Woman's race/ethnicity and menopause status may partially determine the severity of GI symptoms

Reviewed by Emily Henderson, B.Sc.Dec 8 2021

Hormonal changes during the menopause transition have been shown to affect a woman's gastrointestinal (GI) functions with some unpleasant results such as nausea, bloating, and abdominal pain. A new study suggests that a woman's race/ethnicity and menopause status may partially determine the severity of these symptoms. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

With the menopause transition, the level of estrogen decreases and cortisol levels increase. This change initiates an increase in adrenalin, which leads to changes in digestive functions and a variety of digestive symptoms. For example, gas could build up with bloating. Foods could go through the GI tract without being fully broken down, resulting in constipation. Acid could break the mucous lining of the stomach wall, resulting in abdominal pain and/or indigestion. Other common GI problems include vomiting, diarrhea, loss of appetite, weight loss or gain, and heartburn.

Racial/ethnic variances in hormonal changes during the menopause transition have been reported, but very little is known about the association of race/ethnicity and menopause status to GI symptoms experienced during the menopause transition. A new study based on data from more than 1,000 women explored the possible associations of race/ethnicity and menopause status to GI symptoms experienced during the menopause transition while considering multiple other factors that could influence the symptoms. Based on study results, the researchers concluded that such an association did exist.

More specifically, the total number and total severity scores of GI symptoms were significantly different across premenopause, perimenopause, and postmenopause stages in all symptoms except weight loss. Premenopausal women had lower total number and total severity scores across all racial/ethnic groups.

Looking at racial/ethnic differences, the study demonstrated that the mean total severity scores of GI symptoms were significantly different among racial/ethnic groups. Asians, for example, had significantly lower total numbers and lower total severity scores of GI symptoms than other racial/ethnic groups. In contrast, non-Hispanic White women had higher total severity scores compared with other groups, especially in regard to nausea/vomiting, diarrhea, constipation, and loss of appetite. Hispanics were more likely to have higher severity scores for constipation, weight gain, and bloating, whereas non-Hispanic Blacks were more likely to have higher severity scores for weight loss. Among all symptoms, the highest severity score in all participants was for weight gain.

Study results are published in the article "Gastrointestinal symptoms in four major racial/ethnic groups of midlife women: race/ethnicity and menopausal status."

This study highlights significant associations between GI symptoms and menopause status, with postmenopausal women generally reporting a greater number of symptoms and more severe symptoms. It also shows important racial/ethnic differences in GI symptom reporting, similar to what has been shown with menopause symptoms. Additional study is needed to confirm these findings and to determine optimal management strategies for midlife women with new, bothersome GI symptoms."

Dr. Stephanie Faubion, NAMS medical director