The Gut Microbiome and Perimenopause Symptoms: What's the Connection?

Gut health has been a hot topic in recent years, and for good reason.

Gut health, which refers your body’s delicate balance of good vs. bad bacteria within your gastrointestinal tract, is one useful measure of overall health and longevity.^1,2 Having “good” gut health may indicate that you have a strong immune system, healthy metabolism, and well-functioning digestion – while poor gut health is more likely to be linked with things such as allergies, fatigue, skin irritation, food intolerances and more.³ And while there are all of these potential connections between gut health and overall health, could there also be a link between gut health and hormonal changes, such as those experienced during perimenopause and menopause?

In recent years, scientists within the women’s health space have begun to ask two important questions— what, if any, is the potential connection between menopause and gut health, and can sustaining a healthy microbiome help with menopause symptoms?

Let’s take a look at what the current research says.

Gut Health and Hormone Health – A Potentially Symbiotic Relationship

Sex hormones, such as progesterone and estrogen, have been shown to affect your balance and composition of gut bacteria,⁴ and vice versa.

Once in menopause, hormones, like estrogen, aren’t the only things to fluctuate and decline—the diversity of your gut microbiome may be shifting as well.⁵

But why is this so important?

There are thousands of species of bacteria present in the human microbiome, all playing different and unique roles throughout the body.⁶ It’s generally accepted in the scientific community that not only does the human microbiome begin to develop at birth, but it also grows and changes rapidly based on dietary exposures and is considered “healthier” as it diversifies.^7,8,9 A more diverse microbiome, according to research, may point to lowered risks for certain diseases as well as less inflammation in the body.^10,11

So, if less estrogen is associated with a reduction in the protective nature of a diverse gut microbiome, that means menopausal women may potentially be more vulnerable to certain negative health outcomes like poor cardiovascular health, depressed moods, obesity and diabetes, to name a few.^12,13 

A 2021 study looking at the gut flora of 9,000 people echoed this line of thinking, with those who had poor gut bacterial diversity displaying signs of unhealthy aging like cognitive decline, loss of strength and mobility, and poor cardiovascular health.¹⁴

But does this mean all women approaching menopause are destined for poor health? Fortunately, the answer to this is, no.

Improving Gut Health May Actually Help with Some Menopause Symptoms

Just as with other pillars of your health, gut health doesn’t have to take a backseat once menopause starts. You can take steps to improve your gut health, which can in turn help to alleviate a number of symptoms associated with the menopausal transition. Let’s look at a few things that could help.

Digestion and Dietary Changes

As women navigate menopause, they may experience digestive issues such as bloating, constipation, and diarrhea.¹⁵ Poor gut health can exacerbate these menopause-induced digestive woes, but incorporating some tweaks to your diet may help.

One of the more important dietary changes you can make is incorporating adequate amounts of fiber. Experts recommend that women aged 51 and older eat 22 grams of fiber a day, while women under 50 should shoot for 25-28 grams daily.¹⁶ Not only does fiber aid in smoother digestion, but it also is associated with a lower risk of heart disease, stroke, diabetes, and potentially even certain cancers.¹⁷

Fiber can be found in a variety of foods such as:¹⁸

• Certain fresh fruits and vegetables (i.e. peas, broccoli, carrots, oranges, bananas and strawberries)
• Various nuts and seeds (i.e. almonds, pistachios, chia seeds)
• Oats and other grains
• Whole-grain breads, cereals, and other products
• Potatoes (with skin)
• Beans
• Lentils
• Whole wheat pasta, rice, and other wheat products

Additionally, incorporating fermented foods, such as yogurt or kimchi, more garlic as well as collagen-boosting foods, such as bone broth, may help support your gut biodiversity as well.¹⁹

Stress Management

For many women, there’s no shortage of stress in mid-life.

But stress can negatively alter levels of bacteria in the gut, which are already being impacted by changing hormones.²⁰ To better manage stress in an effort to improve your gut health, research suggests investing in certain activities to regulate the nervous symptom and to help lower levels of cortisol throughout the body.²¹

Some ideas to help reduce your stress and calm your nervous system can include:²²

• Meditation
• Exercises, like walking
• Hot baths
• Low stimulation activities, like gardening, reading, etc.
• Breath work

Stay Hydrated

It may sound like second nature, but staying well-hydrated, especially during menopause, can be harder than it seems.

Keeping yourself hydrated supports gut health by aiding in digestion, helping your body to break down food and properly absorb its nutrients.²³ By drinking the right amount of fluids per day, you’re essentially giving your body the tools it needs to remove waste and soak up all of the essential nutrients in your meals.²⁴

Most guidelines suggest that adult women should drink no less than 11.5 cups of fluids like water per day.²⁵ However, your body’s hydration needs may increase (or fluctuate) in hot weather, with intense exercise, during illness, or if you’re experiencing symptoms like hot flashes or night sweats.

Gut Health and Menopause — A Mystery Unfolding

As far as medical research goes, the science behind gut health is still developing— especially when it comes to how it correlates to menopause. But what we do know is that taking steps to improve your gut health at any stage of life, menopause included, can certainly pay off in other areas of your health and wellness. 

Resources

1. https://www.nm.org/healthbeat/healthy-tips/7-reasons-to-listen-to-your-gut
2. https://www.betterhealth.vic.gov.au/health/healthyliving/gut-health#
3. https://www.healthline.com/health/gut-health
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7612624/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379122/
6. https://www.healthline.com/nutrition/gut-microbiome-and-health#
7. https://www.amnh.org/exhibitions/the-secret-world-inside-you/microbiome-at-birth#
8. https://pubmed.ncbi.nlm.nih.gov/20668239/
9. https://www.healthline.com/nutrition/gut-microbiome-and-health#
10. https://www.ox.ac.uk/news/2023-12-15-study-shows-diverse-gut-bacteria-communities-protect-against-harmful-pathogens
11. https://www.nature.com/articles/s41467-020-18871-1
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379122/
13. ​​https://www.everydayhealth.com/digestive-health/can-menopause-change-your-gut-microbiome/
14. https://www.nature.com/articles/s42255-021-00348-0
15. https://www.orlandohealth.com/content-hub/digestive-problems-menopause-might-be-to-blame
16. https://www.healthline.com/health/food-nutrition/how-much-fiber-per-day
17. https://www.healthline.com/health/food-nutrition/how-much-fiber-per-day
18. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/high-fiber-foods/art-20050948
19. https://www.healthline.com/health/gut-health#foods-for-gut-health
20. https://www.womenshealthmag.com/uk/food/a45481427/menopause-and-gut-health/#r3z-addoor
21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213601/
22. https://www.healthline.com/health/mind-body/give-your-nervous-system-a-break#takeaway
23. https://www.everydayhealth.com/water-health/water-body-health.aspx
24. https://www.medicalnewstoday.com/articles/290814#benefits
25. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256