Far 2 Fabulous

The Gallbladder & Menopause: Why This “Forgotten” Organ Matters

• Julie Clark & Catherine Chapman • Episode 91

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Episode 91

Most of us don’t give the gallbladder a second thought — until it becomes a problem. But this small organ has a big role to play in women’s health, especially during perimenopause and menopause.

In this episode, I dive into the hidden connection between the gallbladder, bile flow, and hormone balance. You’ll learn why bile isn’t just for digestion, how sluggish clearance can fuel estrogen dominance, and the early warning signs your gallbladder may be struggling — before it becomes an emergency. I also unpack why gallbladder removal rates have skyrocketed in the UK, what life looks like after surgery, and, most importantly, how you can support gallbladder and liver health naturally.

If you’re navigating hormone changes in midlife, this episode will give you fresh insight into an organ that’s anything but irrelevant.

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Thank you for listening.

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For more information about Julie Clark Nutrition, click HERE
For more information about Catherine Chapman, click HERE

We look forward to you joining us on the next episode.

SPEAKER_00:

Welcome to Far Too Fabulous, posted by Julie and Catherine. Join us on a mission to embrace your fabulousness and read mine wellness. Get ready for some feistiness, inspiration, candy chat, and humour as we journey together towards empowered wellbeing. Let's dive in!

SPEAKER_01:

