Does melatonin help with bloating during perimenopause?

Bloating is a genuinely frustrating symptom during perimenopause, driven largely by fluctuating estrogen and progesterone levels that affect fluid retention, gut motility, and the gut microbiome. The honest answer to whether melatonin helps with bloating is: the evidence is limited and mostly indirect. But the indirect pathways are worth understanding.

Melatonin is a hormone produced by the pineal gland that regulates your circadian rhythm, the internal timing system that governs sleep and wakefulness. During perimenopause, melatonin production falls alongside estrogen. Research by Toffol et al. (2014) documented lower melatonin levels in perimenopausal women and noted correlations with sleep disturbances. This is where the indirect connection to bloating begins.

Sleep deprivation and poor sleep quality affect cortisol regulation. When cortisol remains elevated due to fragmented sleep, the body tends to retain water more readily, which can contribute to that full, puffy, bloated feeling, particularly in the abdomen. By improving sleep quality and helping to normalize the sleep-wake cycle, melatonin may reduce the cortisol burden that worsens fluid retention and bloating. This is a plausible mechanism but has not been tested in clinical trials specifically targeting bloating in perimenopausal women.

There is also a more direct gut-related angle, though the evidence is modest. Melatonin receptors exist in the gastrointestinal tract, and melatonin is actually produced in significant quantities by enterochromaffin cells in the gut lining, separate from the pineal gland entirely. Animal research suggests melatonin has a role in modulating gut motility and protecting the intestinal lining from oxidative damage. Some small studies in irritable bowel syndrome have explored melatonin supplementation for gut symptoms, with mixed results. This research has not been replicated in perimenopausal populations specifically.

For bloating driven by the hormonal fluctuations of perimenopause itself, the more direct contributors are estrogen's effect on water retention and progesterone's effect on gut motility. When progesterone is low, the gut slows down, leading to gas accumulation and constipation-related bloating. Melatonin does not directly address either of these hormonal mechanisms.

Bellipanni et al. (2001) reported general improvements in wellbeing among perimenopausal women who took melatonin for six months, but gastrointestinal symptoms were not among the primary outcomes measured. Melatonin's antioxidant properties, reviewed by Rossignol and Frye (2011), may offer some systemic benefit by reducing inflammatory signaling, which can affect gut health, but this connection to bloating specifically remains speculative.

Research has examined doses of 0.3 to 3 mg taken at bedtime. Zhdanova et al. (2001) found that lower doses (around 0.3 mg) were as effective as higher doses for sleep in middle-aged women, and low doses are generally better tolerated. Talk to your healthcare provider about the right dose for your situation, particularly if you have other health conditions or take medications.

Safety considerations: melatonin is generally well tolerated for short-term use. Higher doses can cause next-day drowsiness. It may interact with blood thinners, immunosuppressants, and some diabetes medications. Women with autoimmune conditions should consult a provider before use.

For bloating specifically, the lifestyle interventions with the strongest evidence remain dietary changes (reducing highly fermentable foods, staying hydrated), regular movement, and stress reduction. If you are tracking your cycle phases and daily symptoms using PeriPlan, you may notice that bloating peaks at particular hormonal moments in your cycle, which can help you connect it to its root cause and target your approach accordingly.

When to see a doctor: Bloating that is persistent, worsening, accompanied by changes in bowel habits, blood in stool, unexplained weight loss, or significant abdominal pain should be evaluated promptly. These symptoms can indicate conditions that are unrelated to perimenopause and require proper medical investigation. Do not attribute persistent or severe bloating to hormones without ruling out other causes.

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