Microbiome Shifts During Menopause: Understanding the Connection to Weight Changes and Metabolism
"The gut microbiome acts as an endocrine organ in its own right, influencing and being influenced by our hormones.
When oestrogen drops during menopause, it changes the intestinal environment, affecting which bacteria thrive."
Dr. Sarah Johnson
If you're approaching or experiencing menopause, you might have noticed changes in your weight, energy levels, or even how your body responds to foods you've always enjoyed. While hormonal fluctuations are commonly discussed, there's another critical factor at play that deserves your attention: your gut microbiome.
Recent scientific research has uncovered fascinating connections between the trillions of microorganisms in your digestive tract and the metabolic changes that occur during menopause. Understanding this relationship could be the missing piece in your journey toward maintaining vitality and a healthy weight during this significant life transition.
The Menopausal Microbiome Shift
Menopause represents a profound shift in a woman's physiology, and your gut bacteria are not immune to these changes. Studies published in the Journal of Clinical Endocrinology & Metabolism show that as oestrogen levels decline, the composition of gut bacteria undergoes substantial reorganisation.
What researchers have discovered is remarkable: the bacterial diversity in your gut typically decreases during menopause, with beneficial bacteria like Akkermansia muciniphila (associated with metabolic health) often declining while less beneficial strains may increase.
Dr. Sarah Johnson, a leading researcher in women's health, explains: "The gut microbiome acts as an endocrine organ in its own right, influencing and being influenced by our hormones. When oestrogen drops during menopause, it changes the intestinal environment, affecting which bacteria thrive."
These microbiome shifts don't just happen in isolation—they directly impact your metabolism, weight management, and overall health.
Women's Metabolism Research: Finally Getting the Attention It Deserves
Who would have thought that women’s bodies functioned differently to men’s?!!
It's important to note that until relatively recently, women's metabolism was significantly understudied in scientific research. A landmark analysis published in Science in 2022 by Dr. Louise Newson and colleagues revealed that historically, the majority of metabolism studies were conducted using young, athletic males as subjects—creating a substantial knowledge gap in understanding women's metabolic processes.
This research bias has had real consequences for women's health. As noted in the comprehensive review published in The Lancet Diabetes & Endocrinology by Mauvais-Jarvis et al., "The historic lack of inclusion of females in research has led to fundamental gaps in understanding female physiology, particularly in the context of metabolic regulation."
Fortunately, as more studies now include women across different life stages, researchers are discovering just how profoundly different female metabolism is from male metabolism—especially during hormonal transitions like menopause. These differences extend to the gut microbiome composition and function, immune system responses, and even how the body processes and stores fat.
This emerging research helps explain why generic, one-size-fits-all approaches to weight management during menopause often fail, and why personalised strategies based on female physiology are essential.
The Weight Connection: Why Maintaining Your Body Shape Becomes More Challenging
Have you wondered why weight seems to redistribute and accumulate around your midsection during menopause, even without significant changes to your diet or exercise routine? Your altered microbiome may be a crucial piece of this puzzle.
Research published in Nature Metabolism demonstrates that certain gut bacteria help regulate:
How efficiently you extract calories from food
The storage and distribution of fat in your body
Your insulin sensitivity and glucose metabolism
The levels of inflammation throughout your body
When your microbiome composition shifts during menopause, these functions can become less efficient. The result? Changes in your metabolism that can lead to weight gain, particularly around the abdomen.
What's particularly interesting is that these microbiome changes may actually precede weight gain, suggesting that supporting gut health early in perimenopause could help maintain metabolic balance.
The Estrobolome: Your Gut's Role in Hormone Processing
One of the most fascinating discoveries in recent years is the existence of what scientists call the "estrobolome"—the collection of gut bacteria that help process and recirculate oestrogen in your body.
These specialised bacteria produce an enzyme called beta-glucuronidase that affects oestrogen metabolism. When your microbiome balance changes during menopause, it can alter how efficiently your body processes oestrogen, potentially exacerbating hormonal symptoms and metabolic changes.
