Gut Health During Menopause: Causes + Fixes

For many women, menopause marks a time of transition and a wave of physical and emotional changes. Hot flashes, night sweats and mood swings can become unwelcome companions. But what if there was a hidden player in these experiences – a community of trillions of bacteria residing in your gut? The gut microbiome isn’t just about digestion. It plays a crucial role in regulating hormones, immunity and even mood. Here’s what you need to know about the gut-hormonal connection, and how you can support good gut health during menopause.

The estrogen + gut health connection

Estrogen, the dominant female sex hormone, doesn’t just regulate our menstrual cycle and reproductive health. It also plays a surprising role in shaping the gut microbiome.

“Higher levels of estrogen have been observed to support gut bacteria diversity,” explains Michelle Routhenstein, MS, RD, CDCES, CDN, a Preventive Cardiology Dietitian and member of the Medical Advisory Committee for the National Menopause Foundation. “This diversity not only aids in maintaining healthy digestion and overall gut function but also contributes to cardiovascular health and well being.”

How the gut microbiome shifts during menopause

During menopause, as estrogen levels plummet, this disrupts the delicate balance.“When estrogen and progesterone are lost and testosterone continues its steady decline, the fostering nature of these hormones are lost and so is the biodiversity of the bacteria,” says Bruce Dorr, MD, Senior Medical Advisor at Biote. “This can create digestive issues and immunity loss.”

Routhenstein adds that a lack of biodiversity can lead to an imbalance of bacteria. Specifically, she cites “decreased levels of Firmicutes and Ruminococcus, and increased levels of Butyricimonas and Bacteroides.” A decrease in the former two, “known for their role in fiber fermentation and short-chain fatty acid production, could potentially harm gut health and metabolic function.” Consequently, the latter two may “have adverse effects on inflammatory pathways and nutrient metabolism, potentially increasing heart disease risk and compromising overall health.”

The benefits of good gut health during menopause

“Supporting a healthy gut microbiome can help menopausal symptoms by enhancing nutrient absorption, addressing possible delays in gut transit time and reducing inflammation,” explains Routhenstein. “This is important because the gut microbiome plays a strong role in inflammation and immune health, which may decline during menopause.”

But there are more benefits to consider. Routhenstein continues by saying “a balanced gut microbiome can also help to combat, prevent and mitigate hot flashes, mood swings, and weight fluctuations, common during the menopausal period.”

The best foods to eat for a healthy gut

mature woman supporting a healthy gut during menopause by preparing fruits and vegetables in kitchen — Getty

Fortunately, there are several dietary changes you can make to cultivate a gut microbiome that thrives during menopause. “Ideal diets have large amounts of protein fiber and antioxidants, which is why I tell my patients to eat at least 4 colors of the rainbow every day and not just foods that are beige!,” says Dr. Dorr.

So, if fiber is our friend, what types of food can we begin eating? “We want to incorporate a diverse range of fiber rich foods like fruits, vegetables, whole grains, legumes, nuts, seeds, and fermented foods to nourish beneficial gut bacteria,” says Routhenstein. “Healthy probiotics can be found in fermented foods like kimchi, sauerkraut and minimally sweetened yogurt/kefir,” adds Dr. Dorr.

Other ways to improve your gut health during menopause

In addition to dietary changes, here are some other ways to support a healthy gut microbiome during menopause. “Engaging in regular physical activity, managing stress effectively, prioritizing adequate sleep, minimizing unnecessary antibiotic use and scheduling regular health check-ups,” can all help, explains Routhenstein.