During menopause, there seems to be an ever-lengthening list of health concerns to consider. Not only do we need to prioritise our hormone, mental and joint health, but other, more minor (but important) aspects of our health provide the keystone to good health during perimenopause.
For more information on the key areas of health for midlife, check out this article – The Eight Limbs of Perimenopause: Wisdom from Goddess Durga.
In this article, I discuss one area of health that we Naturopaths are so fond of: gut health. But not just any old gut health; the importance of gut health during perimenopause.
Gut Health and Oestrogen Levels
In recent years, many of us have become familiar with the term microbiota – the broad spectrum of microorganisms existing in and on the human body. Research continuously discovers the role and function of each little bacterium harboured by each person, especially in the gut. But did you know that part of that microbiota plays a role in oestrogen levels?
This part of the microbiota is termed the estrobolome, and it consists of a range of bacteria and their genes located in the gut. These specific bacteria produce enzymes such as beta-glucuronidase, which deconjugate oestrogen and influence bioavailability and metabolism. Essentially, these bacteria help to break down oestrogen to convert it into a form that is easier to eliminate or recirculate.
Imbalances with gut function and microbiota can lead to issues with the estrobolome.
Disruptions to the estrobolome can lead to problems with fluctuating oestrogen levels and potentially contribute to health concerns such as metabolic syndrome and weight gain.
It’s a surprisingly fine-tuned system, but certain medications, poor food choices, antibiotics, and other things can cause the estrobolome to drift off track and influence oestrogen.
Gut Health, Moods and Mental Wellbeing
Have you heard the saying, “Your gut is your second brain”? Well, during perimenopause, gut health is paramount for brain health.
Not only is oestrogen required for neuroplasticity, memory and recall, but your gut health also influences your oestrogen levels AND mood. So, you’ve got this double influence of oestrogen and gut health influencing your mood and brain function.
But how exactly does your gut health influence mood?
Because the gut houses its own nervous system – the enteric nervous system, this system readily communicates with your brain via the gut-brain axis. Whatever happens in your gut is transmitted to your brain and vice versa.
All of this becomes crucially important during perimenopause. Around 90% of our serotonin, that feel-good hormone we love, is produced in our gut. Gut bacteria play a role in synthesising and modulating neurotransmitters GABA and dopamine, two of our most essential mood regulators.
And if your digestion and gut function is struggling, so may your mood, potentially contributing to mood swings, anxiety, brain fog, poor concentration and the list goes on.
Gut Health, Weight Gain and Metabolism
Perimenopause is when your body’s cells upgrade their fuel requirements from ‘budget’ to ‘premium’. You notice that you can no longer live on junk food, and any additional calories seem to rapidly contribute to an ever-expanding waistline.
But how much of this is related to gut function?
When we return to the microbiota and bacteria living in the gut, we can learn that much of the population plays a role in absorbing nutrients from food, regulating blood sugar levels, affecting fat storage and appetite control, and influencing inflammation in the body.
These factors, in combination with hormonal shifts during perimenopause, can then contribute to potential health issues such as insulin resistance, cravings and weight gain.
Sigh.
I know there’s a whole bunch of stuff in the media about weight loss and perimenopause, and I have to say that I’m not a fan of the sales pitch for products to ‘lose your meno belly’. But they are tapping into a market where many body changes—hormones, gut health, and emotional well-being—can influence our self-image.
My key takeaway is to continually work on improving, not just your gut function, but also becoming aware of your fuel requirements and adding in some weight training*.
Gut Health, Immunity and Inflammation
The all-encompassing influence of oestrogen and its effects on your body don’t seem to come to mind until you’re in perimenopause (or pregnant). Understanding that oestrogen has immune buffering properties and anti-inflammatory properties can help you understand this link with gut health.
The gut is home to approximately 70% of the immune system. A complex lymphoid tissue network enveloping your digestive system significantly affects immune health. The gut microbiota communicates with immune cells, and when the gut flora is out of balance, so is the immune system.
