Menopause is a natural part of life where the body starts to run out of estrogen and progesterone and eventually stops menstruating. These hormonal shifts can cause numerous symptoms including hot flashes, mood swings, weight gain and sleep disturbances.
But did you know menopause can also affect gut health and that your gut health can help you through this hormonal change?
Gut health means the integrity of the gut lining, a healthy gut immune system and a balanced and diverse community of microorganisms in the digestive tract. These microorganisms play a big role in overall health by helping digestion, regulating metabolism and supporting the immune system.
The gut bacteria also play a role in supporting hormone levels in the body. Let’s get started!
What is the Estrobolome?
The estrobolome is the term used to describe the specialized subset of gut bacteria and their genes that metabolize and modulate estrogen in the human body.
Estrogen is detoxified (or made inactive) by the liver and then excreted into the gut via the bile. Specialized bacteria produce enzymes that re-activate estrogen into active forms or so it can be re-absorbed back into the body depending on the body’s needs. These include enzymes such as beta-Glucuronidase and sulfatase.
During perimenopause when estrogen levels fluctuate, the estrobolome’s role in recycling and balancing estrogen becomes critical.
A healthy estrobolome can support hormone balance and reduce symptoms of low estrogen like hot flashes and mood swings. A healthy microbiome is also linked to lower risk of estrogen-deficiency related conditions like osteoporosis and heart disease.
Why Your Estrobolome and Gut Health Matters in Menopause
Menopause means natural decline of estrogen which can cause hot flashes, sleep disturbances and mood changes.
A balanced estrobolome can help reduce these symptoms by maintaining stable estrogen levels. When estrogen is properly metabolized the body can avoid extremes of too much or too little, both of which can cause symptoms. By supporting a healthy estrobolome women can promote hormonal balance and alleviate the toughest part of menopause.
The Gut-Hormone Connection
The gut microbiome doesn’t just affect digestion; it plays a direct role in hormone health. The gut talks to the endocrine system through the gut-brain axis.
The health of your gut and your gut microbiome affects hormones like stress hormone - cortisol and serotonin which affect mood, mental health, stress and sleep – issues that are common during menopause.
Also, gut bacteria influence thyroid function, energy and metabolism and immune function.
Gut bacteria recycle ‘sex hormones’ like estrogen, progesterone and testosterone. For example, estrogen metabolites that are removed from the liver via bile into the gut can be re-activated and re-absorbed back into circulation by certain bacteria.
Gut bacteria also play similar roles in recycling and re-activating progesterone and testosterone.
The gut microbiome changes during menopause in a way that is associated with metabolic health, for some women there is an increase in insulin resistance.
A healthy gut microbiome is important not only for estrogen management but also for overall hormonal balance during menopause.
Gut Health and Hormonal Imbalance
Gut dysbiosis is the scientific term for an imbalance of gut bacteria. Dysbiosis can worsen menopausal symptoms by disrupting hormone levels and the body’s ability to detox and eliminate estrogen, equally it can disrupt the body’s ability to re-use eliminated estrogen.
Symptoms of dysbiosis like bloating, fatigue and irregular bowel movements are often worse during menopause. A disrupted estrobolome can also cause estrogen dominance which can lead to weight gain, mood changes, PMS or heavier periods.
Chronic gut dysbiosis can disrupt the immune system and long term can contribute to many chronic health conditions like heart disease, diabetes and breast cancer.
Supporting gut health through diet and lifestyle can therefore directly impact hormone regulation and reduce dysbiosis symptoms.
Related: Herbs for Female Hormone Balance
Phytoestrogens And The Estrobolome
Phytoestrogens are natural compounds found in plant foods that act on estrogen receptors in a weak way because of their similar structure to female estrogens. They can bind to estrogen receptors in the body and act as estrogen or anti-estrogen depending on the body’s hormonal needs. This means they act as SERMS or selective estrogen receptor modulators.
Foods that are high in phytoestrogens are soy, flaxseed, grains, fruits and vegetables.
Phytoestrogens are metabolized by gut bacteria into active forms that can interact with the body’s estrogen receptors. The balance of gut bacteria plays a big role in how phytoestrogens are processed and used by the body.
Phytoestrogens primarily interact with one type of estrogen receptor, ERβ, which has different effects on different tissues in the body. They don’t bind as strongly as the body’s own estrogen so their effects vary based on how much natural estrogen is present.
For example in a low-estrogen environment they provide mild estrogenic effects and in high-estrogen situations they can act anti-estrogenic.
Food To Support Gut Health and the Estrobolome During Menopause
You already know that by supporting your gut health your symptoms will improve. Here are the keys to transform your unhealthy gut!
Dietary Changes to Nourish the Gut
The trick to supporting your gut health and hormone health is to focus on fiber rich plant foods especially prebiotic fibers, probiotic foods brassicas and phytoestrogens. A plant-based diet improves the gut microbiome and reduces chronic inflammation (Gut microbiome & plant-based diet).
Probiotic and Fermented Foods
Probiotic foods should be included in your diet and there’s always a type of fermented food for everyone.
Fermented foods include: yogurt, kefir, sauerkraut, kimchi, fermented cheeses, buttermilk, raw unfiltered apple cider vinegar and olives in brine.
