Perimenopause Gut Health Dietitian
—Perimenopause Gut Health Dietitian · Virtual Coaching
Your gut didn’t fall apart.
Perimenopause changed the rules.
Perimenopause changed your hormones and your gut noticed immediately.
If you’ve been dealing with bloating, constipation, diarrhea, reflux, or foods that suddenly don’t agree with you anymore — there’s a real explanation.
But you won’t find it in a standard blood panel, an HRT prescription, or with another referral to a gastroenterologist who tells you to try the low FODMAP diet.
Master of Science In Human Nutrition | 10 Years Gut Health Registered Dietitian | Certified Microbiome Analyst | Certified LEAP Therapist | Virtual 1:1 Coaching
Sarah Neumann Haske, MS, RDN – Gut Health Dietitian – Asheville, NC
The symptoms your doctor shrugged off
aren’t just “part of aging.”
Does this sound like you?
✔️ You used to eat anything. Now certain foods leave you bloated for days and you can’t figure out what’s safe anymore.
✔️ You struggle with constipation, diarrhea, or ping-ponging between the two. Your gut has become completely unpredictable.
✔️ You’ve been told it’s “just stress” or “just aging.” But you know something more is going on.
✔️ You’re skipping dinners out, choosing outfits by how bloated you might get, and canceling travel plans.
✔️ You’ve tried probiotics, elimination diets, every trendy gut health supplement on the internet. And you still feel terrible.
✔️ Your IBS has gotten noticeably worse since menopause but no one can explain why or connect the dots.
Nobody warned you perimenopause
would do this to your gut.
Your cycles started becoming irregular and your gut went completely sideways at the same time. Nobody connected those two things for you.
Foods you’ve eaten your whole life are suddenly triggering you. You’ve cut out gluten, dairy, maybe everything — and you’re more confused than when you started.
You’re on birth control or an IUD and were told your hormones are “controlled” — but your gut is worse than ever and nobody can explain why.
You’re bloated by noon for no obvious reason. Constipated one week, dealing with diarrhea the next — with no predictable pattern and no clear trigger.
You’re exhausted, brain fogged, not sleeping. Your gut is adding to the chaos and nobody is connecting any of this to your hormones.
Your IBS, which you’d mostly managed for years, is suddenly completely unmanageable. And you have no idea what changed.
—HEAR FROM SARAH
Why perimenopause
wrecks your gut.
Estrogen and progesterone do more than regulate your cycle — it regulates your gut motility, your microbiome diversity, and how your immune system responds to food. In this video I explain exactly what’s happening.
—Why this happens
What nobody told you about estrogen, progesterone
and your gut.
When estrogen + progesterone begin to drop and fluctuate in perimenopause— your entire digestive system starts to feel it. Most women are told it’s just stress or aging. But what if I told you there’s more to the story?
Suddenly the IBS you had managed for years is out of control. Foods you’ve eaten your whole life are now triggers. Your body has become unpredictable in more ways than one.
3x
Women are up to three times more likely than men to develop IBS — and menopause is a significant trigger point (1).
Cortisol Rises
The perimenopause stress response amplifies gut-brain signaling and visceral sensitivity — normal digestion starts to feel painful and bloating can feel more intense.
Gut Hypersensitivity Increases
Estrogen and progesterone receptors are found throughout your gut and help regulate how pain signals travel between your gut and your brain. When these hormones fluctuate and then drop, your gut essentially turns up its volume — making normal digestion feel painful. Things that never bothered you before suddenly do (6).
—Not sure if perimenopause is driving your gut issues?
Take the free 3-minute Midlife IBS Quiz — get a dietitian-backed breakdown of your symptoms and what they likely mean.
—Why this works when nothing else has
You've already tried the generic approach before.
This isn't that.
What you’ve probably already tried
- Handed a Low-FODMAP diet with no explanation and no follow-up
- Colonoscopy came back “normal” — so they called it IBS and sent you home
- Spent hundreds on supplements from an Instagram influencer who’s never looked at your labs, doesn’t know your history, and won’t be there when it doesn’t work
- Hours down the Google rabbit hole, ten different answers to the same question, and somehow more confused than when you started
- Ordered your own labs, plugged the results into AI for answers, and got advice that felt like it was written for everyone and no one at the same time
- 7-minute appointments, another prescription, and the unmistakable feeling that no one is actually listening
The perimenopause gut reset
✅ Carefully selected functional labs your doctor can’t order and won’t know about — included in your program.