Hello, hello, and welcome to this week's episode of the Far Too Fabulous Podcast. Now it's just me today because yet again, me and Catherine have got busy schedules, and getting together is proving to be extremely difficult at times. But I would like to talk to you about an organ that is so often overlooked, dismissed as irrelevant, or simply cut out when there's a problem. The gallbladder. Now, if you're thinking, well, I don't need to know about the gallbladder, actually, if you're a female over a certain age, you need to know about this. I tell you why. So there are roughly 60 to 70,000 gallbladder removals each year, and the average age is 50 years old. And here's where it gets more interesting: two-thirds of those operations are done on women, and over the last two decades, there's been an 80% increase in these operations. So we've got to look at what's causing this. Now, there are things like ultra-processed foods are playing a role, the lack of fibre, because that's important for the bile. We will talk about that in a bit more detail later. Insulin resistance, metabolic disease, rise in obesity, and also the use of hormones. There is a massive link between hormones and the gallbladder, which is why two-thirds of those operations are done on women. So if you're thinking, well, I don't really need to worry about my gallbladder, the the here's the trick, you do need to you need to understand what your gallbladder is. And I think that I see a lot of clients in my clinic who've had gallbladder removed, and there isn't a lot of advice given to them afterwards, and it's just it's considered irrelevant. Oh, we're just if there's a problem with it, we'll just cut it out. So the gallbladder is not just about digesting fats, although obviously that is you know the function that we tend to think about, but it is a huge player in detoxification and hormone balance, especially estrogen, and that's why this matters so much for women in perimenopause and menopause. When hormones are shifting and we're getting and we're already dealing with these changes, we need to look at the gallbladder, what it does, how is it connected to estrogen? The signs that your gallbladder might be struggling before it becomes a crisis. Because the trouble is that when the gallbladder starts to become problematic, it can very quickly turn into an emergency situation, and then that gallbladder ends up being removed. So, what happens after the gallbladder is removed, and more importantly, what you can do to support this tiny but mighty organ. So it really is an important one to look at, I think, and often gets overlooked. So, well, let's start with the basics. What is your gallbladder? It is a small pear-shaped organ which is tucked under the liver, and its main role is to store and release bile. Now, the liver actually makes the bile, but the gallbladder times the release of bile into your small intestines when you eat. Now, the small intestines is the place where your nutrients get absorbed. So the bile in the small intestines will help break down fats, but will also absorb the essential fatty acids, really important for their anti-inflammatory role and more, and will also help you absorb the fat-soluble vitamins, which are A, D, E, and K. So, really, really important. And here's the piece that often gets ignored: the bile isn't just for digestion, it's a detox fluid, it carries out waste products, toxins, excess cholesterol, and importantly, hormones, used up hormones, including estrogen. So I've seen this many, many times in my clinic. A client may come in complaining of bloating or diarrhoea after meals, but when we dig deeper, we see there's also fatigue and headaches, and most of the time, hormonal symptoms. And then when we start supporting bile flow, those seemingly random symptoms often improve. So it's very interesting. The liver, bile, and hormone connection is really really key here to understand. And like I said, if you're a if you're a female, you need to know this stuff. So let's look at estrogen because we've spoken a lot about hormones, of course, on this podcast, and let's look at how what happens with estrogen. So once your body has used its estrogen, it has to be broken down and cleared out, and that job starts in the liver. So the liver is the route that estrogen goes through to be detoxified. So the liver takes the estrogen, and then we have two main detoxification phases, phase one and two. So if you think about it like a recycling plant, in phase one, the estrogen is broken down into metabolites. Most of the time, in phase one, these metabolites are more toxic. Then in phase two, they're kept they're kind of packaged up so they're safer and ready to be shipped out. And this is where the gallbladder comes in. Once the liver's done its job, those estrogen metabolites need an exit route, and a lot of them are put into the bile. So bile is like a courier service that carries those packaged hormones from the liver into the gut, and where ideally they leave your body in your stall. That's what should happen. Now, what we've got to consider is how much pressure the liver might be under as well. So the liver isn't just dealing with the hormones, and sometimes we need to support the liver as the first part of this whole process. But that discussion is for another time. But here's where the gallbladder comes in. So once the liver's done its job, we've got the metabolites needing an exit route, and the bile is acting like the courier service. But what happens if the bile isn't flowing? So if the bile is sluggish or it's thick or it's not being released properly, then estrogens can get stuck. And worse, in the gut, we have an enzyme called beta-glucaronidase, and it's often raised if your gut microbiome is out of balance. So I often see this being an issue on stool tests. So these this can cause an unwrapping of the packaged estrogens and send them back into circulation. If you've got a lot of estrogens anyway, and we've got a dominance picture, so there might be heavy periods, there might be breast tenderness, there might be migraines, PMS, mood swings, weight gain, then we've got to look at how much of those estrogens are being unpackaged and sent back into circulation. This is where something like the Dutch test can really look at what's going on because we get to look at the metabolites. So why does this matter in perimenopause? So remember when we've spoken about estrogen before, in in the early stages of perimenopause, estrogen goes a bit crazy. It's swinging between high and low. And if clearance is impaired because the bile isn't flowing well, you suddenly get the perfect storm. The body is flooded with more estrogen than it can handle. Not because you're making too much, or that also might be the case, but because you're not getting rid of it efficiently. And then we've got to look at things like are you able to have a regular bowel movement? Because again, that is going to impact that re-uptake of estrogen's being recirculated. So one um lady I work with had classic estrogen dominance symptoms. She had heavy periods, she had breast tenderness, migraines, and she also had a history of gallbladder issues. So once we started to support her bile and liver, her cycles became lighter and her migraines reduced dramatically. So it's that's how powerful the connection is. It's really, really