How gut health and menopause are connected?

As women hit menopause, the journey brings many changes that go beyond the hot flashes, mood swings and irregular periods. Research is now uncovering a big connection between menopause and gut health, and how the changes in hormones during menopause can impact the gut microbiome and overall health and wellbeing. Knowing the link between gut health and menopause means we can support our bodies better during this time.

Menopause and the Gut Microbiome

We hear a great deal about the words like “microbiome”, “good bacteria”, “bad bacteria from the experts. But what is it exactly and how it is connected to menopause?

The gut microbiome is a community of trillions of bacteria and other microorganisms that live in our digestive tract. They help with digestion, immune function and overall health. During menopause the drop in oestrogen can change the composition and diversity of the gut microbiome. This shift can lead to a less resilient microbiome and increased vulnerability to inflammation, poor digestion and even mental health changes as gut health and mood are connected.

The Gut-Hormone Connection

Hormones and the gut microbiome have a two way relationship; hormones can impact gut health and the gut can impact hormone levels. For example, some gut bacteria can produce and regulate hormones including oestrogen. When the balance of gut bacteria is out of whack so is hormone production and processing. This is especially important during menopause when hormone levels are already changing and an unhealthy gut can make symptoms worse like mood swings, fatigue and even weight gain.

The Microbiome, Hormones and Menopause

The estrobolome is a subset of the gut microbiome that metabolises oestrogens. It’s a key player in regulating oestrogen levels in the body by breaking down and recycling oestrogen from food and other sources. During menopause the drop in oestrogen combined with changes in the estrobolome can lead to oestrogen imbalance and affect everything from bone density to cardiovascular health. Having a balanced gut microbiome can help support stable oestrogen levels which is important for managing menopausal symptoms.

Menopause, Stress and Gut Health

Women experience more stress during menopause transition, from fluctuating hormones and life changes of midlife. Stress affects gut health in many ways. Cortisol the “stress hormone” can reduce gut bacteria diversity, impair digestion and promote inflammation. This cycle can exacerbate symptoms like bloating, indigestion and mood swings. As many women experience more anxiety or stress related issues during menopause these effects on gut health can be more pronounced.

Menopause Gut Issues

During menopause, women can experience a range of gut symptoms but some of the most common are bloating, gas, indigestion, constipation and diarrhea. These can come from hormonal changes that slow down digestion and reduce stomach acid resulting in discomfort and nutrient malabsorption. Loss of estrogen also affects gut motility, slowing down food movement through the digestive tract. This slowing down of food movement exacerbates bloating and constipation, two of the most common complaints for women in midlife.

The Science of Gut Health and Menopause

Research is ongoing on how hormonal changes during menopause affect gut health. A recent study in Frontiers in Endocrinology shows how menopause disrupts the gut microbiome, reducing microbial diversity and increasing inflammation markers, both of which can worsen menopausal symptoms. Research on the estrobolome is also highlighting its importance in estrogen metabolism, making it the area of interest for researchers to understand how to support women’s health through gut microbiome balance during menopause.

The Role of Estrogen in Gut Health

Estrogen is important for a healthy gut lining and microbiome diversity. It also regulates immune function in the gut. When estrogen levels drop the gut becomes more permeable, a condition known as “leaky gut” where bacteria and toxins can pass into the bloodstream and cause inflammation. A healthy gut with balanced estrogen is key to overall wellbeing and helps to alleviate menopausal symptoms like fatigue, digestive distress and inflammation.

Benefits of a Healthy Gut Microbiome During Menopause

Having a healthy gut microbiome during menopause has many benefits:

• Reduced Inflammation: A balanced microbiome can decrease inflammation markers in the body which are often high in women during menopause.
• Improved Mood: The gut and brain are connected via the gut-brain axis, a healthy gut can support mental wellbeing and manage mood swings and anxiety.
• Better Metabolism and Weight Management: The gut microbiome influences metabolism and energy balance which can help with weight changes during menopause.
• Bone: Estrogen loss during menopause leads to bone density loss and research shows a healthy microbiome can support bone health by increasing calcium.

Building a Healthy Gut Microbiome

During menopause, building and maintaining a healthy gut microbiome is about dietary, lifestyle and supplement choices:

• Eat a Rainbow: Foods high in fibre like veggies, fruits, legumes and whole grains feed the good bacteria in the gut and promote a diverse microbiome.
• Add Probiotics and Prebiotics: Probiotics in yogurt, kefir, sauerkraut and other fermented foods can introduce good bacteria into the gut. Prebiotics like garlic, onions and asparagus feed these bacteria.
• Limit Processed Foods and Sugar: High sugar and processed food intake can cause inflammation and feed bad bacteria which can harm the gut.
• Stay Hydrated: Water is good for digestion and the gut lining.

Can HRT Improve Gut Health?

As a functional medicine practitioner, this is one of the common questions I am asked.

HRT is used to manage menopausal symptoms and can have a positive effect on gut health by stabilising oestrogen levels. By replacing oestrogen, HRT can support gut motility and reduce the risk of constipation and other digestive issues. Some research suggests HRT may also promote a healthier gut microbiome but more research is needed to confirm this. If you want to explore more about HRT and how it can help women during menopause or perimenopause, read this article.

Functional Medicine Tests for Gut Health in Menopause

Functional medicine looks at gut health in a holistic way and often uses various tests to get a detailed picture of a woman’s gut health during menopause. Here are some of the tests used:

1. Micronutrient Testing: This checks if key vitamins and minerals are at optimal levels as poor absorption can be a sign of gut health issues.
2. Comprehensive Stool Testing: By looking at the diversity and balance of bacteria in the stool this test can give insight into digestive health, inflammation and microbial balance.
3. Food Sensitivity Testing: Identifying foods that cause inflammation can be helpful for women who experience digestive discomfort or suspected “leaky gut” during menopause.

What Can You Do to Support Gut Health During Menopause?

Along with dietary changes, certain lifestyle habits can support a healthy gut during menopause:

• Exercise: Physical activity supports gut motility and microbial diversity.
• Manage Stress: Mindfulness, yoga or even regular walks can lower cortisol levels and protect the gut from stress related imbalances.
• Get Enough Sleep: Poor sleep can disrupt the gut microbiome so aim for good sleep to support gut health.

Summary

Menopause is a change but knowing about the gut microbiome can give women the power to make informed choices about their health. By nurturing gut health through diet, lifestyle and potentially HRT women can reduce some of the symptoms of menopause and feel better. With every good choice you’re not only managing menopause symptoms but also investing in long term health for your gut and body.

Resource

https://www.genome.gov/genetics-glossary/Microbiome

https://pmc.ncbi.nlm.nih.gov/articles/PMC9379122/

https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1139056/full