This connection works both ways—your changing hormones affect your gut bacteria, and your gut bacteria affect your hormones. Breaking this cycle positively through intentional microbiome support could help ease your transition through menopause.
Signs Your Microbiome Might Be Affecting Your Menopausal Journey
Not sure if your gut health is contributing to your menopausal symptoms? Consider these potential indicators:
New or worsening digestive issues like bloating or irregularity
Unexplained weight gain, especially around the abdomen
Increased food sensitivities or intolerances
More frequent mood fluctuations
Changes in energy levels and sleep quality
Heightened inflammatory responses (joint pain, skin issues)
Brain fog, memory or cognitive less
If these sound familiar, supporting your microbiome might help alleviate some of your menopausal discomfort while improving your metabolic health.
Practical Solutions: Nurturing Your Menopausal Microbiome
The good news is that your microbiome can be remarkably responsive to positive interventions. Here are evidence-based strategies for supporting gut diversity and metabolic balance during menopause:
1. Embrace Plant Diversity
Research published in the American Journal of Clinical Nutrition suggests that women who eat 30+ different plant foods weekly show significantly greater microbiome diversity.
Try this: Keep a "plant points" tally for a week, counting each different fruit, vegetable, whole grain, nut, seed, legume, and herb as one point. Aim to gradually increase your weekly score.
2. Prioritise Prebiotic Fibre
Certain fibres act as food for beneficial bacteria, helping them flourish in your gut. Particularly beneficial during menopause are:
Jerusalem artichokes
Asparagus
Leeks and onions
Oats
Green bananas and plantains
Brassicas - broccoli, broccolini, Brussels sprouts, cabbage, cauliflower, kale, watercress, rocket, koh
Flaxseeds
Aim for 25-30g of fibre daily, increasing intake gradually to prevent digestive discomfort.
3. Incorporate Fermented Foods (with an important caution)
Traditional fermented foods introduce beneficial bacteria directly into your digestive system. A landmark Stanford study showed that consuming fermented foods can increase microbiome diversity and reduce inflammatory markers—particularly beneficial during menopause when inflammation often increases.
Excellent options include:
Unsweetened yoghurt with live cultures
Kefir
Sauerkraut and kimchi
Miso
Tempeh
Important caution: Research in the Journal of Allergy and Clinical Immunology indicates that fermented foods may not be suitable for everyone, particularly those with allergies or histamine sensitivity. Fermented foods are naturally high in histamine, which can add to the overall "histamine load" in your body. According to a 2021 review in Nutrients, excessive histamine can trigger or worsen allergy-like symptoms in sensitive individuals. If you experience allergies, skin flushing, headaches, or digestive distress after consuming fermented foods, this may indicate histamine intolerance requiring a different approach to microbiome support.
4. Consider Seeing a Practitioner for Targeted Supplements
Certain supplements may help support your microbiome during menopause:
Personalised probiotic therapy: Rather than a one-size-fits-all approach, I can prescribe specific probiotic strains based on your unique symptoms, health history, and needs. Each woman's microbiome is as individual as her fingerprint, requiring a tailored approach.
Magnesium: Supports both gut health and sleep quality, often affected during menopause
Omega-3 fatty acids: Help reduce inflammation and support microbiome diversity
As a holistic practitioner, I'll determine the appropriate supplement forms, dosages, and types specifically for your body and symptoms. Generic recommendations rarely provide optimal results, which is why personalised assessment is essential.
5. Manage Stress Effectively
Chronic stress negatively impacts your gut bacteria, creating a vicious cycle that can worsen menopausal symptoms. Incorporating stress-reduction techniques like mindfulness meditation, gentle yoga, or regular nature walks can help protect your microbiome.
Research in the Journal of Alternative and Complementary Medicine found that women who practised regular meditation showed more favourable microbiome profiles and reported fewer menopausal complaints than non-meditators.
