January 2024
Menopause is a universal biological transition associated with a broad spectrum of physiological and psychological symptoms. Despite growing recognition of the gut-brain-hormone axis, the relationship between menopause and gastrointestinal health remains undercharacterised in large community-based populations. This study reports on the prevalence, nature, frequency, and quality-of-life impact of gut health changes experienced by women across all stages of the menopausal transition. The survey was conducted by DR.VEGAN®, January 2024.
A cross-sectional online survey was administered to 1,526 women in January 2024. The sample included women in peri-menopause (37.0%, n=564), menopause (33.5%, n=511), post-menopause (24.5%, n=374), and those uncertain of their stage (5.0%, n=77). The mean age was 53.0 years (median 53, range 25–65); the mean age at first symptom onset was 46.9 years (median 47). The majority (92.3%) had entered menopause naturally. The survey captured broad symptom prevalence, gut-specific symptoms and frequency, psychosocial sequelae, and use of dietary and supplementary interventions. Individual-level response data were available for all analyses.
Brain fog was the most prevalent symptom (81.9%, n=1,250), followed by anxiety or mood swings (79.8%), fatigue (78.9%), hot flushes / night sweats (75.5%), poor sleep / insomnia (73.9%), joint pain (69.9%), weight gain (68.7%), bloating (66.4%), and low libido (62.8%). See Figure 1 for the full symptom profile, including less commonly discussed symptoms such as heart palpitations (43.9%), restless legs (37.2%), formication (24.7%), and tinnitus (24.6%).
| Symptom | Prevalence (n=1,526) | n |
|---|---|---|
| Brain fog | 81.9% | 1,250 |
| Anxiety / mood swings | 79.8% | 1,217 |
| Fatigue | 78.9% | 1,204 |
| Hot flushes / night sweats | 75.5% | 1,152 |
| Poor sleep / insomnia | 73.9% | 1,127 |
| Joint pain | 69.9% | 1,066 |
| Weight gain | 68.7% | 1,048 |
| Bloating | 66.4% | 1,013 |
| Low libido | 62.8% | 959 |
| Dry eyes or mouth | 45.3% | 656 |
| Heart palpitations | 43.9% | 636 |
| Restless legs | 37.2% | 538 |
| Period changes | 35.4% | 512 |
| Changes in body odour | 28.4% | 411 |
| Formication (skin crawling) | 24.7% | 358 |
| Tinnitus | 24.6% | 356 |
| Changing spatial awareness | 22.5% | 326 |
When respondents were asked which symptoms they found most debilitating, anxiety or mood swings led (49.4%), followed by poor sleep (46.2%), brain fog (45.8%), fatigue (41.4%), weight gain (34.6%), hot flushes (34.1%), and joint pain (30.8%). See Figure 2.
| Symptom rated most debilitating | % of respondents |
|---|---|
| Anxiety / mood swings | 49.4% |
| Poor sleep / insomnia | 46.2% |
| Brain fog | 45.8% |
| Fatigue | 41.4% |
| Weight gain | 34.6% |
| Hot flushes / night sweats | 34.1% |
| Joint pain | 30.8% |
Menopausal symptoms carried a substantial psychological burden across 1,448 respondents. See Figure 3.
| Psychosocial consequence | % of respondents (n=1,448) |
|---|---|
| Exhaustion | 62.7% |
| Social anxiety | 47.2% |
| Mild depression | 45.4% |
| Feelings of worthlessness or invisibility | 45.0% |
| Persistent anxiety | 42.7% |
| Not wanting to work | 36.8% |
| Feeling inadequate sexually | 30.2% |
| Loneliness | 27.7% |
| Desire for separation or divorce | 15.2% |
| Severe depression | 8.8% |
Of 1,440 respondents, 66.8% (n=962) reported a noticeable deterioration in gut health compared to before menopausal symptoms began. Among those 962 women, 956 provided detail on specific gut symptoms. Gut symptom burden was high: the mean number of distinct gut symptoms was 3.4 per reporter, with 44.4% experiencing four or more concurrently. See Figure 4.
| Gut symptom | % of gut reporters (n=956) | n |
|---|---|---|
| Bloating | 73.3% | 701 |
| Excessive wind or gas | 57.2% | 547 |
| Constipation / incomplete evacuation | 54.3% | 519 |
| Acid reflux | 42.6% | 407 |
| Diarrhoea | 33.6% | 321 |
| Changes in urine smell or colour | 28.9% | 276 |
| Changes in stool odour | 23.8% | 228 |
Of 1,256 respondents who answered the onset question, 58.1% (n=730) first noticed gut changes during peri-menopause, 34.6% (n=434) during menopause, and 7.3% (n=92) post-menopause. This indicates that gut disruption typically begins early in the menopausal transition, often before formal menopause is established.
