Does calcium help with bloating during perimenopause?

Calcium's relationship to bloating is genuinely complicated: in some forms it may cause or worsen bloating rather than relieve it, while in the right form and dose it may modestly help, particularly when bloating has a hormonal, cycle-linked pattern. Bloating during perimenopause is primarily driven by estrogen and progesterone fluctuations affecting gut motility, fluid retention, and the gut microbiome. Calcium does not directly address these hormonal drivers. However, calcium's role in nerve and muscle function in the gastrointestinal tract means that severe deficiency could theoretically affect gut motility. The bigger practical concern for many women is that the form of calcium they take may worsen bloating and digestive discomfort significantly.

The most relevant research for calcium and bloating comes from PMS studies. The landmark Thys-Jacobs randomized controlled trial found that women taking 1,200 mg of calcium carbonate per day reported reduced bloating compared to placebo over three menstrual cycles. A follow-up study in the American Journal of Obstetrics and Gynecology confirmed these findings, with bloating and water retention among the symptoms most improved. Because perimenopausal bloating often shares the same hormonal timing as PMS, this is modestly encouraging. However, these studies were conducted in premenopausal women with PMS, not in perimenopausal women specifically. What is also clear from gastrointestinal research is that calcium carbonate, the most commonly used and least expensive supplement form, frequently causes gas, constipation, and abdominal fullness as side effects. If you are already experiencing perimenopausal bloating and you add calcium carbonate in large doses, you may make the situation noticeably worse rather than better.

Perimenopause changes gut function in ways that make bloating a common and frustrating complaint, independent of any supplement. Estrogen and progesterone both have receptors throughout the gastrointestinal tract. As these hormones fluctuate unpredictably, gut motility can slow or become irregular, gut sensitivity increases, and the gut microbiome shifts in ways that affect fermentation and gas production. Many women find that bloating is worst in the luteal phase, when progesterone peaks and slows intestinal transit, producing a feeling of fullness and distension even without eating much. Estrogen surges around ovulation can cause fluid retention and gut hypersensitivity. The gut microbiome also shifts during perimenopause, with estrogen supporting greater microbial diversity and its decline favoring less beneficial compositions that may increase gas-producing bacteria.

If you decide to supplement with calcium, calcium citrate is strongly preferred over calcium carbonate for anyone with digestive concerns. Calcium citrate is absorbed without requiring stomach acid, is considerably less likely to cause constipation and gas, and can be taken with or without food. Studies support 500 to 600 mg of calcium citrate taken twice daily as an effective and well-tolerated approach for meeting calcium needs. Talk to your healthcare provider about the right dose for your situation. The total upper safe limit for calcium from all sources is approximately 2,500 mg per day. Account for calcium you get from food before adding a supplement. Dairy products, fortified plant milks, canned sardines and salmon with bones, edamame, and leafy greens provide calcium in a food matrix that is naturally easier on digestion and avoids the constipating effect of high-dose carbonate supplements.

Calcium and iron compete for absorption in the gut, so do not take calcium supplements at the same time as iron. Space them at least two hours apart. If you take acid-reducing medications such as proton pump inhibitors, calcium carbonate is especially poorly absorbed and citrate is a much better choice. There is also an ongoing cardiovascular debate around high-dose calcium supplements in postmenopausal women, with some research suggesting increased cardiovascular risk at very high supplement doses. Getting most of your calcium from food is a prudent approach while that debate continues. If you take prescription medications, check timing with your provider since calcium can reduce absorption of several drugs.

For digestive symptoms, switching from calcium carbonate to calcium citrate, if that is what you currently take, may produce noticeable improvement in constipation and gas-related bloating within one to two weeks. For the broader question of whether calcium reduces hormonally driven perimenopausal bloating, any benefit based on the PMS research would likely emerge over four to eight weeks. Given the limited evidence base and the population mismatch, calcium is unlikely to be a primary solution for perimenopause bloating if your diet is already adequate.

See a doctor if your bloating is severe, persistent without a clear hormonal pattern, or is accompanied by changes in bowel habits, unintentional weight loss, or any blood in stool. These features need evaluation to rule out irritable bowel syndrome, celiac disease, small intestinal bacterial overgrowth, or ovarian pathology, all of which can present or worsen during perimenopause. Bloating that feels like constant weight gain around the abdomen may also reflect fat redistribution rather than a gut symptom, which is a different conversation entirely.

Tracking your bloating alongside your cycle phase is one of the most useful things you can do. Note whether it worsens in the days before your period, around ovulation, or at specific dietary triggers. The PeriPlan app (https://apps.apple.com/app/periplan/id6740066498) lets you log digestive symptoms in the context of your cycle, which can help you and your provider identify whether the pattern is hormonal, dietary, or something else that needs further evaluation.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.