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Bloated belly? Why your hormones might be the secret cause

If you feel like there's an inflatable inner-tube wrapped around your belly, you're not alone. Here's what causes bloating and how to deal.
/ Source: TODAY Contributor

If you feel like there’s an inflatable inner-tube wrapped around your belly, you’re far from alone.

Bloating — that feeling of abdominal fullness that seems to be the bane of every woman — is a common misery.

One review published in International Scholarly Research Notices, Gastroenterology, noted 10-25 percent of healthy people experience bloating.

And bloating isn’t pretty: About half of those who experience it have a swollen abdominal that makes you look like you ingested an extra-large water balloon.

Women seem to suffer through the big, bad bloat more than men and part of that has to do with hormones. Here’s why:

Hormone hell

Women who are menstruating know all about the bloat. And, yes, “You can blame your hormones,” according to Dr. Carrie Smith, assistant professor of obstetrics and gynecology at Rush University Medical Center in Chicago. “Before menopause, for most women, bloating generally is a monthly occurrence, and follows a pattern.”

That’s because the part of the menstrual cycle you can bloat-blame is the so-called luteal phase, which begins right after ovulation and lasts for about two weeks.

It’s during this time that the uterine lining starts to prepare for a possible pregnancy. At the beginning of the luteal phase, the hormone estrogen takes a bit of a nose-dive and then begins to rise and remains high. Progesterone also kicks in.

This hormonal upheaval can play havoc with the digestive tract, according to Dr. Holly Thacker, director of the Cleveland Clinic Center for Specialized Women’s Health.

“When estrogen is high, women seem to retain more water,” said Thacker. That water retention equals bloat.

The role of our sex hormones and gastrointestinal upsets like bloating are well documented, but still somewhat poorly understood, Thacker explained.

Some of the effects of progesterone — when it’s high, like during the luteal phase of menstruation, right after ovulation — include what doctors call delayed GI transit time, which means exactly what you think it does: food moves more slowly through your intestine, resulting in constipation and bloating.

However, when progesterone decreases and bleeding begins, you may experience an increase in bowel activity. That means some women may get diarrhea and bloating.

It seems you just can’t win.

Bloating through the ages

But bloating is not only for the young — peri-menopausal and menopausal women experience the scourge, too.

Too add insult to injury, pregnant women also bloat, and we’re not talking the baby bump.

When women reach peri-menopause, generally in the mid-forties, estrogen begins to fluctuate. The result: water retention, gas, bloating.

During peri-menopause and menopause, lower estrogen levels result in decreased levels of bile, a substance which keeps the intestines lubricated, explains Dr. Lori Tishler, medical director for the Phyllis Jen Center for Primary Care at Brigham and Women’s Hospital.

“Less lubrication means harder and drier stools, which leads to constipation and, then bloating,” she said. Less bile also means more flatulence.

Good times!

Pregnancy and bloating

It's also common, and again blame your hormones.

“There are higher levels of progesterone and your intestine slows down,” she said. “Basically, slower contractions mean potential constipation, gas, and bloat.”

The good news

Most of the time, bloating is nothing much to worry about — though it can be miserable.

“Many women worry that something really bad is going on, and part of our job as doctors is to reassure them that sometimes bloating is really nothing more than just bloating,” said Tishler. “But we all know it’s not much fun.”

She often suggests increasing fiber to help stool move through sluggish intestines, more hydration and exercise. “That’s all the stuff that people don’t want to hear, but it does work,” she explained.

Another trick: Up your magnesium, advised Thacker. Magnesium-rich foods include spinach, peas, almonds, fish, avocados and whole grains, among others. Always remember to talk to your doctor first if you choose to take a supplement.

If bloating is new

If you have any concerns about bloating, or if it's new, doctors urge you to get checked out. Bloating may be due to irritable bowel syndrome, a very common gut problem that causes various symptoms like cramping, diarrhea and/or constipation, bloating and gas. Or it could be due to lactose intolerance.

Eating too quickly, drinking through a straw or chewing gum can also contribute to belly bloat.

But bloating can also be a sign of more serious problems including certain cancers, like ovarian cancer, liver disease, inflammatory bowel disease and a bowel obstruction, among others.

“If you have any concerns or bloating is of a new onset, it’s very important to get to your doctor, especially as you age when risks of certain cancers are higher,” said Tishler.