✅ Someone with an integrative nutrition background who interprets your results in the context of your full health history — not just your numbers.
✅ A protocol built around your body, your individual triggers, and your actual life
✅ Weekly 1:1 coaching to fast track your healing — food and symptom journals reviewed, your plan is adjusted as you respond
✅ 20 years of clinical experience, a master’s degree, and 10 years specializing in women’s gut health issues that get dismissed, misdiagnosed, and overlooked
—Meet Your Dietitian
Sarah Neumann Haske, MS, RDN
Gut Health Dietitian & Certified Microbiome Analyst – Asheville, NC
I built this practice because women kept being
dismissed
I’ve spent over a decade watching women in midlife get told their gut symptoms are stress, aging, or something to manage with a medication — not solve. Almost every time, there were real identifiable root causes that simply hadn’t been looked for.
I’m not going to hand you a Low-FODMAP sheet and a pat on the back. We’re going to use the functional testing your doctor doesn’t have access to, build a plan around your actual body, and I’ll be in your corner for the full three months.
Master’s of Science, Human Nutrition · Registered Dietitian · Certified Microbiome Analyst · LEAP / MRT Certified · 20+ years experience · 10 years gut health specialty
—Real Results
What women
say after working with Sarah
I can now socialize and go on vacation without being so frightened of the reactions I’ll have with food.
After two weeks of following the diet regimen filled with foods that worked well with my body, I was already seeing an improvement. I can now say that I have had three months with hardly any GI issues and it is absolutely wonderful.
I feel better than I have in years, and digestive issues don’t hold me back anymore. Bonus – I even lost some weight! I am so grateful for Sarah and her program.
—How It works
The Perimenopause Gut Reset—
step by step
Free Assessment Call
Functional Lab Testing
Food sensitivity, comprehensive stool, and micronutrient testing kits are all mailed to your address.
Your Personalized Gut Reset Plan
Ongoing Coaching & Accountability
Lasting Relief
—What's Included
Everything in your
3 month program
MRT Food Sensitivity Testing
The most comprehensive food and chemical reactivity test available.
Metagenomic Stool Analysis
Maps your entire bacterial ecosystem and identifies what’s disrupting your digestion.
Micronutrient Testing
Identifies vitamin, mineral, amino acid, and fatty acid deficiencies linked to gut issues and slowed healing.
1:1 Coaching for 3 Full Months
No per-session fees. We typically meet weekly for the first month then every two weeks after that — but if you need more time together we make it happen. Three months, no clock watching.
Food & Symptom Journal Review
I review journals between sessions to catch patterns and adjust your plan.
Personalized Meal Planning
Recipes, grocery recs, and a menu planner so your results are actually liveable.
—Why this works
Why this program works
when everything else hasn't
01
The right order matters
02
Testing that actually finds the answer
03
You won’t be left to figure it out yourself
04
Results that come faster than you expect
—What Changes
Here's what life looks like
when we find the root cause
A realistic picture of what most of my clients experience within the first three months.
You stop planning your day around your gut
Dinners out, travel, social plans — you say yes without the mental calculation of what might happen.
You eat without fear
Not because you’re avoiding everything, but because you actually know what your body can handle — and why.
The brain fog and fatigue start to lift
Most clients are surprised how much their energy and clarity improve once their gut starts healing.
You stop spending money on things that don't work
Reduce your reliance on expensive prescriptions, urgent care visits, or procedures that lead nowhere.
You feel like yourself again
Maybe not exactly like the person you were before perimenopause, but a version of yourself that’s actually thriving in this chapter.
The weight and water retention starts to shift
Most clients are surprised — beyond the digestive relief, energy returns, mood stabilizes, and stubborn weight starts to move.
—Why going it alone keeps you stuck
You've already tried to figure this out.
It hasn't worked
You’ve Googled, you’ve eliminated foods, you’ve bought supplements, maybe you’ve even ordered your own labs and plugged the results into AI. And you’re still here, still dealing with the same symptoms, still frustrated.
It’s not because you haven’t tried hard enough. It’s because gut health has a specific sequence — and without knowing what’s actually driving your symptoms, every change you make is a guess. Some guesses make things worse. Most just waste time and money.
The other problem is information overload. One source says cut gluten. Another says take probiotics. Your friend swears by keto. An influencer is selling a cleanse. None of them know your body, your history, or your test results. And none of them are accountable if it doesn’t work.
