How Menopause Changes Your Gut Health with a Leading Gastroenterologist

Trisha Pasricha (0:00)

Your gut is a brain. A lot of these diseases start in the gut years and years before that disease itself manifests.

Mary Claire Haver (0:07)

You have identified four colorectal red flags.

Trisha Pasricha (0:11)

The obvious ones is bleeding, abdominal pain, change in your bowel habits. And then the last thing is iron deficiency anemia, and this is a big one. It's not the stress causing the symptoms, it's the symptoms causing the stress. The key to why IBS is more common in women than in men is that estrogen plays a critical role in pain signaling from your gut. The interesting thing is that we can treat it though with pretty good accuracy.

Mary Claire Haver (0:45)

The views and opinions expressed on unPAUSED are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis or treatment.

I've heard this from a thousand women. Her gut has turned on her, bloated by the afternoon, constipated in a way she never used to be, and every doctor has told her the same thing. It's stress.

It's your age. It's in your head. For years, I didn't have a better answer. The gut was not in my training. When a woman in perimenopause told me that her digestion was falling apart, I filed it under stress, the way we file almost everything women bring to us. And then I found today's guest.

And she was saying, with the data to back it, that none of this was ever in our heads. Estrogen receptors sit inside the nervous system of your gut. When estrogen drops, your gut slows down and starts feeling pain it used to ignore. This is biological, not psychological. Dr. Trisha Pasricha is a physician scientist at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School. She writes the Ask a Doctor column for the Washington Post and is the author of the book, You've Been Pooping All Wrong. As a neuro gastroenterologist, she proved the gut is a second brain and documented that medicine dismissed these symptoms in women as hysteria for over 100 years. Today, we take that back. Let's get into it. I'm Dr. Mary Claire Haver, a board certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to unPAUSED, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.

Dr. Trisha Pasricha, welcome to unPAUSED.

Trisha Pasricha (2:56)

Thank you so much for having me. I'm so happy to be here.

Mary Claire Haver (2:59)

So those of you who are watching this on video, we are in a very unique location behind us. We are at the Aspen Ideas Festival and she was kind enough to agree. We're both speakers here to have this podcast opportunity with me. So I'm so happy to have you. I've followed you on social media for probably two-ish years. Love everything you're doing. Your book, can't wait to talk about it and dive in. But let's start talking about gut health. This is one of the most requested topics we have from our listeners and our followers.

What is a healthy gut? What does that even mean?

Trisha Pasricha (3:33)

Yeah. Oh, great question. Gut health is a term that is so fraught in some ways because I think traditionally, I've defined gut health as the absence of disease in academia, in medicine. I think we're learning that gut health is a lot more than just not having a disease at this point in time. Part of that is because we're learning that a lot of the diseases that don't even seem to be related to the gut, like Parkinson's disease, which is what I study. A lot of people think that's so odd, a gastroenterologist studying that. A lot of these diseases start in the gut years and years before that disease itself manifests, and it's just brewing quietly in the gut. A healthy gut to me and gut health means you are laying the foundation for longevity to prevent the disease from ever occurring in the first place. A lot of that has to do with diet and lifestyle and even things that we don't necessarily connect, again, to the gut, like stress management, for example, like hormones, all of these exciting things that I know we're going to talk about. Yeah.

Mary Claire Haver (4:30)

I learned zero about this in medical school and absolutely nothing in residency. We share your gastroenterology, I'm OB-GYN. Our areas are literally laying on top of each other.