Gut Health and Restrictive Eating in Perimenopause: When “Healing” Becomes Another Set of Rules
- Irina Pollastri
- 1 day ago
- 3 min read
Gut health has become a central part of the midlife wellbeing conversation, and with good reason. As oestrogen declines and the body ages, the gut microbiome tends to shift, often showing reduced diversity and changes in bacteria involved in hormone metabolism. These changes can contribute to symptoms like bloating, constipation, loose stools, increased food sensitivities and fluctuations in blood sugar and inflammation, all of which are uncomfortable when you are already navigating perimenopausal change.
It is completely understandable that many women turn towards gut-supportive approaches in an effort to feel better and regain a sense of balance. The difficulty is that, for some, “supporting the gut” quietly becomes another set of rules. Multiple food groups may be removed at once, long lists of “allowed” and “forbidden” foods appear, and complex rules form around timing, combinations or supplement routines.
For women who are already perfectionistic, anxious about their bodies or vulnerable to black-and-white thinking, these well-intentioned changes can slide into orthorexia or renewed restriction without anyone quite noticing. What begins as “I’m just supporting my gut” can gradually turn into a fear-based relationship with food and a shrinking social world, where spontaneity feels unsafe and eating with others is loaded with stress.
How this shows up in real life
In practice, these patterns can look very ordinary on the surface. A “menopause reset” might start as a low-sugar or low-carbohydrate plan to help with energy or bloating, but quickly becomes obsessing over every bite, constantly checking labels and avoiding social situations involving food in case there is nothing “safe” to eat. Strength training may be introduced for bone health, only to escalate into daily high-intensity exercise, training through illness or injury and feeling intense anxiety or guilt around rest days.
For others, a binge–restrict cycle takes hold. Several days of “being good” with very controlled eating are followed by evening or night-time eating that feels chaotic or compulsive, often driven by a mix of biological deprivation, emotional overwhelm and sheer exhaustion. The next morning, the response is usually renewed determination to tighten the rules, creating a loop that becomes harder and harder to step out of.
None of these patterns reflect a lack of motivation, insight or maturity. They are understandable responses to a body and brain under sustained pressure from hormonal fluctuations, sleep disruption, digestive discomfort and cumulative life stress. Perimenopause often sits alongside caring for ageing parents, supporting older children, juggling careers and navigating relationship or financial changes, so the drive to find something that feels controllable is very strong.
A more supportive lens
Recognising perimenopause as a biologically sensitive period for disordered eating allows women and clinicians to move away from blame and towards curiosity. Instead of asking, “Why can’t I just get this right?”, a more compassionate question is, “What is my body trying to cope with right now?” This shift opens the door to exploring underlying drivers rather than piling on more self-criticism or stricter regimes.
From a functional-nutrition perspective, the aim is to support gut health, hormones and blood sugar without undermining psychological safety. That means prioritising nourishment over restriction, flexibility over rigidity and sustainability over quick fixes. In practice, this might look like:
Building regular, balanced meals that keep blood sugar steadier, rather than experimenting with repeated elimination diets.
Gently adding supportive foods – for example different fibre sources or fermented foods, where tolerated – instead of cutting long lists of foods out at once.
Considering stress, sleep, movement and nervous-system regulation as part of gut support, rather than assuming food alone must carry all the weight.
This kind of joined‑up approach can create more space for healing, helping women move from self‑blame and rule‑following towards understanding, flexibility and genuine support in midlife.
If you would like support with your gut health and relationship with food, then book a free call with Irina today to see how we can help
