Spotlight on the Gut Microbiome in Menopause

The transition through menopause is often discussed in terms of hormones, hot flashes, and bone health—but did you know that your gut microbiome also plays a vital role in this life stage? Emerging research reveals that the tiny ecosystem of bacteria in our intestines shifts during menopause, influencing metabolism, estrogen regulation, and even long-term disease risk. Could this be one of the reasons why is so difficult to lose weight in menopause?

What the Research Shows

Several studies highlight the complex connection between sex hormones and the gut microbiome. During reproductive years, women tend to have a more diverse gut microbiome compared to men. However, with the hormonal changes of menopause, microbial diversity declines and begins to resemble the less varied microbiome typically seen in males (Shen et al., 2022). Why this happens is not fully understood, and while hormone replacement therapy may play a role, its effects on the microbiome remain unclear.

This reduction in diversity matters because lower microbial variety has been linked to increased risk of chronic disease.

Fortunately, diet and lifestyle are powerful modulators of the gut microbiome, creating opportunities for interventions during peri- and post-menopause (Shen et al., 2022).

Homegrown cabbage fermenting to produce sauerkraut. a microbiome building food

Gut Microbiome and Estrogen Metabolism

The gut microbiome is deeply intertwined with estrogen metabolism. Certain gut bacteria produce an enzyme called β-glucuronidase, which helps recycle and reactivate estrogen in the body (Sheng et al., 2023). When microbial diversity decreases, circulating estrogen levels also decline, potentially increasing risks for lipid metabolism disorders, osteoporosis, and cognitive changes. It is exciting to think that perhaps, increasing our microbiome during menopause can help alleviate some of these health risks.

Interestingly, studies in rodents show that removing the ovaries (to mimic menopause) alters the microbiome in ways that promote weight gain, insulin resistance, and slower metabolism. When estrogen is reintroduced, these effects are partially reversed (Choi et al., 2020). While human studies are less conclusive, they suggest a link between menopause, microbiome changes, and rising metabolic disease risk.

A Two-Way Street: Hormones and Microbes

The relationship between hormones and microbes is a two-way street. Estrogen influences microbial communities, while microbes regulate estrogen metabolism. This means that as hormone levels shift during perimenopause and menopause, the microbial ecosystem shifts as well—sometimes in ways that increase disease susceptibility (Fuhrman et al., 2023).

Because perimenopause is a prolonged transition period, these hormonal fluctuations can significantly impact microbial balance. The result is not just hot flashes and night sweats, but potential changes in weight regulation, cardiovascular risk, and bone health.

What This Means for You

While more research is needed, one thing is clear: the gut microbiome represents an exciting new frontier in supporting women’s health during menopause. Modulating the microbiome—through diet, lifestyle, and possibly specific probiotics—may help regulate estrogen levels and reduce menopause-related health risks. Improving the health of your microbiome could potentially help with weight loss resistance, high cholesterol, insulin resistance and other menopausal health risks.

Some practical steps to support your microbiome during menopause include:

• Eating a diverse, plant-rich diet high in fiber

• Incorporating fermented foods like yogurt, kefir, sauerkraut, and kimchi

• Limiting highly processed foods that reduce microbial diversity

• Considering probiotic and prebiotic support under the guidance of a healthcare provider

By nourishing your gut, you may not only ease menopausal symptoms but also support long-term health.

We are pleased to collaborate with you in creating a nutrition care plan to enhance your microbiome. Schedule a discovery call, and we can provide more information about our programs, which may involve microbiome testing to identify specific optimization opportunities.

References

• Shen Y, et al. (2022). Spotlight on the Gut Microbiome in Menopause: Current Insights. Frontiers in Endocrinology. PMC9330782

• Choi YJ, et al. (2020). Gut microbiome and menopause: associations with body composition and metabolic health. Endocrinology. PubMed 33235036

• Sheng Q, et al. (2023). Gut microbiota has the potential to improve health of menopausal women by regulating estrogen. Frontiers in Microbiology. PMC10173297

• Fuhrman BJ, et al. (2023). Menopausal shift on women’s health and microbial niches. npj Women’s Health.