“That’s the difference between trying radom things and actually having a step by step plan to solve it.”
—From the Blog
Everything you've been wondering about mid-life gut issues, explained
In-depth articles on gut health during perimenopause — from symptoms to real solutions.
Perimenopause · Diarrhea
Perimenopause · Stomach Problems
Midlife · Gut Health
Perimenopause · Gut Health
Curious if Hormones Are Affecting Your Gut?
Take the Midlife IBS Quiz and uncover what may be driving your symptoms.
This 3 minute quiz will help you discover:
✅ Your IBS pattern and what it reveals about your gut
✅ How hormone swings and shifts can impact digestion
✅ Dietitian-backed strategies for faster digestive relief
—Questions
Common questions about the
Perimenopause Gut Reset
DO I NEED A FORMAL DIAGNOSIS OF IBS TO WORK WITH YOU?
No. Many of my clients come to me without any diagnosis — just symptoms that are disrupting their lives and doctors who haven’t found answers. You don’t need a label to get real help. If you’re struggling, that’s enough.
WHAT CONDITIONS & DISEASES DO YOU HELP PEOPLE WITH?
I primarily work with women who struggle with IBS (Irritable Bowel Syndrome). I also work with women who struggle with symptoms like chronic diarrhea, constipation, stomach pain, bloating, gas, leaky gut, and reflux.
I’ve also helped women heal autoimmune conditions, migraines, and skin issues in conjunction with the digestive work we do.
DO YOU RECOMMEND SUPPLEMENTS?
Often I will recommend some sort of supplemental protocol to help speed up your recovery. The supplements I recommend will be specific to your needs, not contain any of your sensitivities, and give you the specific nutrients you need in therapeutic dosages. As a courtesy, my program clients get 15% off professional grade supplements when they shop via my online dispensary while working with me.
HOW MANY SESSIONS DOES THE PROGRAM INCLUDE?
WHAT KIND OF LABS DO YOU DO? CAN I JUST HAVE MY DOCTOR ORDER THEM?
I use specialized functional medicine lab tests that aren’t available in conventional medical practices or covered by insurance. These may include food sensitivity, comprehensive stool, and in-depth micronutrient tests. Your conventional primary care doctor doesn’t use these tests because they aren’t covered by insurance.
People who’ve eliminated their symptoms with my program often have had other tests done with their conventional medical provider that either came back “fine” or offered no direction for therapy. With my program you won’t waste your time going back and forth between your doctor and your health insurance.
If you already have results from a colonoscopy, endoscopy, celiac panel, or other blood test, you’ll want to submit those to me as part of your assessment. If you plan to work with me and haven’t had a physical in the past year, I’ll give you a list of basic lab work to ask your doctor to order; often doctors will skip over important labs unless you ask.
HOW DO WE MEET?
HOW LONG IS YOUR PROGRAM? WHEN CAN I GET STARTED?
ARE YOU AVAILABLE BETWEEN SESSIONS FOR QUESTIONS?
Yes, I’ll typically respond within 24-48 hours on weekdays. While simple questions can be sent through your client portal between sessions, more complex questions are best reviewed during appointments so we can give them the attention they deserve.
DO YOU TAKE INSURANCE?
My Digestive Reset Program is not covered by insurance but you’ll get so much more than what insurance allows or deems “billable” or “necessary.” All clients are self pay. I offer the option for a 6 month payment plan through CareCredit. In some cases you can use your HSA or FSA card to pay for the program (you’ll have to check with them first).
Most clients tell me the investment pays for itself quickly in money they stop spending on prescriptions, urgent care visits, and procedures that weren’t getting to the root of anything.
You can’t put a price on your health and on being able to eat, travel, and function without pain or discomfort from your gut issues. My program will save you time, thousands of dollars in the long run, and provide the answers you’ll need for complete healing.
HOW DO I KNOW IF A DIETITIAN IS QUALIFIED?
A qualified dietitian has:
-
A 4-year bachelor’s degree in dietetics
-
Completed a 1-year supervised internship
-
Passed a national registration exam
-
Maintains credentials with continuing education (CEUs)
HOW MUCH DOES A GUT HEALTH DIETITIAN CHARGE?
Fees for a Gut Health Dietitian will vary depending on:
-
Education and credentials
-
Years of experience
-
Specialty certifications
-
Services offered (lab testing, meal planning, coaching)
Private-pay dietitians, typically charge between $130–$200/hour. The rate is determined by their credentials, certifications, specialties, and years experience.
