The Gut Microbiome and Women's Health | Part 3
How Supporting Microbial Health Can Ease the Transition Through Perimenopause and Menopause
Welcome to Part 3 of our series exploring the intricate relationship between the gut microbiome and women's health. In this installment, I delve into perimenopause and menopause—significant life transitions that bring about profound hormonal changes impacting various aspects of well-being. Understanding how these phases affect the gut microbiome can empower us women to make informed choices that support our health during this time.
Understanding Perimenopause, Menopause, and the Gut Microbiome
Perimenopause, the transitional phase leading up to menopause, and menopause itself are marked by a natural decline in estrogen and progesterone levels. These hormonal shifts influence numerous bodily systems, including the gut microbiome—the diverse community of microorganisms residing in the digestive tract.
Research indicates that estrogen plays a pivotal role in maintaining gut microbiota diversity and balance. As estrogen levels decrease during perimenopause and menopause, notable changes occur within the gut microbiome:
Reduced Microbial Diversity: Microbial diversity — the variety of bacteria living in your gut — is considered a key marker of gut resilience and overall health. During perimenopause and menopause, this diversity tends to decline.
A 2023 review in International Journal of Women’s Health found that women in menopause often show a measurable drop in the number of microbial species in their gut, particularly those associated with anti-inflammatory functions and metabolic health.
Why does this matter?
Less diversity can weaken the gut’s ability to adapt to stressors (like dietary changes or illness)
It may contribute to weight gain, constipation, and poor nutrient absorption
It’s also been linked to higher markers of systemic inflammation — a key factor in postmenopausal disease risk
This is one reason why I always recommend dietary variety — especially plant-based fiber — especially in midlife. You’re not just feeding yourself; you’re feeding the ecosystem that helps you function.
Altered Bacterial Composition: It’s not just about how many types of microbes are in the gut — it’s also about what kinds. During this hormonal shift, studies have found a notable increase in pro-inflammatory bacteria (such as Enterobacteriaceae) and a decrease in beneficial strains like Lactobacillus and Bifidobacterium.
One study from the Menopause Journal noted that postmenopausal women tend to have higher ratios of Firmicutes to Bacteroidetes — a shift that has been associated with insulin resistance and increased fat storage.
This altered balance can lead to dysbiosis, a state where the “bad” bugs outnumber the good — often resulting in bloating, fatigue, skin flares, and sluggish digestion.Increased Gut Permeability: Estrogen is not only a reproductive hormone — it also helps regulate tight junctions in the gut lining, which keep unwanted substances (like pathogens or undigested food particles) from leaking into the bloodstream.
As estrogen levels drop, these tight junctions may weaken, leading to what’s commonly referred to as leaky gut or increased intestinal permeability.
What’s the impact?
More inflammation
Heightened immune reactivity (including food sensitivities)
Increased risk of autoimmune flare-ups
Gut-derived endotoxins entering the bloodstream, which may worsen symptoms like brain fog and joint pain
While more human studies are still needed in this area, this is a growing area of interest in both functional medicine and integrative women’s health — and one that I at Vango Wellness pay close attention to in client care.
Implications for Women's Health
By the time women reach midlife, the body begins a significant biological transition — one that is often misunderstood, oversimplified, or ignored entirely in wellness spaces. Perimenopause and menopause aren't just about hot flashes or irregular periods. They mark a complex shift in hormonal rhythms that influence every system of the body — and the gut microbiome is one of the most critical players in this change.
At Vango Wellness, I see this phase not as a decline, but as a recalibration. And supporting the gut is foundational to feeling vibrant and resilient during this time.
Your gut bacteria don’t just help you digest food; they produce neurotransmitters, modulate inflammation, influence fat storage, and even participate in estrogen metabolism. As estrogen and progesterone levels fluctuate and eventually decline, these changes ripple through the microbiome — often leading to symptoms like bloating, brain fog, fatigue, and increased inflammation.
The interplay between hormonal changes and the gut microbiome during perimenopause and menopause has far-reaching implications, and often could manifest as:
Metabolic Health: The altered microbiome may contribute to weight gain, insulin resistance, and elevated cholesterol. With less microbial diversity and more inflammatory bacteria, the body becomes more prone to fat storage and metabolic sluggishness.
