Welcome to Making Sense of Women's Health. I am Roberta Bass, the founder of Thrive and Shine Women's Wellness. Today we are going to be focusing on a topic that affects many women, particularly around midlife, and that is gut health and energy.

Even if you're not in midlife but you're struggling with your digestion or feeling low on energy, this episode will still be relevant because these are issues that can affect women at any age. You might be feeling sluggish, bloated or constantly tired and wondering if your digestion could be playing a part. So in this episode, I'm going to explain the gut–energy connection, why symptoms often show up or worsen during perimenopause, and what you can do to support your system naturally.

So let's start with, why might you be feeling fatigued, particularly in midlife? Well, there can be many contributing factors. Some of the most common can include hormonal changes, particularly during perimenopause, poor sleep quality or disrupted sleep patterns, chronic stress and mental load, nutrient deficiencies like iron, B12 or magnesium, underlying thyroid issues, low-grade inflammation, and digestive problems that interfere with energy production.

That last one, digestive problems, is what we're going to be focusing on today, because your gut could be the hidden cause of your fatigue.

So what has the gut got to do with energy? Well, your digestive system is more than just about breaking down food. It has major roles, particularly in nutrient absorption. And we need nutrients for energy production, hormone balance and brain function.

Did you know about 70% of our immune cells actually sit within the gut? So if our gut’s not happy, our immune system is going to be depleted. An imbalanced gut can also lead to chronic low-grade inflammation. There's also a gut–brain axis — meaning your digestive health directly impacts how you're feeling mentally. If your gut is struggling, your body has to work harder to extract energy, regulate mood and maintain balance — leaving you feeling drained.

So why are gut symptoms more common in midlife? Well, during perimenopause and beyond, hormonal changes can slow down gut motility, meaning things move more slowly through the system — and that can cause bloating and constipation. It can affect stomach acid and enzyme production, which means digestion becomes less efficient. It can cause new food sensitivities — many of my clients notice new intolerances to things like gluten or dairy that they were previously fine with. It can also disrupt the gut microbiome, which can have a knock-on effect on your immune system, inflammation and hormone balance.

And let’s not forget that chronic stress, disrupted sleep, restrictive diets throughout our lives all affect how the gut responds. So it’s no surprise that lots of women start to feel bloated, sluggish, or notice food sensitivities cropping up at this time of life.

Now I want to touch on the idea of “leaky gut,” which is also called increased intestinal permeability. Now leaky gut is still debated in mainstream medicine, but the idea is that the lining of the gut becomes more porous than it should be, and that allows undigested food particles or inflammatory molecules to pass into the bloodstream.

This could potentially trigger immune responses, low-grade inflammation and fatigue. And although the science is still emerging, many people report real improvements in symptoms when they support their gut barrier through diet and lifestyle changes.

Some of the symptoms linked to this can include fatigue, bloating, joint pain, food sensitivities, brain fog and skin issues like rashes or acne flare-ups. The potential causes of this are also wide-ranging. These can include chronic stress, poor diet (especially one high in processed foods), certain medications like NSAIDs, alcohol, gut infections, or dysbiosis — which means an imbalance of bacteria in the gut.

So what are the signs your gut might need a bit of support? Well, this can include bloating, fatigue after eating, constipation or sluggish bowels, loose stools or urgency, brain fog, especially after meals, sugar cravings, skin flare-ups or sensitivities. These may not be signs of anything serious, but they’re definitely signals from your body that your system isn’t functioning as well as it could be.

So how can you support your gut and improve your energy?

Firstly, eat slowly and chew thoroughly. This helps your digestion by allowing your saliva to start breaking down food, it gives your stomach and intestines less work to do, and it helps trigger that rest and digest response.

Include fermented foods if you tolerate them — things like yoghurt, kefir, sauerkraut and kombucha. These can help support a healthy microbiome and reduce inflammation.

Eat the rainbow — aim for a variety of fruits, vegetables, herbs, and whole grains to feed your gut bacteria. Research suggests that eating 30 different plant foods per week is ideal for gut diversity.

Stay hydrated. Water is essential for digestion and elimination, and can also help with energy and hormone balance.

Reduce ultra-processed foods and excess sugar. These can feed the unhelpful bacteria in your gut and increase inflammation.

Manage stress. Stress has a direct impact on gut health, so practices like breathing, walking, creative rest or journaling can make a big difference.

Establish regular mealtimes. Your gut has a natural rhythm and likes consistency, so try to eat at roughly the same times each day.

And of course, move your body. Walking, Pilates, and gentle exercise support digestion, reduce inflammation and improve energy — especially when done regularly.

Now, if digestive issues are part of your fatigue picture — or you’re just unsure where to start — I’m here to support you. There are lots of ways I can help, including:

Women’s Health Physiotherapy, especially if your digestion is affected by things like constipation, bloating, incontinence, prolapse, or abdominal tension.

Pilates and movement support to help get you moving again, gently and effectively.

Lifestyle support and habit changes tailored to your hormonal and digestive health.

Mind–body support with the CONTROL system if subconscious stress, anxiety or mental overload is affecting your digestion or energy.

You are not alone — and you don’t have to figure it out by yourself.

If you want support, you can visit my website at thriveandshinewomenswellness.co.uk to find out more.

Thanks for listening — and if you’ve missed any previous episodes of the podcast, have a look through the feed — you might find topics like sleep, movement, or menopause especially helpful.

See you next time.