Beyond the Gut: Hormonal Causes of Bloating in Perimenopause

Medically reviewed by: Dr. Dan Wool, NMD

Arizona-licensed Naturopathic Physician and Gastroenterology Specialist

Updated: September 26, 2026

Video transcript originally published: March 26, 2024

Bloating and Perimenopause

[video transcript] Hey, it's Dr. Dan with another "lunch and learn" video. You know, I get a lot of questions about bloating, and some of the causes seem obvious. They're gastrointestinal. It's how we eat. It's what we eat. Did we eat too much? You get a full stomach and you feel bloated.

But I want to talk specifically to women over 40 who are in the time of perimenopause. There are hormonal causes of bloating, and it could persist for days and weeks. I always get the question, "Doc, why do I look like I'm six months pregnant?" Well, sometimes it's your hormones.

The Estrogen-Progesterone Tug-of-War

Let's talk a little bit about some of the things that these hormones do. The typical female dominant hormones are estrogen and progesterone.

Estrogen, one of its functions, is to hold onto water.
One of the functions of progesterone is to release water.

So you can imagine if these things are too low or too high, they're going to be at odds. You are going to be holding onto too much water all the time, or not really having enough progesterone to kind of help to get rid of it. The biggest sign: you're waking up bloated; this usually means progesterone has gone low and water (and bloating) has gone high and is sticking around (gastrointestinal bloating usually resolves overnight as digestion occurs and gas dissipates).

And it can go high or low either way and have similar results. You're holding onto water. You've got a distended belly that's hanging over your gut, and you can't figure out why. You have great diet habits. You have great exercise habits, but somehow you're still bloated and have this pooch going on. Why is it? Well, again, it's the hormones.

If you want someone to take a look at your hormones, to test them, to tell you what's right and how to manage them, I offer free 15-minute consultations. I would love to see you here in my office in Scottsdale, Arizona. I also do telehealth and appointments on Zoom, again - free for 15 minutes. Nobody ever leaves these calls without any direction.

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Hormonal Bloating Deserves More Than Waiting It Out

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Disclaimer:

The information provided on this page is for educational purposes only and is not intended as medical advice, diagnosis, or treatment. Dr. Dan Wool nor his affiliates do not make claims about the effectiveness of supplements, peptides, hormones or other therapies outside of the contexts supported by cited clinical evidence and regulatory approval. Always consult a qualified healthcare provider before starting, changing, or stopping any medical or wellness program.