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The key to easier menopause lies in your gut, say experts

About eight out of every 10 women find at least one menopause symptom “very difficult” to live with, having problems ranging from brain fog to sleep issues and anxiety, and experts now believe our gut health could be the non-medical solution to these symptoms.

Menopause affects every woman, and many, whether on HRT or not, experience some sort of health problem in midlife, often related to this change of life.

A growing science has been looking at the link between our microbiome and an improvement in mental health, reports The Telegraph, with a 2020 review of studies finding a correlation between probiotic bacteria and sleep quality, as well as mood improvement in people with anxiety and depression.

Now experts are focusing more on the menopause, with an increasing number believing our gut health could be the non-medical solution to menopause symptoms.

This approach can also work in tandem with hormone replacement therapy. In some cases, HRT has been shown to positively affect gut health, as lower oestrogen levels during the menopause reduces the diversity of the microbiome, and topping up those levels reverses that effect.

Dr Shahzadi Harper is a GP and menopause specialist. “As HRT directly affects the gut microbiome, it can help with other symptoms like fatigue and mood,” she says.

Dr Jolene Brighten, a naturopathic endocrinologist who specialises in women’s health and hormone balance, agrees. “HRT has a crucial role in oestrogen metabolism.”

Why oestrogen matters

“The drop in oestrogen during both perimenopause and menopause, and the reduction in diversity in the gut microbiome affects how the gut enzyme functions,” says Harper. “This can exacerbate some of our menopause symptoms like low mood and anxiety, while increasing those tired, sluggish feelings.”

Sex hormones, particularly oestrogen, have a powerful influence on the way your gut and brain communicate – this is known as the gut-brain axis. “Because your gut health affects your brain health, metabolism and immunity, poor gut health can amplify the issues many women experience during the menopause,” says Brighten.

“Brain fog and weight gain can accompany menopause, and these are directly impacted by poor gut health. In addition, the gut is a major conversion site for the thyroid hormone – where this hormone is activated – influencing your mood, digestion and energy.”

Rebalancing your gut

Understanding this process starts with understanding the role of the hormone oestrobolome.

“Oestrobolome is made up of the microbes in the gut that interact with oestrogen,” says Brighten. “They are in part responsible for keeping your hormones at optimal levels and your vagina healthy.”

An unbalanced microbiome, however, can disturb levels of oestrobolome, which can in turn impact your weight, libido, sleep and energy levels.

“Poor sleep will in turn affect your cognition, concentration and focus, leading to a general loss of confidence,” says Harper.

“What’s more, as 90% of our serotonin – the happy neurochemical – is made in our gut, when the microbiome is not working well it can cause anxiety and low mood.”

The link between the gut microbiome and your brain, linked through the multitude of nerve endings in your gut, is the subject of ongoing research. “These nerves connect to a larger one called the vagus nerve, which runs like a motorway from your intestines up to your brain,” says menopause nutritionist Penny Crowther.

“Communication travels both ways, meaning that stressful thoughts and feelings can bring about changes in how your gut works as well as the other way around.”

Preventing digestive issues

Some women find the hormonal changes of menopause significantly affect their digestion, causing issues like bloating and excessive gas.

“Oestrogen and progesterone affect our gut transit, so their decrease means our transit slows down,” says Harper. “Our food remains within the guts and fermentation occurs, releasing gas and wind. Also, because oestrogen helps the body retain moisture, the drop in oestrogen often results in constipation.”

“Sticking to regular mealtimes and not missing meals will keep the muscles of your gut moving,” says nutritionist Emily Foster. “Meanwhile, acid reflux is a common problem for menopausal women and like most gut issues this can be heavily impacted by stress levels. Carrying excessive weight can also increase reflux symptoms.

Stress can have other negative impacts, says Crowther: “The stress that goes with the menopause may also affect the vital protective layer of cells in your gut known as your gut barrier. Keeping this barrier healthy is critical because it allows nutrients to be absorbed from the foods you eat, but also keeps harmful toxins out. If your gut barrier is not healthy, you are more likely to get irritable bowel syndrome (IBS).”

Prebiotics and probiotics

Foods that encourage the growth of healthy gut bacteria – prebiotics – include wholegrains and green leafy veg, bananas and almonds. Probiotics – the live bacteria and yeasts that are good for you – can also be taken as supplements and found in some foods, like live yoghurt.

Says Crowther: “Some prebiotics and probiotics produce chemical messengers called neurotransmitters, which help reduce anxiety and improve the way you deal with stress. These include GABA, which has a relaxing effect, as well as serotonin and the feel-good hormone dopamine.”

These neurotransmitters are particularly helpful while navigating the ups and downs of menopausal hormonal mood swings.

“What’s more, probiotics help reduce inflammation, which is known to play an important role in depression and many chronic diseases of midlife and beyond,” she adds.


The Telegraph article – The key to a smoother menopause lies in your gut (Restricted access)


See more from MedicalBrief archives:


Hormone therapies best for menopause symptoms, new review finds


Hormone therapy for menopause symptoms: two decades on, the fear of risks persist


HRT should be given earlier as menopause ‘reshapes the brainʼ – Nature Scientific Reports


Britain launches ‘menopause taskforce’ to tackle workplace taboos


Expensive menopause treatments no better than placebo






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