Menopause and Gut Health

Throughout your life, your gut microbiome undergoes various transformations. One of the most significant shifts occurs during infancy when you transition from milk to solid food. As you reach adolescence, particularly for females, hormonal changes during puberty lead to a more adult-like gut microbiome. And later in life, when menopause arrives (typically one year after your final period), the ovaries stop producing certain sex hormones, like progesterone and oestrogen, impacting the gut microbiome once again.

But what does that mean for our menopausal experience? And can we change the gut microbiome to help support us during this transition? Read on for all the gut loving details. 



Menopause marks a significant phase in a woman’s life. It becomes official one year after the last period, as the ovaries stop production of sex hormones, including progesterone and oestrogen. These hormonal changes affect not only menopausal symptoms like hot flashes, night sweats, vaginal dryness, and mood changes but may also have diverse effect on the gastrointestinal tract and the gut microbiome.



  • Constipation- When oestrogen lowers, transit time in the colon may slow, potentially leading to constipation
  • Bloating- Hormonal fluctuations during menopause can trigger your body to reabsorb and retain excess water and slower bowel movements may leave more time for fermentation and therefore bloating and gas
  • Reflux- Fluctuating oestrogen levels can alter the amount of acid the stomach produces. One study of 497 women found that 42% of perimenopausal and 47% of menopausal women suffer from heartburn. (1)


Have you heard of the estrobolome? Funny sounding word, but it is an incredible part of the gut microbiome that can impact our hormones! The estrobolome refers to a collection of bacteria residing in the gut responsible for metabolising and regulating the body’s oestrogen.

Within the estrobolome, these microbes play a crucial role in producing an enzyme called beta-glucuronidase. This enzyme has the function of converting oestrogens into their unconjugated form, which can potentially be reabsorbed into the bloodstream, affecting various oestrogen-related bodily functions. 

When there is an imbalance in your gut microbiome, also known as dysbiosis, it can alter the activity of beta-glucuronidase. This dysbiosis can result in either a shortage or excess of estrogen, leading to an imbalance between estrogen and other hormones. This imbalance can potentially contribute to the development of oestrogen-related disorders.


While research on the interplay between menopause and the gut microbiome is still early days, preliminary findings are interesting, even if the results are mixed. Some studies indicate a decrease in gut bacteria diversity post-menopause. And it is thought that a woman’s microbiome post menopause has a closer resemblance to men’s microbiome than premenopausal womens! (2) Changes in specific gut bacteria strains have also been documented, including lower levels of Firmicutes and Ruminococcus post-menopause, and higher levels of Butyricimonas, Dorea, Prevotella, Bacteroides, and Sutterella. (3)

The particular gut microbes that impact oestrogen may contribute to menopausal symptom presentation such as vaginal dryness, mood changes and hot flushes. 



Probiotics: Choose probiotic strains, such as Lactobacillus reuteri and Lactobacillus rhamnosus, which are backed by research to support gut microbes and potentially alleviate some menopausal symptoms. 

A 2021 review of studies found that incorporating probiotics into one’s routine may help increase bone mineral density in postmenopausal women. (4)

Fermented foods: Incorporate probiotic-rich, live foods like kefir, natural yoghurt, sauerkraut, kimchi, and fermented veggies into your diet. These foods promote good gut health and a flourishing microbiome. Think about adding in one portion a day!

Seeds: Consume a variety of seeds daily, including flax, pumpkin, sesame, and sunflower seeds. Flax seeds, in particular, have shown potential benefits for hormonal balance and menopausal symptom relief. (5, 6)

I like Linwoods milled flaxseed which is cold milled to preserve nutrients- remember to keep in the fridge once opened! Available here and use code CLAR15 for discount.

Fibre: Aim for at least 30g of daily fibre intake from sources like fruits, vegetables, nuts, seeds, beans, pulses, and complex carbohydrates. Fibre supports gut health and regularity. Kiwis can be particularly fantastic at helping reduce constipation! 

Avoid UPFs (Ultra-Processed Foods): Reduce your consumption of ultra-processed foods. What we eat can positively or negatively impact our gut bugs, with each meal being an opportunity to nourish our microbiomes and encourage our good gut bacteria to flourish. One study showed that higher fruits and veg consumption can decrease menopausal symptoms, and diets higher in UPF’s may increase the risk of menopausal symptoms. (7)

UPFs are often high in salt, sugar and/or unhealthy fats which can all cause negative effects on our gut microbiomes. Studies have shown the link between a higher consumption of ultra processed foods and more intense symptoms such as hot flushes, memory and concentration concerns. (8)

Alcohol: Alcohol can cause skin flushing and may worsen hot flushes. Although symptoms and flare ups can depend on the individual, it’s always best to stick to 4 alcohol free nights per week and opt for low sugar drink choices to avoid any worsened menopause symptoms. (9, 10)


If you’re experiencing uncomfortable menopausal or gut health symptoms,  or are looking for guidance to make healthier lifestyle choices pre or post menopause, contact our team at to find out how we can help. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Please note, Clarissa Lenherr Nutrition Limited uses affiliate links. If you buy something using these links, we may earn an affiliate commission, at no additional cost to you.

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Hi there

London Nutritionist Clarissa Lenherr

I’m Clarissa, a registered nutritionist (mBANT) and workplace wellness expert. In my practice, I have helped hundreds of clients reach optimal health through creating sustainable, effective habits and dietary adjustments. My aim is to empower people with the skills, tools and knowledge to take their health into their own hands and feel the happiest, healthiest versions of themselves. Featured in The Daily Mail, Women’s Health, The Telegraph, and more.




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