Constipation is a silent struggle for many women, often endured rather than addressed. While it might seem like a minor annoyance, its impact can ripple through our lives, affecting everything from our mood and energy levels to the clarity of our skin, the quality of our sleep, and our overall sense of wellbeing. It’s frequently dismissed as a simple matter of not drinking enough water or failing to consume sufficient fibre. However, as clinical naturopath and founder of SolBiome, Emily Carlstrom, points out, achieving gut regularity is a far more nuanced process than just keeping track of your daily fluid intake.
“Constipation isn’t always about infrequent trips to the toilet,” Emily explains. “More often than not, people are experiencing bowel movements, but they can be characterised by stools that are difficult and uncomfortable to pass, or a persistent feeling of incomplete evacuation.”
In her practice, Emily encounters women of all ages who have come to accept their digestive symptoms as normal, or as an unavoidable part of life. The good news is that for the majority, there are practical, evidence-based strategies to support gut regularity, offering a sustainable alternative to long-term reliance on laxatives.
Defining “Normal” Bowel Habits
One of the most pervasive misconceptions surrounding constipation is the definition of a “normal” bowel movement frequency. While research suggests that healthy bowel habits can range anywhere from three times a day to three times a week, this doesn’t always align with how individuals feel.
“Clinically and in everyday life, most women feel their best when they are having a bowel movement at least once a day,” says Emily. “It feels effortless, and they experience a sense of complete evacuation. It shouldn’t be something that occupies a significant amount of their mental energy.”
Certain signs can indicate that constipation may be an issue, including straining during bowel movements, passing hard stools, feeling as though the bowel hasn’t emptied completely, infrequent bowel movements (only every few days), or a reliance on stimulants like coffee, supplements, or laxatives to achieve regularity.
Overlooked Contributors to Constipation
While hydration and fibre are undoubtedly important, Emily highlights that they often don’t tell the whole story.
“A significant factor I observe in my clinic is the impact of stress, imbalances in the gut microbiome, hormonal fluctuations throughout different life stages, and compromised gut motility – essentially, the gut not moving efficiently,” she elaborates.
Furthermore, many women may unknowingly be undereating, skipping meals, or not consuming enough healthy fats, all of which are crucial for forming healthy stools. Another common pitfall is habitually ignoring the urge to have a bowel movement.
“If you’re constantly suppressing that urge due to the demands of getting children ready or rushing out the door, you can inadvertently retrain your bowel to become less responsive,” Emily warns.
Stress, in particular, exerts a profound influence on digestion. “When the body is perpetually in a ‘fight or flight’ state, digestion effectively shuts down. Blood flow to the gut is reduced, leading to slower bowel movements,” she explains.
Travel can also be a trigger for constipation in many women. “Changes in routine, sleep patterns, increased stress, diet, and hydration can all play a role,” Emily notes. “Often, when we travel, we are the primary organisers of everything, which adds to the stress load.” Embarrassment can also lead women to ignore urges or avoid using unfamiliar bathrooms, further contributing to digestive slowdown. Maintaining adequate hydration, regular movement, and consistent meal times while travelling can help minimise these disruptions.
The Influence of Hormones on Gut Health
The ebb and flow of hormones throughout a woman’s life can significantly impact gut regularity. During pregnancy, the surge in progesterone causes a relaxation of smooth muscles, including those in the bowel, which can lead to a noticeable slowdown in digestive transit.
“Things can really decelerate,” Emily observes. Iron supplements, commonly prescribed during pregnancy, are another significant contributor. “Certain forms of iron are considerably harsher on the gut than others, and I frequently identify iron supplements as a major culprit behind constipation.”
Perimenopause and menopause can also introduce unpredictability to bowel habits. “During perimenopause, fluctuating hormone levels can make bowel movements quite erratic,” she explains. “Following menopause, declining oestrogen levels can slow down digestion, even in women who have historically experienced consistent regularity.” The crucial takeaway is that while these hormonal shifts are common, they don’t necessitate a lifetime of discomfort.
The Case for Probiotics
Probiotics are often associated with alleviating bloating or boosting immunity, but their vital role in supporting regular bowel movements is frequently underestimated.