Gut symptoms were predominantly persistent rather than episodic. Among those experiencing bloating, 77.1% reported it daily or near-daily; 78.0% of those with excessive wind experienced it daily or on most days. See Figure 5 for the full frequency profile.
| Gut symptom | Every day | Most days | Daily or near-daily (combined) |
|---|---|---|---|
| Bloating | 28.9% | 48.2% | 77.1% |
| Excessive wind or gas | — | — | 78.0% |
| Acid reflux | 21.5% | 27.8% | 49.3% |
| Constipation | 13.8% | 41.7% | 55.5% |
| Diarrhoea | — | — | 37.2% (occasional majority) |
Among 1,278 respondents who addressed the impact of gut health changes, 79.3% reported at least one psychosocial consequence. The most common were weight gain (41.4%, n=529), poor sleep (40.1%, n=512), fatigue (37.2%, n=475), anxiety or stress (37.1%, n=474), lower confidence (35.4%, n=453), desire to be less active (32.2%, n=412), lack of libido (22.4%, n=286), and vaginal discomfort (13.8%, n=177).
81.6% of 1,378 respondents had modified their diet in an attempt to manage menopausal symptoms. The most commonly adopted changes were increasing plants and vegetables (57.7%), reducing or avoiding alcohol (52.2%), increasing fibre intake (46.9%), and increasing protein (41.6%). However, overall effectiveness was modest: only 10.7% rated dietary changes as very effective for gut health, 55.0% as somewhat effective, and 34.3% as not effective. The changes rated most effective were increasing plants and vegetables (28.7%), reducing alcohol (23.8%), and reducing dairy or gluten (22.7%).
Of 1,342 respondents, 69.4% had tried at least one gut-targeted supplement during menopause. Among rated users, Gut Works® achieved the strongest effectiveness profile. See Figure 6.
| Supplement / treatment | % tried | n | Very effective | Combined positive |
|---|---|---|---|---|
| Probiotic supplements | 37.9% | 509 | 11.6% | 64.3% |
| Gut Works® | 23.2% | 311 | 27.4% | 78.4% |
| Herbal remedies | 20.8% | 279 | 11.5% | 64.4% |
| Debloat & Detox® | 17.1% | 230 | — | — |
| Prescribed medication | 11.1% | 149 | 25.7% | 71.6% |
This large-scale survey of 1,526 women provides robust evidence that gut health disruption is a prevalent, persistent, and functionally significant consequence of the menopausal transition, affecting two-thirds of women. Gut symptoms typically emerge during peri-menopause, are often multiple and concurrent (mean 3.4 symptoms per reporter), and are predominantly daily or near-daily in frequency. They are associated with meaningful downstream psychosocial burden. Dietary modification, while widely adopted, provides only limited relief for most women. Among gut-targeted supplements, Gut Works® demonstrated the strongest effectiveness profile, with a combined positive rating of 78.4% and a very-effective rate of 27.4% - substantially ahead of probiotic supplements and herbal remedies. These findings argue for the routine inclusion of gut health assessment in menopause management and support further research into targeted nutritional interventions for this population.
Keywords: menopause, perimenopause, gut health, gastrointestinal symptoms, bloating, constipation, acid reflux, psychosocial impact, dietary intervention, women’s health
Survey date: January 2024 | Sample size: N = 1,526 | Data: Individual-level responses
Media enquiries: Please contact [email protected]
Your shopping basket is empty. Need some help?
Our Virtual Nutritionist is here to assist you.
Subtotal
£0.00
Shipping and taxes calculated at checkout.
