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The 'Pause
The menopause podcast with unfiltered conversations about the symptoms you hate, the changes you didn’t see coming, and the hilarious moments midlife can bring. You've got questions and we've got the experts to answer them.
The 'Pause
The Menobelly Mystery: Hydration and Hormones
Menopause transforms our hydration needs and digestive function, often leading to that frustrating "menobelly" bloat when hormone levels fluctuate. Understanding the connection between dehydration, electrolytes, and digestion is key to managing this common but rarely discussed symptom.
• Declining estrogen levels can reduce thirst signals, making intentional hydration necessary even when you don't feel thirsty
• Hormonal changes affect electrolyte balance, with increased sodium loss through urination and decreased absorption in the digestive system
• Sipping water throughout the day is more effective than occasional chugging for maintaining hydration without disrupting sleep
• Consider starting the day with natural electrolyte drinks containing ingredients like coconut water, lemon and high-quality salt
• Estrogen plays a critical role in gut health, with receptors throughout the digestive system affecting microbiome diversity
• Incorporating probiotics (yogurt, kefir, tempeh, kombucha) and prebiotics helps restore gut balance
• Gradually increase fiber intake to avoid worsening bloating - aim for 25-30 grams daily with about 10 grams from soluble sources
• Soluble fiber supplements can provide 4-8 extra grams daily while supporting cholesterol management and digestive health
Join our Facebook group, the Pause Diaries, where I'll share a recipe for an electrolyte drink that you can start your morning with. Remember, this is not the end of anything - it's the beginning of the rest of your life, and we are going to talk about it.
Welcome to the Pause, the menopause podcast, with unfiltered conversations about the symptoms you hate, the changes you didn't see coming and the hilarious moments midlife can bring. I'm your host, val Leggo, and I've been a dedicated health reporter for 25 years and I wanted to normalize something that every woman goes through menopause. So together we're going to talk about it the Perry, the Menno and the Post. Welcome to the Pause. So I woke up the other morning and I thought, oh, I'm feeling really good. I looked in the mirror. I was like, oh great, I'm going to the gym. It's really working. Things are really coming into play. I had a lot of positive energy going out the door. I thought, oh, this is awesome. And then by the time I got to the destination and then, by the time I got to my destination, my pants were tight. I went to the bathroom. I looked in the mirror and I was like where did that come from? I did not look like this when I left the house. Either that or I just have a magic mirror that makes me look good all the time, which I don't think I do. I seriously look six months pregnant, but unfortunately, my little bundle of joy is actually my meadow belly expanding and it contracts throughout the day and it drives me nuts and it really really wears on my confidence. Welcome to the midlife magic known as perimenopause and menopause, where your hormones go haywire and your body literally forgets how to do the basics like stay hydrated and digest a salad. So in this episode of the Pause, we are going to talk about dehydration and bloating, which lead to the menobelly. We'll explore how water, electrolytes, fiber and probiotics can help you feel less sluggish, less puffy and more like yourself again. I'm joined by certified menopause practitioner, nisha McKenzie and registered dietitian, Amy Bregagnini, who are going to shed a little bit more light on menobelly and dehydration. Hi ladies, good morning, good morning.
Speaker 1:So one of the reasons why I wanted to talk about this was because I was realizing that I was not drinking as much water as I usually did and I used to be really great at drinking water and I would get you know if, before I even got thirsty, I would carry water around with me and I noticed what I was doing was like I'm carrying my water bottle, I'm filling it up with my ice, like I like really cold water, and I'm carrying it around with me and like two hours later it weighs the same and I'm like I'm not drinking water, I'm literally just carrying this with me, like what is the problem? And so you know me, I love to research and dig and dive. It's like is there any kind of like relation to this? And I'd stumbled upon a little bit of research that talked about how, as you lose your estrogen in your body which, as we've talked about, can start as early as age 37. And definitely you've always said, nisha, if you're 40, you're in perimenopause. So, as you start losing that estrogen, you start losing many other things in your body, including these receptors that tell you that you're thirsty.