When gut health is on track, the immune response is more balanced, inflammatory markers are more on track, and the body is more resilient to allergens and illness—all of which come into play during perimenopause.
Chronic inflammation in the body (think arthritis, fatigue and cardiovascular disease) is driven by gut dysbiosis, and prioritising gut health during perimenopause is an investment in your long-term health, keeping immune and inflammation in balance.
How to support your gut health during perimenopause
Just a few practical tips to get you started. Please note that these are generic tips and no match for personalised professional health advice.
Eat more plants. Aim for a diverse range of colourful vegetables, grains, and seeds. The various types of fibre in plant foods help to provide food for your gut flora.
Use fermented foods. Sauerkraut, kim chi, kefir, natural yoghurt (not the processed stuff) and tempeh provide the pioneer beneficial bacteria to support gut health.
Reduce sugar and ultra-processed foods. High-sugar foods (even excess amounts of fruit juices and dried fruit) can fuel the pathogenic microorganisms in the gut and drive inflammation in the body. Sticking to whole foods that are not processed is the simplest way to avoid this.
Move more. Exercise and physical activity are said to encourage a healthier microbiota. So get moving!
Consider using a probiotic supplement. These are often a good investment in your health. Probiotics supplements can provide concentrated amounts of beneficial flora for gut health, especially important during perimenopause.
Perimenopause, the guts of it …
(Sorry, I couldn’t help myself)
While gut health may not be the first area of physical well-being you would consider working on during perimenopause, it certainly influences many aspects of your health. We Naturopaths tend to view the gut as a central hub of health and immunity, and addressing this aspect of our health can help manage the kinds of chronic health conditions that tend to creep up on us in midlife.
Truthfully, your gut health isn’t something you can shift quickly overnight (unless you eat a dodgy curry), but with persistence and common sense, you can move your health in the right direction.
* Weight training is becoming more popular for women, especially during perimenopause, but it is a subject that is beyond the scope of this article. Please research this topic thoroughly and get some expert advice before you start lifting heavy.
The information provided in this article is for information purposes only and should not be taken as medical advice. We recommend you consult with a GP or other healthcare professional before taking action based on this article. While the author uses their best endeavours to provide accurate and true content, the author makes no guarantees or promises regarding the information’s accuracy, reliability or completeness. If you rely on any information in this article, you do so at your own risk.
References and additional reading:
Plottel, C.S., & Blaser, M.J. (2011). Microbiome and Hormonal Regulation: The Estrobolome and the Implications for Women’s Health. Maturitas, 70(2), 135–141.
Baker, J.M., Al-Nakkash, L., & Herbst-Kralovetz, M.M. (2017). Estrogen–gut microbiome axis: Physiological and clinical implications. Maturitas, 103, 45–53.
Strandwitz, P. (2018). Neurotransmitter modulation by the gut microbiota. Brain Research, 1693(Pt B), 128–133.
Cryan, J.F., & Dinan, T.G. (2012). Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nature Reviews Neuroscience, 13(10), 701–712.
Santos-Marcos, J.A., Rangel-Zúñiga, O.A., Jiménez-Lucena, R., Quintana-Navarro, G.M., García-Carpintero, S., Malagón, M.M., … & Pérez-Martínez, P. (2018). Influence of gender and menopausal status on gut microbiota. Maturitas, 116, 43–53.
Becker, S.L., & Manson, J.E. (2020). Menopause, the gut microbiome, and weight gain: correlation or causation?. Menopause, 27(11), 1225–1227.
Sharma, G., Prossnitz, E.R., & Roy, S. (2020). The peri-menopause in a woman’s life: a systemic inflammatory phase that enables later neurodegenerative disease. Journal of Neuroinflammation, 17(1), 317.
Belkaid, Y., & Hand, T.W. (2014). Role of the microbiota in immunity and inflammation. Cell, 157(1), 121–141.
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