TL;DR
Your gut is ground zero for mood, hormones, energy, immunity… basically everything.
In perimenopause and menopause, gut health takes a hit, and it shows up as bloat, fatigue, anxiety, skin changes, weight gain, and even acne.
The key to improving digestion in midlife is multifold – there are supplements you can take before you eat, and even exercise can improve gut health!
Think of your gut like a garden — and get the right gardener (probiotics), fertilizer (prebiotics), and soil conditions (diverse food, less stress) to keep it thriving.
WHY (Our Gut Changes In Perimenopause)
In midlife, your hormones dip, your stress rises, and your digestive system gets a little… sluggish.
Estrogen, progesterone, and testosterone all rely on your gut microbiome to break down and excrete them properly. When your gut is leaky or inflamed, it can reabsorb “used” hormones (hello, estrogen dominance), leading to mood swings, tender breasts, cravings, and brain fog.
Even just the regular foods we eat on a daily basis can start causing a lot of distention, bloating and gas.
WHAT You Can Do for a Better Belly
✔ ️ Start with a Spore-Based Probiotic: Unlike most probiotics that die in your stomach acid, spores are dormant in the capsule, wake up in your intestines, and actually change the gut landscape. Using a gardener analogy, they like to pull weeds (bad bacteria), and feed the good bacteria to bring balance back to your microbiome
✔️ Add Prebiotics (The Fertilizer): These feed your good bacteria — but only if they’re targeted. Some prebiotics feed the bad guys too, so choose carefully or go with a supplement like Just Thrive’s Prebiotic that only nourishes the good flora
✔️ Eat the Rainbow: Diversity of plant foods = diversity of microbes. More color, more fiber, more phytonutrients, more microbial magic. Here I tend to follow Dr. Terry Wahls advice where she recommends 9 servings of vegetables and fruit: 3 servings of green leaves, 3 servings of sulfur rich and 3 servings of bright colors.
✔ ️ Love Your Ferments (But Don’t Rely On Them): Sauerkraut, kimchi, kefir are all amazing. They support gut health, but keep in mind most bacteria in fermented foods die before reaching your colon.
✔️ Reduce Gut Stressors:
- Skip antibacterial sprays (they kill good bacteria too) and quit it with the hand sanitizers!!! Remember in the good ol’days when we used soap? That is the ideal way to clean your hands.
- Go organic when you can (to avoid glyphosate)
- Take walks, breathe, meditate — your stress hormones mess with your gut lining
Supplements That Support a Happy Gut
Once you’ve got your gut gardener (spore-based probiotic1) and your fertilizer (prebiotic) in place, there are other MVPs that can really help your gut thrive — especially if you’re in perimenopause or menopause and noticing more bloating, sluggish digestion, and food sensitivity.
1. Apple Cider Vinegar (ACV) Before Meals
A splash of raw, unfiltered ACV in water 15–20 minutes before meals can help:
- Stimulate stomach acid (which declines with age/hormone shifts)
- Improve protein digestion
- Reduce post-meal bloating
- Support blood sugar balance
➡️ Tip: Start with 1 tsp in warm water before meals, work up to 1 Tbsp if tolerated.
2. Digestive Enzymes
As we age (especially in midlife), we make less stomach acid and digestive enzymes which means even healthy meals can sit heavier than they once did.
Digestive enzyme blends help break down:
- Protein (protease)
- Fat (lipase)
- Carbs (amylase)
- Fiber (cellulase)
Look for broad-spectrum enzyme blends2, and take them before your first bite of food, if you can around 20 minutes prior to eating.
3. L-Glutamine
This amino acid is gut lining gold. It helps:
- Repair a “leaky gut”
- Calm inflammation
- Support regularity
➡️ Tip: Powdered glutamine is tasteless and easy to stir into water or smoothies. Dose: ~5g/day.
4. Collagen or Bone Broth
Both contain:
- Glycine and proline: key for gut lining integrity
- Gelatin: helpful for soothing inflammation
- Bonus: glowy skin + joint love
Choose grass-fed, unflavored options3, or sip on bone broth between meals.
5. Zinc + Vitamin A
Both support the regeneration of the gut lining and immune system. A deficiency in either can delay gut healing.
- Zinc carnosine is especially studied for gut lining repair
- Retinol (the active form of vitamin A) is gut-protective
6. Magnesium
Constipated? Magnesium can help “move things along” (gently).
➡️ Tip: Start low, go slow. Aim for 400mg daily to start. Especially if you have been under chronic stress for a long time.
🌾 Prebiotics: The Fertilizer for Your Gut Garden
If spore-based probiotics are the gardeners of your gut, then prebiotics are the fertilizer because they help feed and grow the good bugs that keep your digestion, mood, and hormones in balance.
