Menopause: The Gut-Hormone Connection

Menopause: The Gut-Hormone Connection

How gut bacteria may impact estrogen and what that may mean for women's health across the menopause transition.

Introduction: menopause and the gut microbiome

Menopause is a key phase in women’s health when ovarian production of estrogen declines. Beyond the well-known symptoms such as sleep disruption, mood change and brain fog, it is also a period of increased risk of cardiometabolic and muscoskeletal disorders.

One area of growing interest is the gut microbiome (a highly dynamic ecosystem of trillions of bacteria, fungi, and other microorganisms residing within the gastrointestinal tract) and the bi-directional relationship with estrogen. In particular, the implications on women’s health and menopause.

A growing body of research

Emerging research suggests that sex hormones shape microbial communities. Research over the past several years has asked whether menopause also shifts this balance.

Research led by Brandilyn Peters and published in 2022, sequenced stool samples from 2,300 people. Results demonstrated postmenopausal women tended to have lower diversity, and their microbiome differed less from men's than a premenopausal woman. However, it is important to note that menopause status explained only a small share of overall variation, far less than sex, age or antibiotic use.

Mechanisms:

Estrogen metabolism and the estrobolome: Estrogen and your gut bacteria influence each other. Certain gut bacteria and their genes, collectively known as the estrobolome, make an enzyme called β-glucuronidase. This enzyme unpacks the estrogen so it becomes active again and can be reabsorbed into your bloodstream. In other words, your gut bacteria help influence how much active estrogen your body keeps.

The gut barrier: Estrogen appears to also be important in supporting tight junction proteins in the gut lining.

Further links being explored

• Metabolic health. 
• Bone health: postmenopausal women with osteoporosis show distinct microbial profiles.
• Brain health: estrogen is neuroprotective, but a gut–brain axis specific to menopause has not yet been demonstrated.

Actionable takeaways

Lifestyle and diet

1. Aim to increase the amount and type of fibre. Fibre is the primary fuel for gut bacteria. Aim for 30g per day including a broad mix of vegetables, fruit, pulses, wholegrains, nuts and seeds. Try Probio7’s new FibkreKind, with 50g of fibre per 100g, it’s an easy way to add more fibre to your daily routine.
   
   
2. Reduce refined sugars and refined carbohydrates. Focus on fibre-rich, lower-glycaemic carbohydrate.
   
   
3. Add prebiotic foods and fermented dairy. Onions, garlic, leeks, oats and yoghurt are practical choices to incorporate into a range of recipes from breakfast to dinner.
   
   
4. Stay active. Regular physical activity has been shown to positively influence the composition of the gut microbiota. Moderate aerobic exercise is associated with increased microbial diversity, including higher levels of butyrate‑producing bacteria, microbes essential for maintaining intestinal barrier integrity and regulating inflammatory pathways.
   
   
5. Incorporate a targeted probiotic such as Probio7 Menopause containing three clinically studied strains designed to target the gut-estrogen axis, such as Levilactobacillus brevis KABP™052 (formerly known as Lactobacillus brevis), Lactiplantibacillus plantarum KABP™051 (formerly known as Lactobacillus plantarum), Pediococcus acidilactici KABP™021. These probiotics focus on supporting the gut barrier and reducing intestinal inflammation. Probiotic effects are strain-specific, and they work best alongside a fibre-rich diet rather than instead of one!

Conclusion

Emerging evidence suggests the gut microbiome and hormones influence each other in a bidirectional manner. Estrogen decline has been associated with a less diverse microbiome and a more permeable gut barrier. Supporting your gut microbiome consistently and choosing probiotic supplements with strain-level evidence are beneficial steps to support women’s health.

Author: Charlotte, Co-Founder The Nutritional Biochemist

BSc Biochemistry, MSc Management, MSc Nutrition (KCL)

Sources:

·        Liaquat M, Minihane AM, Vauzour D, Pontifex MG. The gut microbiota in menopause: Is there a role for prebiotic and probiotic solutions?. Post Reprod Health. 2025;31(2):105-114. doi:10.1177/20533691251340491

·        Lim MJS, Parlindungan E, See E, Gan CH, Yap R, Yong GJM. Diet, the Gut Microbiome, and Estrogen Physiology: A Review in Menopausal Health and Interventions. Nutrients. 2026;18(7):1052. Published 2026 Mar 26. doi:10.3390/nu18071052

·       Peters BA, Lin J, Qi Q, et al. Menopause Is Associated with an Altered Gut Microbiome and Estrobolome, with Implications for Adverse Cardiometabolic Risk in the Hispanic Community Health Study/Study of Latinos. mSystems. 2022;7(3):e0027322. doi:10.1128/msystems.00273-22

·       Reytor-González, C., Verde, L., Annunziata, G., Román-Galeano, N. M., Horowitz, R., Galasso, M., Muscogiuri, G., Frias-Toral, E., Simancas-Racines, D., & Barrea, L. (2026). The Role of Gut Microbiota in Postmenopausal Women: Implications for Lipid Metabolism and Targeted Nutritional Interventions. Current nutrition reports, 15(1), 32.

·       Wang H, Shi F, Zheng L, Zhou W, Mi B, Wu S and Feng X (2025) Gut microbiota has the potential to improve health of menopausal women by regulating estrogen. Front. Endocrinol. 16:1562332. doi: 10.3389/fendo.2025.1562332