Bloating During the Menopause Transition: Observations from the Seattle Midline Women’s Health Study

OBJECTIVE: Across the lifespan, more women than men report abdominal bloating. However, little is known about bloating during the menopause transition (MT). The purpose of this study was to assess patterns of bloating severity during the MT in relation to age, reproductive aging stage, reproductive- and stress-related biomarkers, and stress-related perceptions in a longitudinal cohort study. METHODS: This analysis included 291 women from the Seattle Midlife Women's Health Study who provided health diary data and could be classified into reproductive aging stages. A subset of 131 women also provided urine samples, which were assayed for estrone glucuronide, follicle-stimulating hormone, testosterone, cortisol, norepinephrine, and epinephrine levels. Mixed-effects multilevel modeling was used to examine the relationship between bloating severity and age, reproductive aging stages, reproductive- and stress-related biomarkers, and stress-related perceptions. RESULTS: In the univariate model, the early MT stage, tension, and anxiety were associated with increased bloating severity, whereas the early postmenopausal stage and testosterone levels were associated with decreased bloating severity. In the multivariate model, both the early and late MT stages were related to an increase in bloating severity. Age and testosterone levels were associated with decreased bloating severity. Tension was related to increased bloating severity. CONCLUSIONS: Tension and anxiety may play a role in increased bloating severity, whereas testosterone levels and age are associated with decreased bloating severity. The MT stage may contribute to bloating through several mechanisms. More research is needed to fully elucidate these relationships.