Speaker 1:Now I'm a little bit beyond 40. So, like, but this literally just happened to me in like the last six months, so wanted to talk about how this affects you, your menopause, your mental body, your perimenopause, all the symptoms you're going through. So, amy, if you could tell us, like what actually happens to your body. Like, what are the hydration signals doing during perimenopause and menopause? Like, can you, when you're lacking water? Is that all affecting this menobelly that we're getting?
Speaker 3:Yeah, I mean really when we have this is such an interesting time of life, right, menopause has so many changes that can happen and it's kind of hard to figure out what's causing what.
Speaker 3:But certainly, like you said, water and hydration is paramount for a lot of our body systems, especially our digestive systems. And when we have our hormones, when they become a little bit imbalanced, we, our bodies, become unable to regulate basically our electrolytes. We. We don't necessarily get the thirst signals and so unfortunately then we don't drink enough and then before we know it we are, we're dehydrated and then, coming with that, we have such a shift in electrolytes we, when our estrogen is low, it can lead to increased amount of our sodium being lost through our urination and then we also have a decreased absorption in electrolytes in our digestive system. So that's great news. It's just, it's just another reminder that we have to almost be. If women didn't need to work harder, we have to. We have to especially work harder to pay attention to. You know, even if it's not, we're not thirsty we almost have to make a plan to either watch the clock or keep a water bottle with you and almost take it on as far, as this is my job for the day.
Speaker 1:I have to totally agree with that, because I used to not have to even think about drinking water and it now has to be something I'm intentionally thinking about doing. You have thoughts on this, nisha? I see you shaking your head.
Speaker 2:I have actually had patients that'll tell me that they'll set a reminder on their watch. They're like I just don't get thirsty. So you know the breathe app and it'll just tell you to breathe. And sometimes we just blow right through, so they'll set something like that that goes off every once in a while, like sip, take a sip. Don't binge drink, right, but just take a sip multiple times throughout the day because we just don't get those thirst signals. And then, like Amy said, we're losing sodium with so many different ways, but also hot flashes and night sweats. We're sweating, so we're sweating more. There's so many ways that we get more dehydrated, even just mildly dehydrated.
Speaker 1:One of the things that I was also reading and, amy, I'm hoping you can shed some light on this is like are you supposed to sip your water instead of chug it? And it seems like such a minute thing to change. And some people are like, oh, I haven't drank a lot of water, I'm going to drink, you know, chug eight ounces right now, and then you know, instead of sipping it throughout the day, I mean, is there really a difference between that we don't have a lot of quote, scientific, studied research on it.
Speaker 3:However, when I think about it, if I think, ooh, I've got to make up for lost time and I'm filling my belly with two cups of water at a time, that's going to fill my belly and it might impact you know so many other things, especially, uh, my pants not necessarily fitting Right. So I mean, I'm of the mindset, like you said, um Val is to sip, you can. Now, that being said is, if you are already forgetting, you know you're already busy, you have so many balls to juggle, then definitely, you know, take as much water as you can. But I think again, like Nisha said, if you can somehow set reminders to be intentional about it in smaller amounts and increments all throughout the day, that seems like the best way to do it.
Speaker 2:Yeah, and I also think if we don't sip throughout the day, then by the time you know those receptors that are telling us to be thirsty, they're more sluggish, right? So by the time we get to the evening, now we're parched and we got cotton mouth and then we're chugging. Well, we're already up half the night with night sweats and peeing, and so now we're up more peeing because we just shoved a whole bunch of fluid into our system, especially in the evening.
Speaker 1:I'm like, oh, I didn't drink enough water and I know I need to stop by six o'clock at night if I want to sleep through the night, but I don't, and then I'm up all night long two or three times and I'm amazed at that.
Speaker 3:So yeah, I'm sorry to interrupt, but that's really well said as far as the importance, obviously, of getting enough water, but sleep I mean and I'm sure we'll talk more about this but certainly trying to up our chances of getting a decent night's sleep, because sleep is such an important part of everything. It can help regulate our weight and our mood and it can help with anxiety and all these things.
