Does evening primrose oil help with digestive changes during perimenopause?

Evening primrose oil is sometimes suggested for digestive symptoms during perimenopause, but the direct evidence is thin. Its anti-inflammatory properties give it a plausible biological rationale, though other approaches, particularly omega-3 fatty acids, have considerably stronger research behind them for gut health. Here is an honest look at what EPO may and may not do for your digestive system during this transition.

Digestive changes during perimenopause are more common than many women expect, and they are genuinely hormonal in origin. Fluctuating estrogen and progesterone affect gut motility, the speed at which food moves through the intestines, as well as the composition of gut bacteria, intestinal permeability, and how the gut responds to stress signals. Women often notice increased bloating, constipation or looser stools, acid reflux, or food sensitivities that seem to appear out of nowhere after years of digestive stability. These are real hormonal effects on the gut-brain axis, not imagined symptoms.

Evening primrose oil's active component is gamma-linolenic acid (GLA), an omega-6 fatty acid. The body converts GLA into dihomo-gamma-linolenic acid (DGLA), and then into prostaglandin E1, a compound with anti-inflammatory effects. This pathway competes with pro-inflammatory prostaglandins that can worsen gut inflammation, increase intestinal sensitivity, and contribute to cramping and discomfort. The theoretical benefit for digestive symptoms comes from this anti-inflammatory action on the gut lining and its effect on the balance of prostaglandins that regulate intestinal muscle contractions.

However, no controlled clinical trials have tested evening primrose oil specifically for perimenopausal digestive changes. The evidence here is largely indirect, drawn from EPO's anti-inflammatory properties in other contexts and from anecdotal reports. By contrast, omega-3 fatty acids from fish oil or algae have been more directly studied for inflammatory gut conditions and general gut health support. If digestive changes are your primary concern, a provider may be more likely to suggest omega-3s as a first step, with EPO as a potential complement if you are looking for additional anti-inflammatory support.

In EPO studies focused on perimenopausal symptoms more broadly, doses of 3,000 to 4,000 mg per day have been used, typically split across meals to reduce GI side effects like nausea or loose stools. Ironically, at higher doses, EPO itself can cause digestive upset in some people, so starting at a lower dose and increasing gradually over two to three weeks is sensible. Talk to your healthcare provider about the right dose for your situation.

Evening primrose oil may interact with blood thinners and anticoagulants. It may also lower the seizure threshold, so discuss with your provider if you take any seizure medications. If you take blood thinners, antidepressants, or any prescription medications, check with your provider before adding this supplement.

If you have or have had a hormone-sensitive condition such as breast cancer, endometriosis, or uterine fibroids, discuss evening primrose oil with your healthcare provider before using it.

Allow four to eight weeks for a fair assessment. Digestive symptoms can be slow to respond to supplement interventions, and many factors including diet, stress, hydration, and sleep affect the gut simultaneously. Keeping a simple food and symptom log alongside any supplement trial will help you see whether things are actually improving or whether another variable is responsible for the change.

Dietary approaches with stronger evidence for perimenopause-related digestive changes include increasing soluble fiber, reducing highly processed foods, staying well hydrated, and practicing stress management, since the gut-brain axis responds strongly to cortisol levels.

Probiotics are another option with more direct gut-focused evidence than EPO. The gut microbiome shifts during perimenopause partly because of estrogen's influence on microbial diversity, and some strains of probiotic bacteria have been studied for bloating, constipation, and gut transit time specifically. Combining a probiotic with EPO is generally safe, but again your provider can help you decide which approach to try first given your specific symptoms.

See your doctor if you experience significant rectal bleeding, unexplained weight loss, persistent abdominal pain, or a bowel pattern change lasting more than four weeks. These are symptoms that should be evaluated regardless of where you are in your perimenopause journey. Not all digestive changes during this life stage are hormonal, and some require investigation to rule out other conditions including irritable bowel syndrome, celiac disease, or inflammatory bowel disease.

The PeriPlan app (https://apps.apple.com/app/periplan/id6740066498) lets you log digestive changes daily so you can spot whether patterns shift over time, giving you clearer data to bring to your provider.

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