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The Gut-Hormone Connection: How Menopause Affects Your Microbiome

The trillions of bacteria residing in your gut, known as the gut microbiome, extend their influence far beyond digestion. Emerging research suggests a link between gut health and various aspects of well-being, including mood regulation (anxiety and depression), appetite control, metabolism, immune function, and fat storage. There is much that science does not yet know about the gut microbiome and its impact on human health, but research has identified a connection between the gut microbiome and menopause. For example, a higher prevalence of gut issues like bloating and constipation is reported in postmenopausal women compared to premenopausal women.

But before we get to the effects of menopause on the gut microbiome, let's talk about how the gastrointestinal (GI) tract processes the food we eat. A rich and diverse gut microbiome facilitates the enzymatic breakdown of complex carbohydrates and fuels the fermentation of indigestible fibers, leading to the production of short-chain fatty acids (SCFAs).  These SCFAs offer many benefits, including decreasing chronic low-grade inflammation, supporting skeletal muscle mass retention, and enhancing insulin sensitivity through improved glucose uptake by peripheral tissues. Additionally, these bacteria contribute to the synthesis of essential vitamins, such as the B complex and vitamin K, as well as some non-essential amino acids.

The gut microbiota also plays a surprising role in the production and regulation of key hormones like estrogen, thyroid-stimulating hormone (TSH), serotonin, and stress hormones like cortisol. For example, following its synthesis, estrogen enters the circulation to do its thing, and then undergoes a series of reactions within the liver that render it inactive and facilitate its excretion via bile into the intestinal lumen. However, a specific group of gut bacteria, collectively termed the estrobolome, possess the enzymatic machinery to modulate estrogen activity. The key enzyme in this process is β-glucuronidase (β-G), which can deconjugate inactive estrogen forms, reactivating them for potential reabsorption into circulation. An imbalance of the estrobolome can lead to either an excess or deficit of β-G, which in turn can increase or decrease the amount of active estrogen. Although the ultimate impact of the estrobolome isn't yet clear, we know that estrogen receptors can be found throughout the GI tract.

The late perimenopausal and early menopausal stages are marked by a significant shift in gut microbiome diversity compared with premenopausal women. This decline in gut bacteria composition might be associated with certain health issues in menopausal women. Reduced levels of beneficial bacteria like Firmicutes and Ruminococcus could lead to problems with digestion, including a lack of important fatty acids that keep the gut healthy. Conversely, bacteria potentially linked to obesity (Prevotella) and inflammation (Odoribacter) increase during menopause, which can weaken the immune system and contribute to various health problems, including osteoporosis and urinary tract problems. A recent report from the Study of Women’s Health Across the Nation (SWAN) showed that gut permeability increases during menopause, which is associated with more inflammation and subsequently lower bone mineral density. But, not everyone experiences an increase in these specific bacteria when estrogen levels decline. And the presence of these bacteria doesn't necessarily guarantee negative health outcomes. Other factors like overall diet and lifestyle also play a significant role.

Scientists are actively investigating the connections between menopause, gut bacteria, and overall health. With a better understanding of this complex relationship, we can develop evidence-based strategies to support women's health during menopause and beyond. Menopausal women should prioritize a well-balanced diet and decreasing stress while awaiting further research on other gut-focused interventions.


  • Focus on a balanced diet: Prioritize whole grains, fruits, vegetables, and legumes. These are rich in fiber, which feeds the good gut bacteria.

  • Incorporate prebiotics: Include prebiotic foods like garlic, onions, asparagus, bananas, and apples in your diet. Prebiotics act as food for the beneficial bacteria in your gut.

  • Consider probiotics: Talk to your doctor about incorporating probiotic supplements or probiotic-rich foods like yogurt, kefir, kimchi, and sauerkraut into your diet. Probiotics can help replenish good bacteria in the gut.

  • Limit processed foods, sugar, and unhealthy fats: These can contribute to the growth of unhealthy gut bacteria and inflammation.


  • Manage stress: Chronic stress can disrupt the gut microbiome. Practice relaxation techniques like yoga, meditation, or deep breathing to manage stress levels.

  • Get enough sleep: Aim for 7-8 hours of quality sleep each night. Sleep deprivation can negatively impact gut health.

  • Stay hydrated: Drink plenty of water throughout the day to aid digestion and support a healthy gut environment.

  • Exercise regularly: Regular physical activity can improve gut health and overall well-being.


  • Consider consulting a nutritionist: A registered dietician can help you create a personalized gut-healthy meal plan based on your preferences and needs.

  • Maintain a healthy weight: Excess weight can contribute to gut imbalances. Aim for a healthy weight through diet and exercise.

Remember, it's important to talk to your doctor before making any significant dietary or lifestyle changes, especially if you have any underlying health conditions.

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