Mood and Cognitive Function: The gut-brain axis is particularly vulnerable in this phase. A disrupted microbiome can reduce serotonin and GABA production, increasing the risk for anxiety, depression, and memory issues commonly reported during menopause.
Inflammation and Immune Function: With leaky gut and lower estrogen, systemic inflammation tends to rise. This can exacerbate joint pain, fatigue, skin conditions, and even increase vulnerability to autoimmune issues — which are already more prevalent in women.
Bone and Cardiovascular Health: An imbalanced gut can impair the absorption of key nutrients like calcium, magnesium, and vitamin D — nutrients crucial for bone density and heart health during and after menopause.
Supporting Gut Health During Perimenopause and Menopause
Navigating the hormonal shifts of perimenopause and menopause is challenging enough — your gut shouldn’t be another stressor. The goal here isn’t to micromanage your microbiome, but to create a lifestyle that supports microbial diversity, reduces inflammation, and helps you feel grounded in your body again.
Here’s how I guide clients through gut support during this stage:
🥦 1. Focus on Fiber and Diversity
A diverse gut microbiome starts with a diverse diet. Aim for 30+ different plant foods a week — including vegetables, fruits, legumes, nuts, seeds, herbs, and spices. Fiber feeds your beneficial gut bacteria, supporting estrogen metabolism and reducing inflammation.
Vango Wellness Tip: Building your meals around plant-based sides, not just protein or starch. Rotate your greens, grains, and legumes regularly.
2. Embrace Fermented and Prebiotic Foods
Add foods that naturally populate your gut with good bacteria and feed them well. These can help restore microbial balance and improve gut lining integrity, especially as estrogen declines.
Fermented foods: Yogurt, kefir, sauerkraut, kimchi, miso, and tempeh.
Prebiotic foods: Garlic, onions, leeks, asparagus, oats, bananas, and Jerusalem artichokes.
💧 3. Stay Hydrated (But Not Just With Water)
Hydration supports digestion, bowel regularity, and the mucosal lining of the gut. Add electrolytes (without added sugars) or infuse water with lemon, cucumber, or mint for added benefits.
Vango Wellness Tip: Herbal teas like ginger, fennel, or peppermint can support digestion and ease bloating.
💊 4. Consider Probiotics — But Be Selective
Not all probiotics are created equal. Look for strains that have been studied for women’s health, such as:
Lactobacillus rhamnosus GG: Known for immune and gut barrier support.
Bifidobacterium lactis: Shown to help with digestion and inflammation.
I typically suggest consulting with your doctor first and rotating probiotics seasonally and focusing first on food before supplementation.
🧘♀️ 5. Manage Stress Through the Gut-Brain Axis
Chronic stress disrupts gut bacteria and increases inflammation. Implement daily tools like:
Breathwork or meditation
Gentle movement (walking, yoga, pilates)
Journaling or creative hobbies
Spending time in nature
Even 10 minutes a day can recalibrate your nervous system — and your gut will feel the difference.
🛏️ 6. Prioritize Restorative Sleep
Sleep and gut health are deeply connected. Hormonal shifts can disrupt sleep, but consistent sleep hygiene (cool, dark room, regular bedtime, reduced screen time) supports melatonin and microbiome regulation.
Vango Wellness Tip: Magnesium glycinate before bed and limiting caffeine past noon.
For more info, read my Article “Sleep Through the Ages”
🍽️ 7. Eat Mindfully and with Rhythm
Digestion begins in the mouth — chewing well, slowing down, and eating without distraction enhances nutrient absorption and gut motility.
Also, maintaining regular meal times helps regulate cortisol and insulin — both of which affect gut health and hormonal balance.
Embracing the Transition with Vango Wellness
Perimenopause and menopause are natural phases of life, and understanding their impact on the gut microbiome offers valuable insights into managing health during these transitions. By adopting supportive dietary and lifestyle practices, women can navigate these changes with resilience and vitality.
At Vango Wellness, I recognize the unique challenges and opportunities that perimenopause and menopause present. My personalized coaching services are designed to support you in making informed choices that enhance your gut health and overall well-being during this transformative time.
Whether you're seeking guidance on nutrition, lifestyle adjustments, or stress management, I’m here to empower you every step of the way.
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