Perimenopause constipation isn't just about fiber or hydration. Hormonal changes—especially fluctuating progesterone and declining estrogen—can slow gut motility and alter the gut microbiome, leading to constipation, bloating, and digestive discomfort. Learn what current research says, how magnesium may help, when symptoms need medical attention, and the practical strategies that made a difference in my own perimenopause journey.