significant. So the signs that your gallbladder might be struggling. So if your gallbladder isn't happy, here are some early red flags that you might be aware of. So bloating or heaviness after fatty meals. This is something that a lot of people will comment to me during our initial consultation. Nausea is another one, so feeling sick after eating, pain or tightness under the right rib cage or into the right shoulder blade. Now, sometimes this pain can be really quite intense, and if we're dealing with gallstones, which are often because that bile's got sticky and everything's got a bit stuck, then that can really cause pain if those gallstones get stuck where the gallbladder is trying to empty into the small intestines. This is a really obvious one. If you've got floating stools and they just won't flush, or they look greasy, or they're pale, that is a sign of undigestive fats. If you've got acid reflux, burping, or indigestion after eating, that is a sign that the bile route is not working properly. Headaches, itchy skin. How many people complain about itchy skin going through perimenopause? Um, fatigue, because when we've got a sluggish detoxification, it's like our body, because we're made up of water, we're just floating around in the disgusting stuff. We're not nice and clear and things aren't moving nicely. So, fatigue, the cell really gets impacted in this situation. So, these are the signs that the bile is either too thick, not flowing well, or that the gallbladder isn't contracting properly. So, I had a client in her 40s who came to me with fatigue and mood swings. When we looked into her history, she mentioned that she had a constant ache under her ribs and her still sometimes floated. And despite the fact that she'd been to the doctor, there'd never been a connection to her hormones. So we looked to support the bile flow with food and lifestyle changes, and her digestion improved, and her mood swings become less severe as well. So you can make a big difference with simple changes. You can add more bitter foods like rocket, chicory, uh, dandelion, watercress, you can help support that gallbladder function. If you're eating moderate amounts of good fats, then that also is helpful. Very low-fat diets or very heavy fried foods you want to avoid, staying hydrated, moving your body because actually movement helps the bile flow. I'll talk more about other things that you can help to support your gallbladder. But why are why are women much more affected? So, estrogen itself thickens bile. So, naturally, during pregnancy, during perimenopause, and when taking the pill or HRT, women are more prone to gallstones. But the thing is that the medical solution to this is to just take the gallbladder out. But removing the gallbladder does not fix the root cause, it simply bypasses the issue, and then it creates new ones. Because, of course, if you've taken away that courier service and you can no longer use that root for detoxification, plus you're not absorbing those key nutrients, the essential fatty acids and the fat-soluble vitamins, that's going to have a knock-on effect of lots of things, and you start to impact the gut more. So, this this small organ is really really important. So, although a lot of people do end up in an emergency situation where the only answer is to actually remove the gallbladder, and you can do things afterwards once it's been removed, but I think we should work on prevention and knowing that there's a huge link with hormones. I mean, whoever tells us this that this organ is directly involved in hormone balance and that impact on detoxification. It's not general knowledge, is it? And so I do like talking about the gallbladder, and I do like helping people with gallbladder issues because it makes such a huge difference to how they feel, it has a knock-on effect of their mood, their weight, their energy, and balancing hormones is really significant when you support the gallbladder. So we don't want to necessarily get to the point where the gallbladder is removed, and I do get rather cross that when that is done, and like I said, in some cases it needs to be removed because it's become an emergency situation, it's very easy to get an infection there when things start to get really um sticky in there, and you've got the gallstones, and yeah, there's a lot that can happen, but knowing that there's an impact with hormones, knowing that as a female, you're two-thirds more likely than a man to need an operation, especially around the ages of 40 to 50. So it's really, really important to know this stuff. So, what happens if you do have your gallbladder removed? So, when the gallbladder is removed, what happens to the bile? Because the liver is still producing the bile, so instead of it being released at the right time, it drips continuously into the gut. So it's it's not being stored or released at the right time, it's continuously dripping into the gut. This means that you don't digest fats as well, so you might end up struggling with bloating and diarrhea and nutrient deficiencies or reflux. These are the types of things that we will see after a gallbladder removal. Now, I have to say that there is a very strong push towards ketogenic diets at the moment. A ketogenic diet is extremely high in fat. That diet is not really going to work for us women who have got hormone changes going on. It is certainly not something you want to do if you've had your gallbladder removed, because you can't handle that fat as it is. You have to be really careful. So the other thing that will happen if you do have your gallbladder removed is that estrogen clearance is going to take a hit because the bile flow is less efficient without that storage and release mechanism. So if you're already battling with hormone issues, that can make symptoms worse. So I've supported many women post-gallbladder removal who suddenly discovered that those perimenopausal symptoms have gone into overdrive. So then we see hot flushes, fatigue, skin breakouts. And again, no one ever talks about this, no one ever explains. Oh, you've had your gallbladder out. The bile flow is now part of the reason why this is causing you an issue. So we need to be able to put support in and recognize that we've just taken out a major component of that whole digestive and detoxification and hormone balancing system. And what we can do to look after our gallbladder or support your gallbladder or support your body if you've already had it removed, very important to support your gallbladder before you get to the stage of needing it removed, or at least know how to support it after it's been removed. For prevention and support, bitter foods are really really key here. So if we eat those rocket, chicory, radish, watercress, dandelion greens, lemon, apple cider vinegar can be useful, then we can help support that bile root if we include good quality fats, so olive oil and avocado, oily fish, nuts and seeds, and we avoid those ones that are causing us the most problem. So when we look at why there's been an 80% increase in these operations, we've got to consider the fact that ultra-processed foods often have really damaged fats in them. If things are fried, that can that that's a again, it's a fat that the body doesn't like. If we've got excess sugars and processed foods and white carbs going in, this all thickens the bile, and it's really