Why Your Gut Health Matters During Menopause

Why Your Gut Health Matters During Menopause

Gut health aka the microbiome. It’s a hot topic right now. The science on the connection between the gut and female hormones is relatively new. Researchers have found that female sex hormone levels influence the composition of the microbiota in many sites of the body, especially the gut. However, many questions still remain unanswered on the role of microbiota during menopause. We do know that gut health and overall well-being are linked and there are steps we can take to boost our gut health during perimenopause and postmenopause.

What is the microbiome?

The microbiome is the gut’s complex ecosystem made up of billions of bacteria. These bacteria are ultimately responsible for major bodily functions from digestion to the immune response to cerebral activity.

A balanced gut, full of beneficial bacteria and usually the result of clean living, promotes sustained wellness and a better perimenopause and postmenopause experience. An unbalanced gut, where beneficial bacteria is compromised by other bacterial populations, is often the underlying cause of everything from acid reflux to, in some cases, depression and anxiety. The latter issues are common during the phases of menopause making gut health even more important for midlife women.

The gut bacteria affect and often signal the beginning of most processes at the microbial level. They form a blueprint for your system’s operations. If this blueprint is out of whack, chances are you will be too.

How does the microbiome affect hormones and menopause?

If the gut is the basis of hormonal response, how can we effectively boost our gut health to minimize menopausal symptoms?

The gut doesn’t lie, and neither does the science behind it.

Let’s dive in and see what a healthy gut has to offer on the journey through menopause and beyond.

The gut-hormone connection

The microbiome is a wild jungle of bacterial microbes which serve multiple biological functions, including:

  • producing short-chain fatty acids
  • metabolizing drugs
  • maintaining the body’s homeostasis
  • producing anti-inflammatory secretions and responses the body needs
  • fighting invasive pathogens
  • acting as an endocrine organ

Each of these processes deserves its own article, but for our purposes let’s hone in on this last part involving the endocrine system, and how it may affect women during menopause.

What is the endocrine system?

The endocrine system is the body’s network of glands that produce hormones. We are learning now that the microbiome, while not a gland per se, operates like an organ of the endocrine system. Scientists have observed certain gut bacteria producing hormonal chemicals that are released into the bloodstream. From there, these hormonal substances travel throughout the body to multiple other organs including the brain.

Further evidence directly links hormones associated with metabolism to higher populations of particular bacterial strains in the gut, namely Ruminococcaceae and Lachnospiraceae.

In essence, the gut’s microbiome acts as a command center, a base for creating and disseminating the proper hormones through the proper channels to the proper places. And the bacteria themselves form the blueprint.

Gut health during perimenopause

If you are in the stages of perimenopause, your body has begun its decline in estrogen production. We used to think this was all about the ovaries, but now we know the gut plays a pivotal role.

Fluctuating levels of estrogen are the elemental causes of menopausal and perimenopausal manifestations, such as:

  • hot flashes
  • depression
  • mood swings
  • breast pain
  • insomnia

Take a wild guess as to what regulates estrogen levels…


In fact, there’s a subset of bacteria called the estrobolome that specifically work to metabolize estrogens. In a healthy and balanced gut, the estrobolome maintains homeostasis.

Estrogen and the microbiome

An unbalanced and distressed microbiome can cause either the deficiency or excess of free estrogen. Consequently, estrogen-related health issues are bound to arise.

This includes those annoying menopausal symptoms.

And there’s also evidence that a compromised estrobolome in postmenopausal women is associated with an increased risk of osteoporosis, obesity, and cardiovascular disease. The risk spike is caused by the aggravation of the low-estrogen state by an imbalanced gut.

But the relationship between the gut and estrogen is not a one-way street.

Just as the gut regulates and affects estrogen levels, the natural decline of estrogen levels caused by menopause has a direct effect on the microbiome. Annoyances like weight gain around the belly and IBS in menopausal women are thought to occur as a result of the marked difference and subsequent imbalance of the microbial ecosystem caused by plummeting estrogen levels.

Benefits of a healthy estrobolome

A healthy estrobolome, the gut’s estrogen-specific microbial network, will effectively metabolize estrogen and keep estrogen levels in check. However, your gut health will be compromised anyway, or at the very least undergo a drastic change, if you have already entered the perimenopausal state…

Boosting your microbiome health now will have a tremendous effect on your menopausal symptoms and overall health. Look at your entrance into this new stage as the perfect impetus to make some easy and positive changes. The gut is a resilient place; it just needs to be put on the right track by cultivating some simple habits.

3 easy ways to boost your gut health

Change what you eat.

Unlike other endocrine organs, the microbiota has intense plasticity and can alter dramatically and rapidly in response to diet.

Cut the processed foods OUT. They’re gut-killers. Incorporate fermented foods like sauerkraut, kombucha, and kefir. These have live probiotic strains that can replenish beneficial bacteria fast.  Regular consumption of fermented foods is associated with longevity to boot, so don’t miss out!

Take a daily probiotic.

Because low estrogen levels have an impact on the microbiome’s balance, a daily probiotic is helpful to continuously provide a source of beneficial flora. Look for a supplement that contains multiple types of strains. An ounce of apple cider vinegar daily is also a great gut-booster.

Avoid antibiotics (when possible).

Antibiotics are destroyers of bacteria by nature. Many physicians tend to prescribe antibiotics at the drop of a hat, effectively disrupting the gut’s delicate ecosystem and also decreasing the body’s ability to fight off infection on its own. If the issue at hand is not serious, try to avoid taking an antibiotic. A few days of rest, fluids, probiotics, and raw juices can do wonders for immunity.

Just like the immune system, the endocrine system and our hormonal network are in a relationship of mutual causality with our gut. Keeping your gut health in mind and in check will have sweeping impacts not only on menopausal symptoms but your general well-being altogether.

All good things.

Whether you’re just starting to dip your toes into perimenopause, continuing to experience symptoms into postmenopause, or simply looking for some guidance on what to expect in the coming years of life, we’re here for you! For more information and support around your menopause journey, as well as ideas for symptom relief, join us over at Lisa Health.


Dr. Hemalee Patel, DO, is board certified in internal medicine and currently practices at California Pacific Medical Center, Stanford University Hospital & Clinics, and Crossover Health-Facebook Headquarters. Known as a thought leader in the lifestyle medicine movement, Dr. Patel is a frequent speaker and advisor on topics related to empowering and educating individuals using the latest advances in health and wellness so they can prevent and control the development of chronic diseases and achieve balanced lifestyles. She received her BA in Economics and English from UC Berkeley with an emphasis in Preventative Medicine and Nutrition. She completed her medical degree at Touro University and residency at Santa Clara Valley Medical Center.