The cost of a 3-month coaching program by an expert Gut Health Dietitain is determined by the level of their experience in this specialty, the types and number of tests used, and level of 1:1 coaching support provided.
HOW DO I VET A GUT HEALTH DIETITIAN EXPERT?
Useful questions to ask a potential Gut Health Dietitian Expert:
- How often do you work with people with gut issues? Are you comfortable working with my specific condition?
- Do you provide meal plans and detailed coaching for implementing dietary changes into my lifestyle?
- Do you understand the difference between a food allergy, food intolerance, and food sensitivity? Do you know how food sensitivities contribute to immune reactions and gut inflammation? Do you know which foods are common irritants to the gut?
- Do you understand the potential harm of long term restrictive diets (i.e. low-FODMAP) on gut health?
- Do you know how to interpret microbiome tests and know which ones are best? Do you understand the important role of microbiome imbalances in digestive issues and utilize research backed tools to re-balance it? Do you understand that use of certain herbs at high doses can actually harm the delicate ecosystem of keystone beneficial bacteria? Do you understand how to asses if someone is producing inflammatory by-products from overgrowth of opportunistic bacteria? Do you know how to assess and interpret inflammatory markers on these reports? Do you know what foods support a healthy microbiome?
- Do you understand which nutrient deficiencies are linked to gut issues and slowed healing?
- Do you offer frequent check-ins to evaluate progress and adust my plan as needed?
- Do you evaluate my food and symptom journals to identify food sensitivities or intolerances that may have been missed?
WILL I NEED TO CHANGE MY DIET IF I'M WORKING WITH A GUT HEALTH DIETITIAN?
Most likely, yes — but the changes will be likely be so beneficial that you won’t miss your old way of eating. Your diet will be individualized based on your food sensitivity test results and overall digestive profile.
I provide coaching with:
-
Recipe ideas and how to edit them to fit your new diet
-
Food product recommendations you can find at your grocery store and that don’t contain your reactivities
-
A detailed menu planner to help you implement your food sensitivity results in real life
You may need to temporarily discontinue eating out, stop drinking alcohol, and remove your individual trigger foods.
The dietary changes are typically temporary. Most reactive foods are removed for 3 to 6 months while your immune system resets, then they’re reintroduced.
The goal isn’t a lifetime of restriction — it’s a period of healing followed by the freedom to eat more broadly than you can right now.
The diet changes do more than calm your gut. Most clients notice more energy, better mood, clearer thinking, and a reduction in the water retention and extra weight that came with menopause.
WHAT STEPS SHOULD I TAKE TO GET READY FOR THIS 3 MONTH GUT HEALTH COACHING PROGRAM?
To prepare for your 3 month Gut Health Coaching Program, you’ll want to:
- Stop unnecessary supplements so your body is clear for micronutrient testing and Phase 1 of the MRT food sensitivity diet. If supplements are absolutely necessary, we can find alternatives that fit your food sensitivity profile.
- Go through your pantry and remove packaged foods with long ingredient lists. Keep ingredient lists simple.
- Start exploring ideas for healthier foods — visit my Pinterest page for inspiration.
- Begin shifting your mindset — check out my meditation blog and the Nerva app for guided support.
MY QUESTION WASN'T ANSWERED HERE.
Gut health can be complex, and many people have struggled for years without relief. I’ve answered the most common questions here, but if your question isn’t addressed, please reach out via my contact form or email [email protected], and I’ll get back to you as soon as I can.
Ready to Start?
You're gut is telling you something. Let's
finally listen to it
Book a free 30-minute digestive assessment call. No pressure — just an honest conversation about what’s going on and whether my program is the right fit for you.
Sarah Neumann Haske, MS, RDN is an Gastrointestinal Dietitian & Nutritionist with over 20 years of experience, specializing in digestive health for the past decade. She holds a Master’s of Science in Human Nutrition, is a Certified Microbiome Analyst, and is the Owner of Neumann Nutrition & Wellness, LLC.
Her practice helps women heal their gut using a root-cause approach to their health.
As a result of her Perimenopause Reset Program, her clients are able to know exactly which foods they can eat without issue, come off medications, and engage in their life to the fullest.
If you’re interested in being a partner in your own health journey while finding the direction and accountability you need to reach your digestive health goals, you can schedule a call with Sarah here.
Results will vary person to person.