Toilet Talk - what to do about constipation in menopause.


It's not something many of us talk about, however, hormone changes in perimenopause and menopause affect our gut, causing amongst other things, constipation; the irregular passing of stools, difficulty passing stools, or the sensation of incomplete emptying. Constipation causes gases to build up as the gut gets full, sometimes resulting in bloating and abdominal pain. It may make you strain on the loo as stools get stuck, this sometimes has an impact on your pelvic floor, causing a risk of prolapse! It could also aggravate other menopause symptoms; fatigue, headaches, joint aches and mood swings. 

Let’s be honest, we all run a mile from talking about poo, yet it’s something we all do, ideally at least once a day! Strange bowel activity or lack of activity can indicate underlying health problems as well as make your menopause symptoms worse. 

We spoke to Women’s Health Physiotherapists, Christien Bird and Sophie Vohralik from The White Hart Clinic, about how to ease constipation, breaking another menopause taboo! They shared top tips on how we can pass the perfect poo.


Identify your stool!

Using the diagnostic Bristol Stool Chart (easily found online) check what type of stool you routinely pass. Stools are graded 1 to 7, from hard-to-pass, small lumps (indicating constipation & increasing the probability that you’ll be straining), to entirely liquid (not constipated), the ideal stool is a type 3-4, sausage-like and smooth. Now you know!

Answer the call!

Don’t ignore that urge. Sensitive nerves in the sphincter can tell what needs to come out, be it gas, liquid or a stool. Lots of us avoid going to the toilet when we’re out and about, preferring to wait until we’re at home, but Sophie says go when your body tells you!

Knees up!

Christien says our bodies are designed for us to squat behind a tree but when we sit on a toilet pan, we’re positioned too high so there’s no directional impact. In other words, stools can’t pass as they’re not at the right angle, causing us to strain more than we should. So, make sure your knees are about a foot apart and are higher than your abdomen so that stools can come out more easily and smoothly. Either rest your feet on a small step (there’s a range of squatting stools available from around £10 on Amazon), or try using two upright toilet rolls to support your feet. Wearing heels will have the same effect!

Bowels like a routine

Keeping stools in your bowel can cause constipation and stools can get stuck. The longer you hold a stool in, the more water it absorbs, the harder it becomes, the more sluggish it gets in the colon and the more difficult it is to pass. Find a time in the day that suits you and try to stick to this, your bowels will thank you.

Up your fibre

Fibre is a happy bowel’s friend. Eat a range of fibre, fruits, vegetables, nuts, wholegrains, seeds, beans. It’ll help deal with both constipation and diarrhoea.

Hydration to beat constipation

Fibre alone won’t help. Make sure you drink plenty of liquids to stay hydrated otherwise you’ll find stools become hard, dry and painful to pass. Remember to increase liquids if you’ve been sweating as you’ll need to top up liquid levels to stay hydrated. Some people find hot liquids in the morning, such as water and lemon, get the gut moving!

So, remember, don't push it, don't force it, it'll happen naturally, if you look after your gut health!

If you're sitting comfortably, watch us chatting to Christien and Sophie about doing the perfect poo. We've got even more advice from Christien and Sophie about prolapse and maintaining your pelvic floor in previous blogs.