Part 2 of the Women's Health Series

Your digestion suddenly feels different, your sleep is falling apart, your mood and patience are all over the place — and you start wondering whether it’s stress, aging, or something bigger. Joined by two extraordinary Mayo Clinic experts, Drs. Chrisandra Shufelt and Jami Kinnucan, we pull back the curtain on perimenopause and menopause, explaining how shifting estrogen and progesterone can ripple through the entire body — from constipation and bloating to metabolic health, cardiovascular risk, and even the gut microbiome. Most importantly, this episode reminds women that these changes are real, common, and worthy of attention.

• Defining perimenopause versus menopause as a life stage and why symptoms vary so much
• Linking estrogen and progesterone changes to motility, constipation, bloating, and visceral sensitivity
• Discussing microbiome shifts, dysbiosis, and how gut health may influence estrogen recycling
• Outlining cardiometabolic changes including central weight gain, lipid changes, blood pressure, and insulin resistance
• Clarifying brain fog, sleep disruption, and increased anxiety and depression risk during perimenopause
• Reviewing SSRIs and SNRIs as options that may also reduce hot flashes
• Covering bone loss timing, hormone therapy limits, and when DEXA scanning makes sense
• Summarizing what is known about IBS symptom severity and what is less clear in IBD
• Debunking hormone panels in perimenopause and pointing to menopause-trained clinicians
• Breaking down soy, supplements, placebo effects, and lifestyle factors like weight loss and exercise snacks
• Detailing vaginal estrogen for dryness, painful sex, and recurrent UTIs, including how to use it correctly

This episode has been sponsored by Ardelyx.

References for this episode:

The 2022 hormone therapy position statement of The North American Menopause Society

The association between metabolic dysfunction-associated steatotic liver disease diagnosis and vasomotor symptoms in midlife women

Impact of Menopause and Clinical Considerations in Patients With Inflammatory Bowel Disease

Understanding the sexual concerns of older women presenting for care to women's health clinics: a cross-sectional study

Find a Menopause Practitioner: Menopause.org

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Part 1 of the Women's Health Series

Endometriosis can show up like a gut disorder, and that confusion keeps many people stuck for years without answers. We map the overlap between endometriosis and IBS, explain what symptoms should raise suspicion, and share practical ways to build a care plan that supports both digestion and quality of life.

• Endometriosis prevalence, symptoms and why it is often missed
• IBS-like symptoms explained, including inflammation, adhesions, and visceral hypersensitivity
• Hallmark signs beyond pelvic pain, including heavy periods, pain with sex, and pain with urination
• Why diagnosis can be delayed and how updated guidance supports symptom-based evaluation plus imaging
• Fertility considerations, diminished ovarian reserve risk, and why early treatment can matter
• Low FODMAP as a short-term tool for GI symptoms, not a cure for endometriosis
• Mediterranean-style and anti-inflammatory eating patterns as a less restrictive foundation
• Stress, sleep, and gut-directed hypnotherapy as nervous-system support for pain and gut symptoms
• Gluten-free and dairy-free myths, plus why celiac screening matters before cutting gluten
• Supplement reality check, when to correct deficiencies, and why third-party testing matters
• The “dream team” approach, including medical doctor, dietitian, pelvic floor physical therapy and mental health support

This episode has been sponsored by Ardelyx.

References for this episode:

2023 narrative assessment on gluten and endometriosis

2025 meta-analysis on endometriosis and supplements

2023 UK survey dietitian support for endometriosis

Exploring the Nutrition‐Related Healthcare Experiences of Individuals With Endometriosis: Qualitative Interviews With Consumers and Dietitians

Rachelle’s delicious spaghetti & meatballs recipe

Find Rachelle Mallik on Instagram

Consumer Lab

You can also follow us on social media at the Gut Health Podcast, where we'd love for you to share your thoughts, questions, and experiences.

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Part 2 of the IBS-D Series

We sit down with GI dietitian Beth Rosen to talk about her lived experience with IBS-D, and how the absence of a clear diagnosis and effective treatment plan early on led to frustration and unnecessary food restriction.

With the right diagnosis and support, she was able to shift toward a clearer path, building a sustainable, flexible approach to eating and symptom management.

We share real-world strategies for identifying triggers, eating enough without panic, and using gut-brain tools so symptoms don’t run the show.

• Beth’s IBS-D origin story after C. diff and the missteps that delayed care
• Why “everything looks normal” needs context plus a plan
• Building an IBS story document to speed up appointments and strengthen self-advocacy
• Common IBS-D triggers and why broad food cuts can backfire
• Fructans, lactose, gluten, and the value of a targeted approach
• Coffee variables to consider including caffeine dose and acidity
• Digestive enzymes as practical support when appropriate
• Dining out tactics like menu scouting, calling ahead, and simple safe orders
• Travel and social scripts that protect privacy and reduce stress
• Beth's IBS toolbox picks: adequate + regular meals, targeted fiber, hydration, modified low FODMAP, gut-brain strategies
• Diaphragmatic breathing for urgency (Check out Dr. Riehl's video on diaphragmatic breathing, here.)

Other resources from our guest, Beth Rosen MS, RDN:

Hot off the press: Gut Goals - the book for IBS patients, by Beth Rosen!

The EDGI Training Project - the book and resources for practitioners on the intersection of ED and GI

Learn more about Beth: Beth Rosen's website

This episode has been sponsored by Salix Pharmaceuticals.

Don’t forget to subscribe, rate, and leave us a comment. You can also follow us on social media, instagram @theguthealthpodcast, where we’d love for you to share your thoughts, questions, and experiences.

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.