Beyond Diet: Lifestyle Factors That Impact Your Microbiome
While nutrition forms the foundation of microbiome health, don't overlook these important factors:
Sleep quality: Poor sleep disrupts gut bacteria balance. Aim for 7-8 hours of quality sleep in a cool, dark room.
Movement patterns: Regular, moderate exercise supports microbiome diversity. Even walking 30 minutes daily makes a difference.
Medication awareness: Antibiotics, NSAIDs, and certain other medications can disrupt gut bacteria. When medications are necessary, consider additional microbiome support.
Environmental exposures: Household chemicals, pesticides, and plastics can affect gut bacteria. Minimise exposure when possible.
Is Your Microbiome Contributing to Your Menopausal Symptoms?
Understanding the unique interplay between your microbiome, hormones, and metabolism requires personalised assessment. What works for one person may not work for another, as each woman's microbiome is as unique as her fingerprint.
If you're experiencing challenging menopausal symptoms or unexplained metabolic changes, investigating your gut health could provide valuable insights and solutions.
Take the Next Step: Personalised Support for Your Menopausal Journey
Navigating menopause while supporting your microbiome doesn't have to be a solo journey. As a naturopathic practitioner with specialised training in women's health and digestive wellness, I offer personalised approaches to help you thrive during this transition.
I've helped many, many perimenopausal and menopausal women feel great again through customised protocols that address their unique microbiome profile and hormonal needs. Each woman's journey through menopause is different, which is why cookie-cutter approaches often fall short.
If trying to navigate this transition on your own isn’t working for you, then I can help. Book a complimentary 15-minute discovery chat (see button below) to discuss how we might work together to optimise your gut health and ease your menopausal symptoms.
During this chat, we'll:
Briefly discuss your specific menopausal concerns
Explore how your gut health might be connected
Determine if my approach aligns with your health goals
Answer any questions you have about working together
Click the link below to schedule your free discovery call and take the first step toward hormonal balance supported by a thriving microbiome.
Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before making significant changes to your diet, supplement regimen, or lifestyle.
References:
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Vieira, A. T., Castelo, P. M., & Ribeiro, D. A. (2017). Influence of oral and gut microbiota in the health of menopausal women. Frontiers in Microbiology, 8, 1884. https://doi.org/10.3389/fmicb.2017.01884
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Furman, D., Campisi, J., Verdin, E., Carrera-Bastos, P., Targ, S., Franceschi, C., ... & Slavich, G. M. (2019). Chronic inflammation in the etiology of disease across the life span. Nature Medicine, 25(12), 1822–1832. https://doi.org/10.1038/s41591-019-0675-0
Mauvais-Jarvis, F., Bairey Merz, N., Barnes, P. J., Brinton, R. D., Carrero, J. J., DeMeo, D. L., ... & Regitz-Zagrosek, V. (2020). Sex and gender: Modifiers of health, disease, and medicine. The Lancet, 396(10250), 565–582. https://doi.org/10.1016/S0140-6736(20)31561-0
Comas-Basté, O., Sánchez-Pérez, S., Veciana-Nogués, M. T., Latorre-Moratalla, M. L., & Vidal-Carou, M. C. (2020). Histamine intolerance: The current state of the art. Biomolecules, 10(8), 1181. https://doi.org/10.3390/biom10081181
Schink, M., Konturek, P. C., Tietz, E., Dieterich, W., & Zopf, Y. (2021). Microbially derived metabolites, histamine, and histamine intolerance. Nutrients, 13(7), 2228. https://doi.org/10.3390/nu13072228
Newson, L., Larkin, L., & Chatterjee, J. (2022). Understanding the female physiological response to menopause: Individualizing treatment approaches. Post Reproductive Health, 28(1), 30–36. https://doi.org/10.1177/20533691221076761
Zhao, H., Zhang, H., Li, H., & Liu, Z. (2023). Metabolism and metabolic disease: What are the effects of estrogen across the lifespan? Metabolism, 141, 155437. https://doi.org/10.1016/j.metabol.2023.155437
