim for at least eight glasses of water a day, and consider incorporating hydrating foods like cucumbers and watermelon into your diet. Proper hydration supports digestion and helps prevent constipation by softening stools and facilitating smoother bowel movements.

Physical activity: Keep moving

Regular physical activity is key to maintaining a healthy digestive system. Exercise stimulates the muscles in the intestines, promoting regular bowel movements and reducing the likelihood of constipation. Aim for at least 30 minutes of moderate exercise, such as walking or cycling, most days of the week. This not only supports digestive health but also enhances overall well-being.

Stress management

Chronic stress can impact gut health and contribute to constipation. Techniques such as mindfulness, yoga, and deep breathing exercises can help manage stress and support digestive function. Incorporating stress-reducing activities into your daily routine can make a significant difference in your digestive health.

A personalised approach

Managing constipation often requires a tailored approach. Start by assessing your dietary habits, hydration levels, and physical activity. Introduce natural remedies gradually, observing how your body responds. For persistent issues, consulting with a healthcare provider or a nutritional therapist can provide personalized guidance and ensure that your approach aligns with your overall health needs.

Incorporating these strategies into your lifestyle not only addresses constipation but also fosters overall well-being. Embrace these natural solutions and adjustments to reclaim comfort and vitality, and make every day a step toward a healthier, happier you.

References

Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011;106(9):1582-1591.

Bharucha AE, Pemberton JH, Locke GR 3rd. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013;144(1):218-238.

Dukas L, Willett WC, Giovannucci EL. Association between physical activity, fibre intake, and other lifestyle factors and constipation in a study of women. Am J Gastroenterol. 2003;98(8):1790-1796.

El Sabbagh R, Kourie HR, Kourie MJ, et al. Impact of physical activity on constipation in premenopausal obese women. Diabetes Metab Syndr Obes. 2019;12:2409-2417.

Lembo A, Camilleri M. Chronic constipation. N Engl J Med. 2003;349(14):1360-1368.

Whitehead WE, Palsson O, Jones KR. Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology. 2002;122(4):1140-1156.

Talley NJ, Weaver AL, Zinsmeister AR, Melton LJ 3rd. Functional constipation and outlet delay: a population-based study. Gastroenterology. 1993;105(3):781-790.
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Bittner AC, Croffut RM, Stranahan MC. Prescriptive exercise for women: influence on body image, self-esteem, and mood state. J Women Health Gend Based Med. 2001;10(1):73-83.

Nilsson SE, Nilsson AM, Hedberg P, Sundh V. The metabolic syndrome and incidence of cardiovascular disease in non-diabetic elderly men and women. Am J Epidemiol. 2003;156(5):460-468.

Anti M, Pignataro G, Armuzzi A, et al. Water supplementation enhances the effect of  high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation. Hepatogastroenterology. 1998;45(21):727-732.

Attaluri A, Donahoe R, Valestin J, Brown K, Rao SS. Randomized controlled trial of dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther. 2011;33(7):822-828.

Lembo AJ, Kurtz CB, MacDougall JE, et al. Efficacy of linaclotide for patients with chronic constipation. Gastroenterology. 2010;138(3):886-895.e1.

Heymen S, Jones KR, Scarlett Y, Whitehead WE. Biofeedback treatment of constipation: a critical review. Dis Colon Rectum. 2003;46(9):1208-1217.