Specific bacteria (like Lactobacillus and Bifidobacterium) can be supplemented to support hormone balance.
Prebiotic Foods
Prebiotic foods are important because they feed your good bacteria and help them to help you.
Yummy prebiotic foods include garlic, onions, leeks, asparagus, bananas, flaxseeds, apples, soy and cruciferous vegetables like broccoli and cauliflower.
Post Biotics
Prebiotics, plant fibers and fermeted foods provide substrates for bacteria to ferment into POSTBIOTICS.
Post biotics include short chain fatty acids such as butyrate, and vitamins such as K2. They have beneficial effects on our hormones, metabolism and immune function.
Increase Brassicas for Estrogen Metabolism
Cruciferous vegetables like broccoli, cabbage, cauliflower and Brussels sprouts support estrogen metabolism by aiding liver detoxification. These vegetables also contain phytochemicals that have anti-cancer properties.
Indole-3-carbinol (I3C) when digested is converted into diindolylmethane (DIM) which helps to break down estrogen into its beneficial metabolites.
Sulforaphane is an antioxidant that enhances phase II liver detoxification enzymes. These are needed to neutralize and prepare estrogen and other hormones for excretion. This pathway also reduces oxidative stress and chronic inflammation, supporting overall hormone health.
Phytoestrogen Foods Support Estrogen Balance
Phytoestrogen foods and herbs can make a big difference in hormonal balance.
These foods are found in whole foods:
Soy and soy products (tofu, tempeh, miso)
Flaxseed
Sesame seeds
Legumes (beans, lentils and peas)
Garlic
The best phytoestrogen herbs for estrogen hormone balance are:
Red clover – rich in phytoestrogens and other nutrients that support estrogen metabolism.
Siberian Rhubarb root - some research indicates it helps with menopause symptoms.
S-equol, an active version of daidzein, a phytoestrogen, is a new supplement that may help with hormone balance.
Minimise Alcohol
Alcohol does provide much benefit to gut and hormone health. It is well-known to contribute to gut dysbiosis, promotes leaky gut (increased intestinal permeability) and small-intestinal bowel overgrowth (SIBO). It also triggers immune imbalance that contributes to colon and breast cancer, diabetes, inflammatory bowel diseases, irritable bowel and liver cirrhosis.
Some women do find they use more alcohol if their menopause symptoms are poorly managed. If you find our alcohol consumption increasing, seek advice from you health provider.
Related: HRT for Menopause
Lifestyle Habits for a Healthy Estrobolome and Hormone Balance
Exercise Improves Gut Health
Exercise has been shown to increase gut microbiome diversity and the Bacteroidetes-Firmicutes ratio which is associated with better metabolic health and less inflammation.
Exercise not only supports gut health but also helps with menopausal sleep disturbances (Exercise, Sleep & Menopause) and reduced menopausal symptoms and increased wellbeing (Exercise & Menopausal Symptoms).
Exercise’s impact on the gut microbiome helps to maintain a balanced estrobolome and overall hormone health.
Sleep Quality
Good sleep is key to hormonal health. Bad sleep increases cortisol which disrupts gut health and hormones. Prioritize sleep by good habits like limiting screen time before bed and having a consistent sleep schedule supports the gut-brain axis and overall hormonal balance.
Stress and Gut Health
Chronic stress can damage gut health by increasing inflammation, damaging the gut lining and encouraging bad bacteria growth. Stress induced cortisol can also worsen hormonal imbalances including menopausal symptoms.
Mindfulness, meditation and regular exercise can help manage stress and support the gut-hormone connection. By reducing stress women can have a healthier gut environment and support hormone regulation.
Related: Stress & Digestion
The Bottom Line: Hormones and Estrobolome
Menopause is tough on hormone health but supporting the gut especially the estrobolome can help your hormone health.
By following a plant-based gut friendly diet, reducing stress and incorporating supportive lifestyle habits women can achieve more hormonal balance and less symptoms.
Nurturing gut health is a proactive way to ease the menopausal transition and overall well being.
If you are interested in joining our Menothrive program to help you thrive through menopause
Register your interest here!
References
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Knezevic J, Starchl C, Tmava Berisha A, Amrein K. Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function? Nutrients. 2020 Jun 12;12(6):1769.
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Qian J, Sun S, Wang M, et al. The effect of exercise intervention on improving sleep in menopausal women: a systematic review and meta-analysis. Front Med (Lausanne). 2023 Apr 25;10:1092294.
Engen PA, Green SJ, Voigt RM, et al. The Gastrointestinal Microbiome: Alcohol Effects on the Composition of Intestinal Microbiota. Alcohol Res. 2015;37(2):223-36.
siamah N, Aladenola OB, Cronin C, et al. Effects of physical activity on menopausal symptoms, psychosomatic factors and well-being among working women in England: A path analysis. Womens Health (Lond). 2024 Jan-Dec;20:17455057241290370.
Østergaard SK, Cetin Z, Rasmussen HH, et al. Modulating the gut microbiota in Crohn's disease: a pilot study on the impact of a plant-based diet with DNA-based monitoring. Front Nutr. 2024 Oct 31;11:1502967.
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