Among the many symptoms associated with menopause are those that involve the gastrointestinal tract. One of the symptoms that affects some women is loose stools. Isn’t loose stools the same as diarrhea? No, and we’ll clear up that question along with a few other things you should know about loose stools and menopause.

What are loose stools?

Yes, there is a difference between loose stools and diarrhea. Basically, if you have diarrhea, your stools may be mushy, watery, or loose, and they will occur about three or more times a day. If, however, you experience loose stools only occasionally, you do not have diarrhea. Loose stools typically occur without accompanying symptoms, but occasionally there may be stomach discomfort or nausea.

Loose stools may be caused by food poisoning, infection, lactose intolerance, taking too much magnesium, consuming too much coffee, or spicy or greasy foods. They are also associated with celiac disease, hyperthyroidism, dumping syndrome (common after gastric or weight loss surgery), ulcerative colitis, Crohn’s disease, irritable bowel syndrome, and bile acid malabsorption.

How are loose stools associated with menopause?

As estrogen and progesterone levels decline beginning in perimenopause, your digestive system slows down. This means the time it takes for food to move through your system is greater, which can result in constipation and then loose stools or diarrhea.  

More indirectly, if you are experiencing stress as your body goes through the perimenopause and menopause phases, your cortisol levels can rise. Loose stools can occur in the presence of stress and anxiety. If you had irritable bowel syndrome before entering these transitional years, the occurrence of loose stools might increase or worsen.

Read about menopause and irritable bowel syndrome

How can you manage loose stools naturally?

If your loose stools seem to be related to the consumption of specific foods or beverages, you can eliminate each item from your diet for several weeks and then reintroduce each of them one at a time over a few weeks. If you develop loose stools after consuming any of the foods or beverages, you have identified the cause, and you can avoid the triggers. Other solutions include:

• Probiotics: These beneficial organisms repeatedly have been shown to aid with loose stools and diarrhea as well as help restore balance to the gut. In a 2022 meta-analysis that included 16 trials and 1,585 patients, the authors reported that probiotics could improve stool frequency and form and related irritable bowel syndrome symptoms. 
• Berberine: Research has shown this herbal remedy to be effective for managing loose stools and diarrhea either alone or when combined with probiotics, vitamin B, or montmorillonite (green clay powder). Take according to package directions or ask a knowledgeable professional.
• Bentonite/montmorillonite clay: This green clay powder has a long history of use for managing diarrhea and loose stools, as well as removing toxins from the body. A typical dose of bentonite clay for diarrhea is 1 teaspoon mixed in water no more than twice daily. 
• More fiber: Gradually increase the amount of fiber in your diet from vegetables, fruits, beans, nuts, popcorn, seeds, and brown rice. Including too much fiber in your diet too quickly can result in constipation. Aim for about 30 grams of fiber daily.

When to call your doctor

Loose stools are typically not serious. However, if you begin to experience chronic loose stools (diarrhea), severe and persistent stomach pain, bloody stools, high fever, severe dehydration, confusion, chills, or a fast heart rate, contact your doctor immediately.  

Bottom line

Loose stools in perimenopause and menopause are generally temporary but can be an inconvenience. You can help reduce or eliminate their occurrence by trying a few of the natural management tips described here.