Speaker 1:So, yeah, I think, like you said, sipping throughout the day if you can is most important. Do women in perimenopause and menopause need more water? Do you need more than 80 ounces of water a day, or is that too much? Do you need 60? Like, is there a sweet spot?
Speaker 3:Well, so I did look this up.
Speaker 3:It's so funny how individualized our water needs are, and I know that every publication I read says drink your eight cups of water.
Speaker 3:But then I think, well, if I've got, you know a woman that's five foot in her sixties versus, uh, you know a woman that's 20, I, there's so many different, um, there's so many different calculations you can use to to figure out. So the first thing, uh, hashtag I'm going to plug registered dietitians here, but it would be, it would be a really good idea to sit down with the expert and to to calculate out, individual, individualize, how much water you need. But certainly, like you mentioned, with hot flashes, if you are shedding water in other ways, yes, your needs would go up. But the one thing that I did read is and this is the calculation we should be getting about 33 milliliters per kilogram per day. So if you want to do the math on that, you can, but I think, like I said, it's most important that you try to see an expert that can kind of tailor the recommendations to you specifically, and you talked a little bit about electrolytes and losing electrolytes.
Speaker 1:You know, through sweating and everything else, that we're doing throughout the day, and I've been reading a little bit about how you need to start the day with like, like an electrolyte water and I'm not talking about the sports drinks, like you don't want to do that but like a natural one. There is one where they you know they're using anything from like coconut water, lemon and sea salt. They're always talking about sea salt or the pink Himalayan what am I trying to say? Himalayan, himalayan salt and some lemon water and then some kind of like molasses or honey or the coconut oil. Are you in agreement with like starting that off first thing in the morning or what are your thoughts?
Speaker 3:Well, again, I don't think it's wrong at all. I think I would. I really. You know I'm kind of science-y, right, so I really like studies when it says that this amount of women that started with electrolytes versus this amount of women that didn't, there's a vast market improvement with the women that did so. But that being said, is I am a fan of, if we know this about our bodies in menopause and we're losing electrolytes and we're not drinking or eating maybe the appropriate things, and certainly starting the day with electrolytes, and it's finding something that you like the taste of and it's finding something that doesn't have a lot of added sugar, you know, because we just we need to get enough.
Speaker 2:And Amy, why would we not want to start with some of the sports drinks, you know, with those kinds of electrolytes?
Speaker 3:Yeah, so there's so many variables in different sports drinks. As far as I have, a lot of people that have the mindset of if a little is good, then more is better, and what then happens is they might be over consuming various electrolytes, which can cause shifts in all of our body systems. Also, I would want to you know again, being a nerd, I would want to look at the label of whatever is the sports drink and see, you know, just how much of individualized electrolytes are in each thing. Because, again, consumers, manufacturers, really like to sell their products and they like to kind of wow us with if you drink this, then you're going to be you know X, y, z. But sometimes the products themselves have just a ton of additives, preservatives, artificial colors, all those things, and it's better to, like Val said earlier, to try to go as natural as possible, if you can.
Speaker 1:So electrolytes and you're the expert here but sodium, potassium, magnesium, those are all part of those electrolytes then yes, absolutely, and it seems like they do play a really huge role in menopause. Like you know, if you're on an even keel with them, they're going to help with anxiety, they're going to help with your sleep, your brain fog, your dizziness, all that kind of stuff.
Speaker 3:Yeah, absolutely there. You know, there's some good research actually that says that various vitamins and trace elements can participate in the melatonin synthesis. So, speaking of sleep right and anxiety, so they include the magnesium, the B vitamins, folic acid, things like that. So again, it's just one of those things where, if we're paying attention to what the science is telling us and we can actually take that information and be you know and be prepared and try to kind of plan out these things during our day, get familiar with where these elements and these vitamins are in various foods you know and beverages, and make sure that you're planning ahead to make them a part of the day.
