Menopause and microbes - is there a connection?
- audrone8
- Sep 3
- 4 min read
Author: MD. Rugile Kancaite
Menopause marks the end of a woman’s reproductive years. While completely natural and inevitable, for many, it comes with numerous frustrating symptoms, including hot flashes and vaginal discomfort, primarily caused by declining sex hormone levels. These bothersome symptoms can last for years and significantly affect the quality of life [1].
Photo source: Cristian Rojas - Pexels.
Researchers have shown that this hormonal drop affects the human microbiome, the collection of all microbes that naturally live on and inside of our bodies [2]. Subsequently, this may play an important role in how some menopause-related health problems start or get worse.
What could this mean for us? Let’s see what the scientific evidence says.
Menopause-associated health issues and the gut microbiome
Recent studies have shown that some gut bacteria can break down and use hormones like estrogen and progesterone, both of them dramatically declining around menopause. Therefore, changes in hormone levels affect the types and roles of bacteria in different parts of the body, such as the mouth, gut, vagina, and skin [3].
Menopause is closely linked to a whole bunch of health issues, including obesity, type 2 diabetes, cardiovascular disease, osteoporosis, and mental health disturbances [4].
And while the evidence exploring the connection between gut microbes and the development of these diseases is still very scarce, a few studies have suggested that the gut microbiota may play a role.
For example, it’s been suggested that microbial changes in the gut post-menopause might be associated with changes in bone density [5], and that certain probiotics may help positively influence bone metabolism [4].
Another interesting finding is that changes in gut microbiome might impact the risk of heart and vessel disease after menopause: one study has demonstrated that those that did not receive hormonal therapy (HT) experienced a rise in Proteobacteria levels and a decline in Bacteroidetes levels in the microbiome of the duodenum as well as its reduced microbial diversity and several other changes associated with heightened disease risk; while those who received HT shown gut microbiome, hormonal and metabolic changes related to a lower heart and vessel disease risk [4].
Similarly, another small study has shown favorable effects of probiotic supplementation on hormone levels in perimenopausal women, which may eventually have an impact on heart and metabolic health [6].
Gut microbes and menopause symptoms
The evidence exploring the association between menopause symptoms and our microbes is, unfortunately, still very limited.
A very small study with 54 participants has suggested that the development of hot flashes and other related symptoms might be accompanied by a significant decrease in the main representatives of the “good bacteria”, such as Bifidobacterium and Lactobacillus, and an increase in the number of strains of potentially dangerous microorganisms as Klebsiella and Clostridiodes difficile in the gut [7].
Perhaps the most is known about how menopause affects the vaginal microbes, which are closely associated with estrogen levels. Approaching menopause, declining estrogen leads to changes in vaginal lining, making it less stretchy and moist, causing discomfort, dryness, and pain during sex; as well as a drastic reduction of the amount of Lactobacilli [4], which produce various compounds to fight the potentially dangerous microorganisms in order to protect and maintain vaginal health [8].
This change may lead to elevated risk of vaginal infections [4], including bacterial vaginosis (BV), which is caused by an overgrowth of the bacteria normally living in the vagina, and is associated with further vaginal discomfort. It’s estimated that the prevalence of BV might be as high as 57% among postmenopausal women [9].
However, while the use of probiotics alone or in combination with typical BV treatments has been suggested to positively alter the vaginal microflora and lowering the risk of vaginal infections in postmenopausal women, larger studies are required to see whether it could really help [11].
What could this mean to us?
Like most things women's health, menopause has been ignored by scientists for many years [10], meaning that our understanding about the connection between our microbiome and menopause-related diseases or symptoms is still in its infancy.
Currently available studies are extremely limited as well as inconsistent, highlighting the need for further investigation [5].
While this emerging knowledge allows researchers to look into whether probiotics could be a strategy to help avoid or manage menopause-related diseases and symptoms [12], for now, reputable health bodies such as The North American Menopause Society (NAMS) do not recommend probiotics for managing hot flashes [13] or any other menopause-related ailments.
If you’re undergoing the menopausal transition or are in menopause and struggle with symptoms, talk to your healthcare provider for guidance. They will suggest evidence-based treatment options, depending on your personal needs.
Meanwhile? Make sure you consume a healthy, fiber-rich diet and engage in regular physical activity, which may help promote the growth of beneficial gut bacteria and create an environment for it to thrive [4].
References
https://hms.harvard.edu/news/how-gaps-scientific-data-lead-gaps-care-aging-women
https://menopause.org/wp-content/uploads/professional/2023-nonhormone-therapy-position-statement.pdf
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