interesting that stress reduces bile flow. Another one for the stress, right? We know that stress impacts digestive function anyway, but it actually reduces the bile flow. Being hydrated is incredibly important for the gallbladder, so it's another reason to focus on that water intake, and then we need to keep our gut microbiome healthy because it plays a role in estrogen recycling. So this is one of the reasons why I do a stall test when I'm looking at supporting someone with hormone balance or hormone issues. Yes, I run the Dutch test, but also a stall test, even if there doesn't seem to be gut-related issues. Sometimes you can have these problems and you you're not even aware because the symptoms have become your normal. And I've had I've asked a question before in consultations when I've asked someone, are your bowel movements normal? and they've said yes, and then I've asked them for a bit more detail, and then they say, Well, you know, I go every three days, and and I go, What? What do you mean you go every three days? You should be going more than once a day, but that's always been their normal. So we we we sometimes see that what somebody would consider to be normal is is not normal. If your gallbladder has already been removed, then smaller and more frequent meals can often help. There are certain digestive support supplements that I will specifically use with clients who've had a gallbladder removed, they're going to need bile sorts and certain enzymes. We need to focus on the liver because the liver becomes very, very busy and there is a link between the liver and the gut health, so we got to make sure that the hormones are still cleared effectively, even if we've got no gallbladder helping us there. I remember one woman telling me that she said, Oh, I thought my digestion was ruined after surgery, but then she started to use bitters, and actually, there are some herbal the avogal do a bitters uh tonic that you can take before you eat, but we included bitters for her and use digestive support, and then she was able to enjoy her food without the constant bloating. That was the issue that she had after the gallbladder problem. That bloating become really quite problematic. So, although we tend to think of the gallbladder as just being non-essential, you know, almost put into the same category as tonsils and uh appendix. No, don't get me started on that, but it is so essential for digestion detoxification and especially for hormone balance. So, in perimenopause, when the estrogen is already tricky, or we've we've been put on or we're using hormone replacement therapy or contraceptive hormones, then we're putting those we're putting the pressure on that liver bile route. It is really important to support the bile flow, and gallbladder health can be the difference between struggling with symptoms to do with perimenopause or going through that transition more smoothly. So, again, look out for some of the signs that you might be compromised here. Remember bloating or heaviness after fatty meals, nausea, feeling sick after eating is a classic one. If you get pain in that upper right rib cage area or into that right shoulder blade, the biggest one for me, which is really easy to see, is those floating or pale stools or stools that are greasy, the ones that just won't flush away. You keep putting the toilet paper down there and floating, they won't flush away. That is a sign of undigested fats. If you've got acid reflux, burping, indigestion, then we've got to look at the gallbladder and bile flow. And if you've been getting more headaches, we know that a drop in progesterone will also cause more headaches. But if we're if we've got a combination of headaches and itchy skin and fatigue, and we've got symptoms of hormone imbalance, then we really need to look at the gallbladder. So I know that I've gone into quite a bit of a rant there about the gallbladder, but I think it's really important. One of the other things to help support the gallbladder is fibre. So I mentioned at the start that some of the reasons why we think that gallbladder operations have increased by 80% is due to a lack of fibre and an increase in processed foods, and then we've got to look at things like insulin sensitivity, the rise rising obesity levels, and also the use of hormones. A lot of women are put on estrogen and progesterone, uh, hormone replacement when many of them have higher levels of estrogen anyway, and insufficient progesterone. So we see if we look at trends that often estrogen gets over-prescribed and progesterone gets underprescribed. And just remember that estrogen, the more estrogen we've got, the more sticky that bile root is going to be, the more pressure on the liver to detoxify, and we're missing that courier to deal with that situation if the gallbladder has been removed. So it's quite an interesting situation, I think. And again, as I said, I think it's important that you know. So, as a female, going through changes in the hormones, there you are you increase your risk of gallbladder issues a lot. So please look after this organ because it is amazing and it's going to help you. And if you've had your gallbladder removed, remember you are going to struggle with the digestion of fats. There are things that can help. All of the things for prevention and support also are relevant here. So, gut microbiome, managing stress, reducing the excess um refined carbs and processed foods, staying hydrated, making sure that the fats you eat are good quality, using bitter foods, all of these are going to help. But if you've had your gallbladder removed, then you'll probably need some extra support with things like bile sorts or certain enzymes, and you need to make account for the issue with absorbing some of those fat-soluble vitamins through the small intestines. So we've got to support the fact that that gallbladder has been removed, but it is possible to do and it may it will make a huge difference. So, thanks for joining me today. I hope this has been useful. It's always a bit different doing a podcast episode on your own, but please share this with a friend who might be dealing with hormone issues or gallbladder problems. As I said, it's very under the radar, and not many people seem to know about this connection, and it could make the difference between someone struggling going through those hormone changes versus moving through that transition much more smoothly. So, again, if you've got any questions about this, then please put them in the far too fabulous Facebook group, and I'll see you on the next episode.

SPEAKER_00:

Thank you so much for joining us today. We love creating this for you. We'll be back next week with another great episode. Until then, we'd be beyond grateful if you'd subscribe to the podcast and leave us a glowing review. If you've already done this, thank you so much. Please do share the podcast with friends and family. You never know which tiny piece of information could be life-changing for someone you care about. We absolutely love hearing from you. So connect, comment, or message us on our social media channels. You'll find all the links in the show not. And if you haven't already, come and join us in our free Facebook group where we continue the conversation and you get to connect with like minded women. We'd love to welcome you in. Until next time, stay fabulous!