Perimenopause constipation (and diarrhoea): why your bowels change and what helps
By Softer Mind · Updated 15 October 2026 · 6 min read · Based on NHS guidance and published research
You used to be regular. Now days go by without a poo, and when you do go it's hard work. You feel heavy, bloated and not quite empty. Or your bowels swing the other way, and you're never sure where the nearest loo is.
Perimenopause constipation is common, and it's not something you have to keep quiet about. In a 2025 UK survey of nearly 600 women aged 44 to 73, 54% said they had constipation, and 82% said their gut symptoms started or got worse around perimenopause or menopause (The Menopause Society). That was early research shown at a conference, not a full published study. But it fits with what many women describe.
A change in your bowels can also have other causes, and a few of them need checking. So please read the box below first.
See your GP if you have any of these (NHS):
- changes in your poo, such as softer poo, diarrhoea or constipation that is not usual for you
- needing to poo more or less often than is usual for you
- blood in your poo, which may look red or black, or bleeding from your bottom
- often feeling like you need to poo, even if you've just been to the toilet
- tummy pain, bloating, or a lump in your tummy
- losing weight without trying
- feeling very tired or short of breath
NHS Wales says to see a GP if bowel symptoms like these have lasted 3 weeks or more.
Get help sooner: ask for an urgent GP appointment or call 111 if your poo is black or dark red, or you have bloody diarrhoea. Call 111 if diarrhoea lasts more than 7 days (NHS). Go to A&E or call 999 if you're bleeding non-stop from your bottom, or there's a lot of blood.
Having these symptoms does not definitely mean you have bowel cancer, the NHS says. Many are very common and have other causes. But it's important to get checked, and the NHS says not to be embarrassed: doctors and nurses are used to talking about this.
What counts as constipation?
The NHS says you may be constipated if you haven't had a poo at least 3 times in the last week, or you're going less often than usual. Other signs include:
- poo that's large, or small, dry, hard or lumpy
- straining or pain when you poo
- feeling that you haven't fully emptied your bowels
- tummy ache, bloating or feeling sick
Normal varies a lot. Guts UK says healthy bowel habits range from three times a day to three times a week. What matters most is a change from what's normal for you.
Can perimenopause cause constipation?
It may play a part, but the research is limited.
Some animal and human studies suggest that sex hormones may slow down how fast food moves through the gut, but other studies haven't found this (Lenhart and others, 2020). Guts UK notes that some women find their bowels are slower at certain times in their cycle. In perimenopause, those hormones go up and down, so it makes sense that your bowels could feel it. But this isn't proven.
The same 2020 study looked at women with irritable bowel syndrome (IBS). Women past the menopause had more severe IBS symptoms overall than younger women. More of them had IBS where constipation was the main problem, although that difference could have been chance.
Other things that make constipation more likely in midlife
Hormones are rarely the whole story. The NHS lists these common causes:
- not eating enough fibre (fruit, vegetables and cereals)
- not drinking enough fluids
- not moving much, or sitting for long periods
- often ignoring the urge to poo
- changes to your diet or daily routine
- stress, anxiety or depression
- a side effect of a medicine
Guts UK adds that some people develop a weak pelvic floor, which is more common in women who've had children. It lists this as one cause of constipation.
Rarely, constipation is caused by a condition such as diverticular disease or bowel cancer, the NHS says. Guts UK says to tell your GP about any sudden slowing of your bowels, especially if you're over 40.
Perimenopause diarrhoea
There's less research on diarrhoea in perimenopause than on constipation. In the 2020 study, women past the menopause actually reported loose or watery poo less often than younger women (Lenhart and others, 2020).
So if you've started having diarrhoea, it's worth thinking about other causes:
- A stomach bug or something you ate. The NHS says diarrhoea usually stops within 5 to 7 days.
- IBS. This can cause diarrhoea, constipation, or both at different times (see below).
- Stress and anxiety. The NHS lists these as triggers for IBS flare-ups, along with alcohol, caffeine and spicy or fatty food.
- A change that isn't usual for you. The NHS lists softer poo or diarrhoea that's new for you among the symptoms of bowel cancer. If it's lasted 3 weeks or more, see your GP.
Is it IBS?
IBS is a common condition that affects the gut. The NHS says the main symptoms are:
- tummy pain or cramps, often worse after eating and better after a poo
- bloating
- diarrhoea
- constipation
Symptoms often come and go in flare-ups. The NHS says to see a GP if you think you have IBS and have had symptoms for more than 4 weeks. Your GP can check it's IBS and rule out other problems.
What can help with perimenopause constipation?
Simple changes are the place to start. The NHS says they may take a few days, or sometimes a few weeks, to work.
Add fibre slowly. Increase fibre gradually. You could add oats, linseed or wheat bran, and fruits such as apples, apricots and grapes. Guts UK suggests a high-fibre food at each meal and at least five portions of fruit or vegetables a day.
Drink enough. Guts UK says about eight mugs or tall glasses of fluid a day is a normal amount for most adults. The NHS also suggests avoiding alcohol.
Keep moving. The NHS says a daily walk or run can help you poo more regularly.
Give yourself time. Try to go at a regular time and place, and allow enough time. Don't put it off when you feel the urge.
Change your position. The NHS suggests resting your feet on a low stool while you're on the toilet, with your knees above your hips if you can.
If you have diarrhoea, the most important thing is to drink lots of fluids, such as water or squash, so you don't get dehydrated. The NHS says fruit juice and fizzy drinks can make diarrhoea worse.
Talk to a pharmacist
If diet and lifestyle changes aren't helping, the NHS suggests speaking to a pharmacist about a laxative. It says most laxatives work within 3 days, and they should only be used for a short time. A pharmacist can tell you which type suits you, especially if you take other medicines.
What your GP can do
Your GP will ask about your symptoms and may examine your tummy and bottom. They may suggest tests or refer you, depending on what they find.
Things you can talk to your GP about include:
- Checking for other causes, such as IBS or a medicine that might be making things worse.
- Your medicines. The NHS says to see a GP if you take a medicine that causes constipation. Don't stop any prescribed medicine without talking to your GP first.
- Treatment for IBS, if that's what it turns out to be.
- Other menopause symptoms. If you have other perimenopause symptoms too, ask about HRT and other options. We couldn't find good research on whether HRT changes constipation.
When to see a GP about constipation
As well as the signs in the box at the top, the NHS says to see a GP if:
- you're constipated and it's not getting better with treatment
- you're often constipated
- you're often bloated
- you're constipated and always tired
- you notice a sudden change in your bowel habits
- you have tummy pain
You might also find these useful: menopause bloating, perimenopause cramps and perimenopause nausea. Or see the full list of perimenopause symptoms.
This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.