Unlike probiotics (which are live bacteria), prebiotics are fibers and plant compounds your body doesn’t digest, but your good gut microbes love to munch on. When those good microbes eat, they produce short-chain fatty acids like butyrate, which help reduce inflammation, improve gut lining integrity, and even impact brain health.
| Food | Prebiotic Fiber Type | Benefits |
| Jerusalem Artichokes | Inulin, FOS | High in potassium + iron |
| Asparagus | Inulin | Supports detox + estrogen clearance |
| Garlic & Onions | Inulin, FOS | Antibacterial + anti-inflammatory |
| Leeks | Inulin | Great for digestion and estrogen metabolism |
| Bananas (especially green) | Resistant starch | Helps feed bifidobacteria |
| Oats (cooled overnight) | Beta-glucans + RS3 | Great for cholesterol + gut lining |
| Apples (with skin) | Pectin | Supports gut lining and regularity |
| Chicory Root | Inulin | Found in many fiber supplements |
| Dandelion Greens | Inulin | Liver and gut support |
| Flaxseeds & Chia Seeds | Mucilage + soluble fiber | Helps with elimination + estrogen excretion |
| Cooked + cooled potatoes | Resistant starch (RS3) | Enhances microbial diversity |
Supplement Alternative To Fibre
You can also add targeted prebiotic blends like Just Thrive’s Prebiotic, which uses precision oligosaccharides that only feed beneficial bacteria (not the “weeds”). This is especially useful if you're sensitive to FODMAPs or fiber-rich foods.
🏋️♀️ HOW Fitness Fits In
Movement is magic for your microbiome and especially in perimenopause, when digestion slows, hormones fluctuate, and stress can take over.
Here’s exactly how the right types of exercise improve gut health:
💩 1. Improves Motility (A.K.A. Helps You Poop)
Regular movement helps “massage” your intestines and keep things moving through your digestive tract. This means:
- Less bloating
- Fewer backup toxins
- More regular and satisfying BMs (💃)
Even just 15–20 minutes of walking after a meal can significantly reduce post-meal bloating and gas by helping move food through the system.
🌬️ 2. Lowers Gut-Damaging Stress Hormones
Chronic cortisol messes with your gut lining, leading to:
- Leaky gut
- Sluggish digestion
- Mood and sleep issues
Gentle movement like:
- Strength training
- Pilates
- Walking in nature
- Yoga or breathwork
…helps calm the nervous system, reduce cortisol, and support the gut-brain axis.
🦠 3. Increases Microbial Diversity
Moderate exercise has been shown to increase the number and diversity of good gut bugs, especially those that produce butyrate, a powerful anti-inflammatory short-chain fatty acid.
This is key for:
- Reducing belly fat
- Improving insulin sensitivity
- Calming gut-related inflammation
Too much cardio, though, especially when paired with under-eating or chronic stress, can have the opposite effect causing inflammation and damaging the gut lining.
💪 4. Enhances Nutrient Absorption
Muscle contractions improve blood flow to the gut which means your body can:
- Digest food more efficiently
- Absorb more nutrients
- Detox more effectively
It also improves lymphatic drainage, which helps remove waste and toxins from the body faster.
✅ NOW: 3 Easy Gut-Loving Steps Today
- Start a spore-based probiotic: Look for something like Just Thrive Probiotic (I love their gummies!)
- Eat 30+ plants a week: Aim for fruits, veggies, legumes, spices, herbs. More diversity = better microbial diversity.
- Ditch your chemical cleaners: Swap antibacterial sprays for vinegar + essential oil blends to protect your good gut flora.
WHAT I LOVE THIS WEEK
The Midlife Muscle Secret We've Been Ignoring Too Long
Can we talk about something that might surprise you? Creatine isn't just for gym bros – it's actually one of the most important supplements we midlife women should be considering.
Here's why you should start taking creatine NOW: after 40, we lose muscle mass rapidly, our brain energy tanks, and recovery becomes painfully slow. Creatine directly addresses all three. It fuels our muscles, supports cognitive function (hello, brain fog!), and helps us bounce back faster from workouts.
Create's creatine gummies make this so much easier than choking down chalky powders. Finally, a form that doesn't make you feel like you're drinking sand! The research is crystal clear – creatine helps preserve lean muscle, improves strength, and even supports mood stability during hormonal fluctuations.
Ladies, we've been missing out on one of the most researched, effective supplements available. Our muscles, our brains, and our energy levels deserve this support.
Get 20% off Create's Creatine Gummies with code DRSTEPHANIE at https://trycreate.co/DRSTEPHANIE.4
Why Your Achy Joints Aren't Just “Part of Getting Older”
Let me tell you about something that's quietly revolutionizing my recovery routine – and it's not another supplement or gadget. It's Incrediwear's bamboo charcoal-infused fabric that actually increases blood flow and reduces inflammation.
Here's why this matters for us: midlife brings achy joints, slower recovery, and that persistent stiffness we pretend isn't happening. Whether it's my knees protesting after workouts, my elbows aching from too much tennis, or my feet screaming after long days, these aren't just “getting older” issues – they're circulation and inflammation problems.
Incrediwear's socks, knee sleeves, and elbow supports work by increasing blood flow at the cellular level. No compression, no weird sensations – just better circulation that helps reduce pain and speed recovery. I wear their socks during travel and sleep, and honestly? The difference in how I feel the next day is remarkable.
Get 20% off Incrediwear with code DrSteph20 at https://incrediwear.com/.
The Real Reason You're Tired (And It's Not What You Think)
Ever wonder why that afternoon energy crash hits harder now, or why your skin looks tired despite expensive serums? The answer might be happening at the cellular level – specifically, in your mitochondria.
New research reveals that after 40, our cellular powerhouses start accumulating damage faster than our bodies can clear it out. This mitochondrial decline affects everything from energy and muscle strength to skin health and recovery time. But here's the fascinating part: there's a compound called urolithin A that can actually help activate our cells' natural cleanup process.
Most of us can't produce meaningful amounts of this compound naturally, even if we're eating pomegranates daily. The science behind why this happens – and what we can actually do about it – is pretty eye-opening.
Read the full article to discover how supporting your mitochondria could change how you age from the inside out.
🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!
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