Menopause is a huge transition, and while we often focus on declining oestrogen levels, we don’t always consider the role our gut plays in this journey. The latest research is shedding light on just how much our gut microbiome affects menopause symptoms—and even how menopause, in turn, affects our gut.
Understanding this connection could be the key to reducing symptoms like bloating, brain fog, weight gain, and mood swings. Let’s dive into it and explore how we can support our bodies through this natural phase.
The Gut’s Role in Hormone Regulation
Our gut microbiome is home to trillions of bacteria, and among them are specific microbes that help regulate oestrogen levels. This collection of bacteria is called the oestrobolome, and it plays a crucial role in metabolising and recycling oestrogen in the body.
Here’s how it works:
- Oestrogen is produced by the ovaries and travels through the body in an active form.
- Once used, oestrogen is deactivated by the liver and sent to the gut for excretion.
- Certain gut bacteria can reactivate oestrogen, allowing the body to reuse it.
This recycling process is important, especially during menopause when natural oestrogen levels decline. If your gut microbiome is diverse and healthy, it can help you retain beneficial oestrogen, potentially alleviating some common menopause symptoms. However, if your gut is out of balance—known as dysbiosis—this process may be disrupted, leading to an excess or deficiency of oestrogen.
What Happens to the Gut During Menopause?
Oestrogen and testosterone help regulate the gut microbiome, meaning their decline during perimenopause and menopause can lead to changes in gut bacteria. Studies show that postmenopausal women tend to have less microbial diversity, which can impact digestion, metabolism, and overall health. Here’s what that means:
- Increased gut permeability: Lower oestrogen levels can weaken the gut barrier, allowing harmful bacteria and toxins to enter the bloodstream. This can trigger inflammation, which has been linked to weight gain, insulin resistance, and even mood disorders. This can also lead to an increase in food sensitivities which are linked to gut symptoms as well as fatigue, brain fog, skin disorders and aching joints.
- Shifts in bacterial balance: Within the gut there are specific bacterial families (or phyla). These include Firmicutes and Bacteroidetes. A higher ratio of Firmicutes to Bacteroidetes bacteria has been associated with weight gain and metabolic issues in menopausal women.
- Digestive issues: Many women notice changes in their bowel habits during menopause, including bloating, constipation, and increased sensitivity to certain foods.
Hormonal shifts can also influence the way we metabolise food, store fat, and absorb nutrients, making it even more important to maintain a healthy gut during this time.
Common Menopause Symptoms Linked to Gut Health
Your gut health could be influencing a range of symptoms you may not have connected to menopause, such as:
- IBS-like symptoms: Oestrogen helps regulate gut motility and inflammation. When levels drop, you may experience bloating, wind, diarrhoea, or constipation.
- Weight gain: The gut microbiome influences metabolism. A shift in bacterial balance may contribute to fat storage, especially around the abdomen.
- Brain fog & mood swings: The gut-brain axis means that gut imbalances can impact serotonin and other neurotransmitters, affecting mood and cognitive function.
- Hot flushes & night sweats: Some research suggests that the gut microbiome plays a role in regulating body temperature through its effect on hormone metabolism.
- Joint pain & inflammation: An unhealthy gut can lead to increased inflammation, which may contribute to joint stiffness and discomfort.
Can HRT Help Restore Gut Health?
Hormone Replacement Therapy (HRT) is widely used to help manage menopause symptoms, but could it also support gut health? While research is still ongoing, early studies suggest that replacing oestrogen and progesterone may help restore microbial diversity and improve gut barrier function.
Animal studies have shown that HRT can positively influence gut bacteria, but more research is needed to confirm whether this is also true for menopausal women. If you’re considering HRT, it may be an additional benefit to keep in mind alongside its other effects.