“Each probiotic strain has a unique function within the gut,” Emily clarifies. “Strain specificity is paramount, and it’s essential to choose a strain that has been substantiated by human clinical research for its efficacy in addressing constipation, at the therapeutic dosage used in that research.”
Emily specifically highlights Lactobacillus plantarum 299v, a strain that clinical studies have indicated can reduce Irritable Bowel Syndrome (IBS) symptoms, including constipation, in the majority of participants within four weeks.
“Probiotics can be incredibly beneficial for promoting regular bowel movements by enhancing gut motility, improving stool consistency, and helping to calm low-grade inflammation,” she states. “However, the effectiveness hinges entirely on the specific strain.” Rather than selecting the first probiotic encountered on a pharmacy shelf, Emily strongly recommends consulting with a healthcare professional, such as a General Practitioner, dietitian, or naturopath. “This informed conversation can make a substantial difference compared to simply making a random choice.”
When initiating a probiotic regimen, patience is key. “While some strains can yield results in as little as four weeks, others may take up to 12 weeks to demonstrate their full benefits,” Emily explains. “I generally advise a minimum of three months of daily use to experience the complete spectrum of benefits, as these beneficial bacteria are working to repair the gut barrier, a process that requires time.”
Can You Overdo Fibre?
The short answer is yes. While fibre is indispensable for gut health, an excessive intake isn’t always beneficial.
“If you’re experiencing issues with gut motility or have a microbiome imbalance, simply increasing your fibre intake can paradoxically exacerbate bloating and constipation,” Emily cautions. For fibre to function optimally, it requires adequate hydration, physical activity, and a healthy gut bacteria profile. Her recommendation is to gradually increase fibre intake and prioritise diversity over sheer quantity. “Consuming a wide array of different plant-based foods nourishes a diverse range of microbes within your gut microbiome, fostering a healthier and more resilient gut environment.”
Daily Habits for Lasting Regularity
Simple adjustments to daily habits can yield significant improvements in gut regularity, with consistency being the cornerstone. Eating meals at regular intervals helps to regulate the digestive system, as does consciously calming the nervous system before meals. “Even something as straightforward as taking three deep, diaphragmatic breaths before eating can help transition your body from a ‘fight or flight’ state,” Emily suggests.
Physical activity is also crucial, as is mindful snacking. Constant grazing can disrupt a vital digestive process known as the migrating motor complex.
“Think of it as a housekeeping system for your gut,” Emily explains. “It’s responsible for moving undigested food and bacteria through the digestive tract, but it only operates during periods of fasting. If you’re continuously snacking, this essential clean-up process is impeded, which can lead to sluggish transit times and constipation.” Allowing a minimum three-hour gap between meals can facilitate this natural cleansing mechanism.
Foods for Prompt Relief
For those seeking food-based solutions before resorting to laxatives, Emily offers several evidence-backed recommendations.
“My primary recommendation is to consume two kiwifruits daily, ideally in the evening, and to eat them with the skin on if possible,” she advises. “Studies have shown that kiwifruits can improve constipation and may also contribute to better sleep.”
Ground flaxseeds are another dietary staple. “Two tablespoons daily add bulk to stools and help stimulate bowel movements. They are also an excellent plant-based source of omega-3 fatty acids.”
Chia seeds can also be beneficial, but their preparation is critical. “They must be soaked, either in water or as a chia pudding,” Emily stresses. “Consuming raw chia seeds can actually worsen constipation as they absorb water from the bowel.”
When combined with adequate fluid intake, daily movement, and consistent habits, many women experience noticeable improvements within days to weeks.
When Constipation Signals a Red Flag
While constipation is a common ailment, there are instances where it warrants medical attention from a General Practitioner.
“If the onset is new, sudden, or if the constipation is progressively worsening over time, it’s important to take it seriously,” Emily states.
A family history of bowel cancer, or the presence of symptoms such as blood in the stool, persistent severe abdominal pain, vomiting, fever, unexplained weight loss, anaemia, or ongoing fatigue, all necessitate seeking professional medical advice.