Speaker 2:Amy, I'm so lucky that I get to work with you in our practice and so I know how you work. But I wonder, so many people ask you and I both, what supplements do I take? And I know that you often try to encourage us to get it through our foods. So can you speak a little more on that? Like, what can we it through our foods? So can you speak a little more on that? Like, what can we get through our foods and what's reasonable in a normal American life that we could get through foods, versus what we should supplement because we're not getting through foods, because we're not really living off the land?
Speaker 3:right, that's so true, yeah, and that's, and that's true. You know that. That my mantra is and we know this. Basically, we, we absorb vitamins, minerals, nutrients much better and utilize the nutrients better if we can plan it ahead and get them through whole foods. That does not mean I'm anti-supplement by any means, but certainly it is better to try to put your energy behind trying to find whole foods to consume that will deliver what is beneficial for us.
Speaker 3:Now, if, um, because a lot of the women that I treat, I find that they are, they're busy, busy, busy people and they're not able to consume enough. So I'm never against a good um multivitamin, especially it's tailored for women. Um, I think you know it's again very individualized as far as what, um, how much is needed, and again, that's where a dietician can really analyze what your typical intake is like. And then what we can do is kind of see gaps, and holes and what nutrients might be missing. And truly, if an electrolyte replacement drink or coconut water or something like that is going to be beneficial, then we can make recommendations from there.
Speaker 1:And speaking about all of the foods and getting the right nutrients, I think that really is a nice segue to start talking about the menno belly, Because when we're not eating right or when we're off kilter man, I'm seriously you can look fine in the morning and 10 minutes later your pants don't fit, or you look six months pregnant, and it's amazing to me, like how fast that happens, and I'm like is it just me? No, it's everybody that's going through this. Well, I shouldn't say everybody, but most women that are going through this. So, gut health, you know you're talking about what we're taking in and that we want to really, you know, concentrate on eating the right foods. But, wow, how does your estrogen affect that digestion, though? How does your if you've got a lack of estrogen and you're trying to eat right? Sometimes it seems like nothing's working and you're still getting the menopause.
Speaker 3:Yeah, no, you're absolutely right. You know there's estrogen is such an important part of our lives and certainly it can really play a factor in helping the diversity of our microbes in our gut. And a lot of researchers feel that actually during menopause we have a decrease of diversity of our gut bacteria. It can be for a number of reasons, you know sleep, anxiety, not getting as much physical activity, certainly not consuming the right kinds of foods. So that is something that, if we have lower estrogen amount, it could play a role in just the right kinds of foods. So that is something that if we have lower estrogen amount, it could play a role in just the diversification of all the things that we need in our gut to help balance our systems.
Speaker 2:So, amy, do you recommend probiotics during menopause and perimenopause?
Speaker 3:I do 100% actually, probiotics and prebiotics, and when I say pro and prebiotics I just mean not necessarily from a supplement, you know what? Again, as I've said, with this up with different vitamins and minerals, you know it's most important if we can kind of focus on consuming the foods that are rich in these things because, again, we know we can utilize them better. But, yes, probiotics are something that, because of various reasons, we have a just we have a microbiome that tends to not flourish right. So if we can definitely try to put our energy behind number one, consuming more foods that are high in probiotics, that are considered probiotics so yogurt, kefir, tempeh, kombucha, that kind of thing that will further help to kind of improve the health of our guts, and prebiotics are actually the good little nutrients that actually feed the probiotics. So we're consuming foods that tend to be higher in prebiotics, which is, again, a variety of different fruits and vegetables. That's going to be the two. It's like a power punch that's going to be perfect for our digestive system.
Speaker 2:Oh my gosh. I never thought about the foods being probiotics and prebiotics. And I also have to say thank you for saying kefir oh my gosh.
Speaker 1:I was just going to say that I always call it the kefir I need some kefir.
Speaker 2:Oh, that's pronounced it.
