At first glance, it might seem like menopause and gut health have little to do with each other. But research shows that nearly every system in our body, including our digestive tract, relies on oestrogen to function optimally. And that includes the gut microbiome, the vast community of trillions of microorganisms that live in our digestive system.

Our gut flora doesn’t just help digest food; it supports nutrient absorption, produces short-chain fatty acids (SCFAs), and even generates over 90% of the body’s serotonin – a key chemical involved in regulating mood and digestion. But there’s more. Scientists have identified a group of gut bacteria called the estrobolome, which specifically helps process and regulate oestrogen levels in the body. Along with the gut-brain axis,  the communication highway between our gut and brain,  this system plays a major role in our mood, metabolism, and hormone balance.

When oestrogen declines during menopause, it impacts the makeup and function of our gut flora. Let’s look at how these changes unfold and what you can do to support your gut health during this transition.

1. Reduced Gut Microbiome Diversity

Before menopause, women tend to have a diverse and robust gut microbiome, peaking around age 40. After menopause, however, diversity decreases, and the composition of the gut starts to resemble that of men. A diverse microbiome is important for immune function and protecting against harmful bacteria.

Recent studies show that a wide variety of beneficial bacteria can work together to slow the growth of harmful pathogens. For example, when multiple types of good bacteria are present, they can collectively slow the growth of potentially harmful invaders like Salmonella or Klebsiella far more effectively than a single strain on its own.

2. A Shift in Gut Flora Balance

Postmenopausal women often have fewer beneficial bacteria and more of the strains linked to obesity and metabolic issues, such as Dorea, Prevotella,  Sutterella bacteria can produce compounds that increase cravings for sugar and fat or negatively affect mood.

On the flip side, levels of helpful bacteria like Ruminococcus, which produces SCFAs, and Firmicutes, known for supporting nutrient absorption and appetite regulation, often decline after menopause.

3. Greater Risk of Mood Disorders and Metabolic Issues

Changes in gut bacteria may help explain why many women experience increased anxiety or depression during perimenopause and menopause. For instance, some gut flora strains like Klebsiella aerogenes can rapidly break down oestradiol, a form of oestrogen, lowering overall hormone levels in the body and potentially worsening mood symptoms.

Other imbalances in gut bacteria have been associated with perimenopausal mood disorders, indicating that the health of the microbiome could play a direct role in emotional wellbeing during this life stage.

How to Support Gut Health During and After Menopause

The good news? You have a lot of control over your gut health. Here are some effective strategies:

1. Prioritise Fibre-Rich, Anti-Inflammatory Foods

Eating a wide variety of colourful vegetables, fruits, whole grains, legumes, and healthy fats (like those found in nuts and fish) supports a more diverse and balanced microbiome. This way of eating like a Mediterranean-style diet,  helps reduce inflammation and promotes the growth of beneficial gut bacteria.

Avoiding ultra-processed foods, excess sugar, artificial sweeteners, seed oils, and heavily refined grains can also make a big difference in gut and hormone health.

2. Add Probiotics, Prebiotics, and Synbiotics

• Probiotics are beneficial bacteria that support your existing gut flora. You can get them from fermented foods like yogurt, kefir, kimchi, sauerkraut, and miso.
• Prebiotics are fibres that feed those good bacteria. Foods like garlic, onions, leeks, bananas, kiwi, flaxseed, and legumes are rich in prebiotics.
• Synbiotics combine probiotics and prebiotics to support microbial growth and diversity. You can find them in specific food combinations (like yogurt with chia seeds) or supplements designed for that purpose.

3. Consider Hormone Therapy with Medical Guidance

Emerging research suggests that hormone therapy may help preserve a more diverse and beneficial microbiome post-menopause. One study found that women using hormone therapy had gut bacteria profiles more similar to premenopausal women, with fewer strains associated with inflammation and metabolic conditions.

Final Thoughts

Supporting your gut health during menopause doesn’t have to be complicated. Start with small steps: eat more fibre-rich plants, include fermented foods, and consider gut-focused supplements if needed. As your gut adapts, you may experience some initial bloating or gas, a sign your microbiome is adjusting.

If discomfort persists, consult a healthcare provider to rule out conditions like small intestinal bacterial overgrowth (SIBO). Over time, your system will recalibrate, and your cravings and digestion will shift in a healthier direction.

Caring for your gut is one of the most powerful things you can do to support your overall health, at any stage of life.

Thank for reading!

Louise x

To learn more about Louise go here