How to Support Your Gut Health During Menopause
The good news? You can actively support your gut microbiome and improve your menopause experience. Here are some simple but powerful strategies:
1. Eat More Fibre
Fibre is essential for a healthy gut. It feeds beneficial bacteria, supports digestion, and helps regulate hormones. Aim for 30g of fibre a day, but most people only manage around 15-20g. Some of the best sources include:
- Flaxseeds
- Onions & garlic
- Whole grains
- Beans & lentils (start slow if they cause bloating)
- Jerusalem artichokes
- Leeks
- Raspberries & bananas
2. Include Probiotic & Fermented Foods
These foods contain beneficial bacteria that can help balance your microbiome. Good options include:
- Natural yoghurt
- Kefir
- Kombucha
- Miso
- Kimchi & sauerkraut
If you’re new to fermented foods, introduce them slowly. If they cause bloating or discomfort, it could indicate an imbalanced gut that needs extra support.
3. Prioritise Protein
Protein is essential for hormone production, muscle maintenance, and mood regulation. It also helps stabilise blood sugar, which can be erratic during menopause. Aim for 1.2g of protein per kg of body weight daily from sources like:
- Chicken & turkey
- Fish & seafood
- Eggs
- Quinoa
- Nuts & seeds
- Legumes & pulses
4. Include Phytoestrogen-Rich Foods to Support Hormone Balance
Phytoestrogens are plant-based compounds that mimic oestrogen in the body. While they’re not as strong as the oestrogen our bodies produce, they can help modulate hormone levels, which may be beneficial during menopause when natural oestrogen declines. Including these foods in your diet can offer gentle hormonal support:
- Flaxseeds – One of the richest sources of lignans, a type of phytoestrogen that can help balance oestrogen levels.
- Soy & Soy Products – Tofu, tempeh, edamame, and miso contain isoflavones, another type of phytoestrogen linked to improved menopause symptoms.
- Sesame Seeds – Like flaxseeds, sesame seeds contain lignans that may support hormone balance.
- Chickpeas & Lentils – These legumes contain isoflavones and are a great plant-based protein source.
- Apples, Berries & Peaches – Certain fruits contain small amounts of phytoestrogens and provide antioxidants to support overall health.
- Cruciferous Vegetables – Broccoli, cabbage, and Brussels sprouts help the body metabolise oestrogen effectively, supporting hormonal balance.
- Oats & Whole Grains – Whole grains provide fibre and phytoestrogens while also helping to stabilise blood sugar levels.
5. Eat Healthy Fats
Fats are crucial for hormone production and brain health. They also keep you feeling satisfied after meals. Include:
- Avocados
- Salmon & tuna
- Almonds & walnuts
- Pumpkin seeds
- Extra virgin olive oil
6. Stay Active
Movement helps support digestion and encourages a healthy gut. Even 20 minutes of daily exercise—like walking, yoga, or strength training—can make a big difference.
7. Manage Stress
The gut-brain connection means that stress can disrupt digestion and microbiome balance. Try:
- Deep breathing before meals
- Meditation or mindfulness
- Gentle movement like yoga
- Spending time in nature
8. Stay Hydrated
Water helps keep digestion smooth and prevents constipation. Aim for at least 1.5-2 litres per day.
9. Reduce Alcohol & Caffeine
Both can irritate the gut lining, trigger cortisol (the stress hormone), and worsen menopause symptoms like hot flushes and insomnia.
10. Give up Smoking
Smoking negatively impacts gut health and increases the risk of digestive issues and bowel cancer. If you smoke, quitting is one of the best things you can do for your overall health.
Final Thoughts
Menopause is a natural transition, but it doesn’t have to be a struggle. By focusing on gut health, you can help balance your hormones, reduce uncomfortable symptoms, and feel your best. The microbiome is incredibly responsive to diet and lifestyle changes, so even small adjustments can have a big impact—sometimes in as little as a week!
If you’re experiencing persistent gut or menopause symptoms, consider speaking to a healthcare professional to explore personalised strategies. Supporting your gut through menopause is one of the best investments you can make for your long-term health and wellbeing.