Speaker 3:I had to look it up, ladies.
Speaker 2:I had to look it up. Did you use the little pronounce function on the on the google, I sure?
Speaker 3:did because I've had to be. I had to be on tv and I pronounced it like kefir and I'm one of my friends was like uh, I went to school with a guy named kefir, is that really?
Speaker 1:I mean, maybe it's like tomato, tomato oh my gosh, that's funny, that's really funny. So the other thing that a lot of women have a hard time with too and I think this relates back to the gut and estrogen is like you're either constipated or you're going all the time. Is that estrogen having a problem on that part of your gut as well?
Speaker 3:Yeah, really, when you think about it, if we have a reduction of estrogen, again we have a disruption of our microbiome and our microbes and certainly, if you don't have the right balance of the microbiota diversification in your gut, then you're going to, it's going to be.
Speaker 3:It's almost like you your body's confused all the time, it's like it doesn't really know how to properly break down the various foods that we're eating. Now, on the flip side, if you are spending time trying to intentionally increase the variability of our diet, even trying to choose different plant-based primarily foods, that's going to naturally just increase the bacteria in our gut and then you'll have more of an even flow right, you'll have the right bacteria that kind of knows which nutrients are coming its way and how to break it down and how not to break it down and produce a lot of fermentation and gas. So it's just it's a long road, it's not. That's why, again, I'm not anti-supplements when it comes to pre and probiotics by any means. I think there's just a lot of products out there that are now really focusing on soluble fiber and prebiotics. But if we can do it the natural way, that's kind of you know the ways to go.
Speaker 2:I love that, and I just want to add to that all that information, which is amazing, that we have estrogen and progesterone receptors all along our gut and our colon and our abdomen, and so I mean all of these hormones need good optimization, if we can.
Speaker 1:Yeah, that's a good point. Estrogen always gets all the flash.
Speaker 2:I know she gets all the attention.
Speaker 1:Poor progesterone and testosterone You're important too, friends, and so once you can figure all that out and add in the hydration, I think that's what's going to help with that mental belly, and maybe it's not going to take it completely away, but maybe it won't change from like this five minutes to that five minutes and you'll have to time out your day like whoa. I'm going to go meet my friends here. I hope my menopause doesn't join us. I hope my menopause doesn't join us Right.
Speaker 2:right Turns out. Your gut and your hormones are having this whole behind the scenes conversation.
Speaker 1:during perimenopause and menopause, you should make a movie like that, like they do for the what's the kids movie, with all the different characters Inside Out, yeah, inside Out. I love those movies.
Speaker 2:We could call it Inside In. I love it. What was the old movie with Dennis Quaid Interspace, innerspace, yeah yeah, we'll just put a camera down in there.
Speaker 1:Yes, and call it In Her Space In.
Speaker 2:Her Space. Yes, I love it.
Speaker 1:I do want to touch on one final thing, though, amy, about fiber, because I know fiber is super important and they're saying 25 to 30 grams, which is pretty standard for whether you're in perimenopause, menopause or not, but also just how you go about increasing that. You just can't go all in, oh my gosh.
Speaker 3:No, you're right, you're very right, it is so. Like I mentioned earlier, if a little is good, more is better. So now, when we're reading a lot of the publications about the importance of fiber importance of fiber get more, get more people want to go. I'm all in here and I'm going to go from eating maybe 10 grams of dietary fiber a day I'm going to shoot for 30. No, don't do that.
Speaker 3:We need to kind of slowly again, long road it implement little dietary changes that can slowly increase the amount of fiber in our diet, because if you go too big, too fast, you're going to have a lot of not desired symptoms like bloating, which again, we discussed. We don't want that. We want to just have you know, we don't want a lot of extra gas, we don't want a lot of switching between constant right, right, right. So you know, what I always tell people to do is get curious. Well, first see a dietician you've heard it but get curious about how much you're eating in a typical day and then aim to try to increase that number by a couple grams every day Because, again, if you find that well, I think I'm doing pretty good, I'm going to, just, you know, shoot for this amount, or if I should be getting 25, I'm going to go for 50.
