Reflux in Menopause: A Gut Insight

As a nutritional therapist working within a natural health setting, I’ve spent years supporting clients with digestive health—so I never expected to find myself struggling with acid reflux. Yet during menopause, this has become part of my own journey.

Like many women at this stage of life, I’ve experienced noticeable changes in how my body responds to food. What began as subtle digestive shifts has developed into more persistent symptoms, including silent reflux. For me, this hasn’t always been classic heartburn, but rather a salty or sour taste in the mouth, a sensation of a lump in the throat (globus), frequent throat clearing, occasional coughing, dry mouth, and increased gas. At times, I also feel a mild burning sensation around my chest.

The Menopause–Gut Connection

Menopause is a time of significant hormonal change, and I’ve personally felt how deeply this can affect the gut. As oestrogen levels decline, the gut microbiome can shift, potentially increasing sensitivity to foods and contributing to imbalances such as dysbiosis.

I’ve recently come across The Menopause Gut by Cynthia Thurlow, which explores the relationship between menopause and gut health. While I haven’t had the chance to read it yet, it highlights how important this connection is and reflects what many of us are beginning to experience and question. 

Rethinking Acid Reflux

One of the biggest shifts in my understanding—and something I often discuss with clients—is that reflux isn’t always about too much stomach acid. In my case, and in many others, it may actually be linked to too little.

Low stomach acid can impair digestion, particularly of proteins, allowing bacteria to thrive where they shouldn’t. As these bacteria ferment undigested carbohydrates, they produce gas, increasing pressure in the stomach. This pressure can force open the lower oesophageal sphincter (LES), allowing stomach contents to move upward and trigger reflux symptoms.

Possible Drivers Behind My Symptoms

Through both personal experience and clinical insight, I’ve been exploring several possible contributors to GERD during menopause:

• Helicobacter pylori: A bacterial infection that can disrupt stomach acid production and increase inflammation. If symptoms persist, testing is worth considering.

  
  

• SIBO (Small Intestinal Bacterial Overgrowth): When bacteria migrate into the small intestine, they ferment food and produce gas, increasing pressure on the LES.

  
  

• Reduced gut motility: Something I’ve personally noticed—food sitting longer in the stomach, contributing to that uncomfortable pressure and reflux.

  
  

• The vagus nerve: This key nerve regulates digestion, including stomach acid and gut movement. When irritated—by reflux or stress—it can further disrupt digestive function.

  
  

• Stress: A major factor in modern life, and one I’ve had to consciously manage. Stress alone can significantly worsen reflux symptoms.

What Has Been Supporting Me

Managing these symptoms has required a gentle, consistent, and realistic approach. Rather than searching for a quick fix, I’ve been focusing on supporting digestion and restoring balance in sustainable ways.

Some of the practices that have helped me include:

• Supporting digestion with 1 tablespoon of apple cider vinegar in a little warm water before meals.

• Choosing nourishing, easy-to-digest foods such as asparagus, courgette, fennel, green beans, berries, and melon.

• Increasing fibre intake with oats, brown rice, sweet potatoes, and seasonal vegetables.

• Eating smaller meals to reduce digestive pressure and discomfort.

• Including fermented foods daily — particularly milk kefir — to support the gut microbiome and digestive resilience.

A Simple Exercise That May Help

I’ve also come across a helpful exercise designed to support the function of the lower oesophageal sphincter, shared by Nirabi Jacobi. You can watch it here.

It’s a simple, practical tool that may complement dietary and lifestyle changes.

Why Fermented Foods Matter

Fermented foods have been part of traditional cultures for generations, yet many of us have lost touch with their everyday healing potential.

Foods such as kefir, sauerkraut, kimchi, and fermented vegetables contain beneficial bacteria that may help support the gut microbiome, digestion, immunity, and even mood. During menopause — when hormonal shifts can affect digestion, inflammation, and the balance of gut bacteria — these foods can offer gentle but powerful support. I’ve personally noticed that when I consistently include fermented foods in my diet, my digestion feels calmer, lighter, and more resilient.

What I love most about fermentation is that it reconnects us to slower, more natural ways of preparing food. It’s simple, practical, nourishing, and deeply rooted in community and tradition. Even small, regular servings can make a meaningful difference: a glass of milk kefir with breakfast, a spoonful of sauerkraut alongside lunch, or a few forkfuls of fermented vegetables at dinner. These steady, everyday practices help cultivate microbial diversity and resilience in the gut — foundations that can be especially supportive through the transitions of perimenopause and menopause.

Final Thoughts

Going through menopause while experiencing reflux has been both humbling and insightful. It has reminded me that even with knowledge, our bodies can shift in ways that require us to adapt, listen more closely, and approach healing with patience.

If you’re navigating similar symptoms, you’re certainly not alone. Supporting the gut during menopause is rarely about quick fixes — it’s about understanding the deeper changes taking place and responding with care, nourishment, and consistency. If you’d like support with reflux, SIBO, gut health, or would like to join one of the upcoming fermentation workshops, feel free to reach out — I’d love to connect.

About the Author

Audrey is a nutritional therapist specializing in women’s health, fertility, gut health, and genitourinary wellness. Her approach combines the power of food as medicine with advanced functional diagnostic testing to uncover hidden imbalances that prevent the body from thriving with health and vitality. In June & July, she will be hosting a Fermentation Workshop at The Hague Natural Health Centre, see our events section for details and registration. To find out more about Audrey, please visit her website.