There are many moments in a woman’s life when you say to yourself “do I have cancer, or is this menopause?”  This is one of them.

I’ve been pooping less. For a while I ignored it. I don’t feel particularly bloated, or gassy, but suddenly I realized that I could go a whole long weekend with no poop! A few years ago, when my periods were slowing down and all hell broke loose, I discovered that a fun side effect of the Magnesium I took to help me sleep, was improved and more regular first-thing-in-the-am bowel movements. All good, except that now, two years into proper menopause, the effect has worn off completely.

Hmmm. I started to worry and bought some prunes. Nothing. I had a colonoscopy. All clear. Ovarian cancer? Screened for that too. I turned to my mother’s old standby, Senna tea, and that helped, but do I want to be addicted to laxatives? I eat well, I exercise, I drink lots of water. What’s going on?!

The fact is that as we get older, both during perimenopause and menopause, our wildly fluctuating hormones cause us to dry up, both inside and outside. Faces, vaginas, intestines. It’s just true.

Why?

One of the many jobs estrogen performs in our body is to keep our cortisol levels low. When estrogen declines, cortisol levels rise (hello stress!), and this slows down our digestive system. Additionally, lower progesterone levels also cause our colons to get sluggish, and then it gets worse: the longer food waste hangs out in our colon, the dryer it gets, and that makes it harder to eliminate. Adding insult to injury, our weakening pelvic floor muscles can make it harder for us to go! It’s a nightmare!

Do I Have to Poop Every Day?

It turns out that while yes, pooping is one of the essential ways we eliminate toxins, each of us in unique in our pattern of frequency. According to my gastroenterologist, NYC based Dr Gil Weitzman, the once-a-day requirement is a myth. You should go at least three times a week, and some people go three times a day; we’re all different.

Fun Fact: Men Do It Differently

Because we have extra internal organs (uterus, ovaries) and wider pelvises, our colons are longer than men’s (10 cm on average) and hang a bit lower. Men also have more rigid abdominal walls, so they’re actually better able to push food more efficiently through the GI tract. Those bastards! So basically, women have it worse in this regard: food takes longer to go through our systems, making us more prone to bloating. Men are more regular. Is this news to you? Wink, wink.

I’ve decided to stop worrying. Dr. Weitzman tells me that a lot of women fall into this chronically constipated category. He wants me to up my Magnesium and take Senna as needed and I told him I’d report back in a few months. After surveying a few hundred of my closest online buddies, I also compiled this helpful list, because what I’ve learned is that lots of people try lots of things before they hit on the combination that works for them. (As always, please consult with a doctor if you’re suffering from constipation.)

Lastly, Water, Exercise, and the Porta-squatty, which a surprising number of my friends swear by…

If you want to learn more about pooping overall, we recommend this book:

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Nina Lorez Collins
Nina Lorez Collins a lifelong New Yorker, born there in 1969. She graduated from Barnard College in 1990 and got a Masters in Narrative Medicine from Columbia in 2013. She has four kids who are mostly launched, is the founder and author of WWVWD, and serves as a trustee on the board of the Brooklyn Public Library.