Speaker 3:You know, that's that's not the balance that we really need. We need you to kind of slowly, incrementally increase. And I will say that because it manufacturers again, I'm not anti-supplement, not anti any of these like probiotic, prebiotic, sodas and things they're kind of making it a little bit easier if we want to choose different products other than fruits and vegetables and whole grains. That will help us increase, you know, the dietary fiber in our diet.
Speaker 1:Yeah, I use a little powder. I stick it in either a protein shake or, like my, oatmeal, or, and I mean it's only four grams, but if I do it twice a day it's an extra eight. And it's, it's. It helps so much because I just can't possibly eat that much fiber in food. I can't.
Speaker 3:Well, and Val, I think that's such a good point and it's funny because usually I'm I try to just be as level-headed as possible. I'm just going to try to increase the diversity of my diet. But I'm going to tell you right now I have read enough good research about the importance of getting enough soluble fiber, aka the powder that you mentioned that I've started adding the powders twice a day. Yes, and it's mainly for many reasons. Number one, that again our microbiome. Number two, cholesterol and our heart health. It can definitely help in so many ways, help naturally, assist with lowering cholesterol levels, which helps prevent heart disease. It can help us feel fuller longer, which can improve the satiety and might help us from over consuming. You know, it's just, it's never really a bad thing, unless with a caveat of if you have, you know, ulcerative colitis or you have some, you know, really kind of issues with your gut or your bowels, then obviously talk to your doctor first before you start adding anything like that. But I do, I think I'm on board with that for sure.
Speaker 2:You said soluble fiber, Amy. How do we know the difference between soluble and insoluble and how much of each we need and what they do for our bodies?
Speaker 3:I always think that when you think about soluble fiber, soluble fiber is kind of it's a little softer than the insoluble fiber. Insoluble fiber would be like if you ate bran or if you ate nuts and seeds They've actually traveled through our entire digestive system, whole right. Soluble fiber is more like if you say that I have a patient with a lot of loose stool right and say that you can picture a cup of water and you put some oats in the water. What did the oats do? Well, they actually kind of form a gel and they actually suck up some of the water. So what can happen is it can actually help with. It can help prevent and manage diarrhea, but also, because of the gel and the slickness of it, it can actually help you have bowel movements Right. So it's kind of. In my opinion, it's kind of a perfect fiber. But we need about 10 grams of soluble fiber a day. And again, the way that Val does it I think is wonderful. But just you know, oatmeal is just an excellent form of soluble fiber.
Speaker 1:I could see the like visually. I could really see what it was that you were talking about and I'm like all right, I got it. I do like oatmeal gets a bad rap because of so many that, because normally my cholesterol was really really good and I noticed it started to get up closer to the point where we don't want it to be and I was like, oh man, like I've always had great cholesterol, it's always been super low. It's what's going on here. So, knowing that the estrogen does that as well when you lose it, this has all been really great.
Speaker 1:We could talk forever on so many different things, but what we really want to do is make sure that we're managing our mellow, mellow belly and we are staying hydrated. That's the main thing. We want to stay hydrated, and then that will help with everything else when we're eating and we're trying to get rid of everything else. Amy, you've been awesome. You've got a wealth of information and I'm sure we're going to invite you back to talk more. So thanks so much for making some time for us today.
Speaker 1:Thank you, Amy.
Speaker 3:Oh, thank you guys so much. I love speaking with you.
Speaker 2:I learned tons today from you, me too.
Speaker 3:You guys are great.
Speaker 1:Well, until next time, join our Facebook group, the Pause Diaries. I'm going to share a recipe for an electrolyte drink there that you can start your morning with. I really like it, I've tried it, I use it, so let me know if it works for you. That's going to be on our Paws Diaries Facebook page, so be sure to join and remember this is not the end of anything. It is the beginning of the rest of your life and we are going to talk about it.
