What current research tells us about our gut, hormones and healthy ageing
By Ilze Ziverte – 50 & Thriving
When most people think about menopause, they think about hot flushes or night sweats. However, many women also notice changes in their digestion, mood, energy, joints and weight.
These changes can feel confusing, especially when we have never been told how closely connected the body’s different systems are.
One developing area of research is the relationship between the gut microbiome and female hormones. Scientists have discovered that our gut microbes do much more than help us digest food. They interact with the immune system, communicate with the brain, and participate in how our bodies process oestrogen.
Researchers are still working to understand what this means for women during perimenopause and menopause.
What is the gut microbiome?
The gut microbiome is the community of trillions of microorganisms—including bacteria, fungi, viruses and other microbes—that live in our digestive tract, particularly the large intestine.
These microorganisms and the substances they produce can help with:
- breaking down parts of food that we cannot digest by ourselves
- producing certain vitamins and other useful compounds
- supporting the immune system
- maintaining the protective lining of the gut
- communicating with the brain through the gut–brain axis
- influencing inflammation and metabolism.
Every person’s microbiome is different. It is shaped by many factors, including diet, age, environment, physical activity, stress, illness and medication—particularly antibiotics.
There is no single “perfect” microbiome that everyone should try to achieve.
What is the estrobolome?
Within the gut microbiome is a collection of microorganisms and microbial genes involved in the metabolism of oestrogen. This is known as the estrobolome.
To understand its role, it helps to know how the body processes oestrogen.
After circulating oestrogen has been used by the body, the liver changes it into a form that can be removed through bile and passed into the intestine. Some gut bacteria produce enzymes—including beta-glucuronidase—that can deconjugate, or reactivate, some of this oestrogen.
This may allow a proportion of the oestrogen to be reabsorbed through the intestine and returned to the bloodstream rather than being removed from the body.
Researchers believe this process may help influence the amount and type of oestrogen circulating in the body. However, the estrobolome is complex, and scientists are still investigating how much it affects individual health outcomes.
What happens during perimenopause and menopause?
During perimenopause, ovarian hormone production becomes less predictable. Oestrogen levels can rise and fall before eventually declining, while progesterone also decreases.
These hormonal changes may contribute to symptoms including:
- hot flushes and night sweats
- disrupted sleep
- changes in mood
- anxiety
- difficulties with memory and concentration
- muscle and joint discomfort
- changes in body composition
- changes in menstrual bleeding
- vaginal and urinary symptoms.
Some women also experience bloating, constipation, diarrhoea, abdominal discomfort or changes in food tolerance during midlife.
Hormonal changes may play a part in digestive health, but they are not the only possible cause. Stress, medication, changes in diet and activity, irritable bowel syndrome and other medical conditions can also affect digestion.
New, severe or persistent digestive symptoms should therefore not automatically be assumed to be menopause.
Does the gut microbiome change after menopause?
Research suggests there may be a two-way relationship between sex hormones and the gut microbiome.
Oestrogen can influence the gut environment, while gut microbes can participate in oestrogen metabolism. Studies have found differences between the microbiomes of premenopausal and postmenopausal women, but the results are not completely consistent.
Some research has reported changes in particular groups of bacteria or reduced microbial diversity after menopause. However, a 2026 review concluded that current evidence does not demonstrate consistent differences in overall gut-microbiome diversity or in the main bacterial groups between women with higher and lower oestrogen levels.
This does not mean that no relationship exists. It means the relationship is complicated and may be influenced by age, diet, medication, body composition, geography, health conditions and many other factors.
This does not mean that no relationship exists. Instead, it shows that the connection between menopause and the gut microbiome is complex and may be influenced by age, diet, medication, body composition, health conditions and many other factors.
Researchers are still trying to understand which changes are directly connected to menopause and what they may mean for women’s symptoms and long-term health.
Can diet support gut health?
Diet cannot stop menopause, and no food has been proven to “balance” the estrobolome or cure menopause symptoms.
However, eating well can support digestive health and help protect our heart, muscles, bones and metabolic health as we age.
Among the dietary patterns studied, the Mediterranean-style diet has some of the strongest evidence for supporting overall health and healthy ageing.
This way of eating generally includes:
- a wide variety of vegetables and fruit
- beans, peas, chickpeas and lentils
- whole grains
- nuts and seeds
- olive oil
- fish and other sources of healthy fats
- moderate amounts of dairy products, if tolerated
- fewer highly processed foods, refined carbohydrates and added sugars.
A Mediterranean-style diet usually provides a mixture of fibre and plant compounds that can be used by gut microbes. It is also associated with benefits for cardiovascular health, blood-sugar management and overall diet quality.
It does not have to mean eating unfamiliar or expensive foods. Traditional Latvian foods such as beans, peas, oats, buckwheat, cabbage, beetroot, berries, seeds, fermented vegetables and oily fish can also contribute to a varied, fibre-rich diet.
Everyday ways to support gut health
Helpful habits may include:
- gradually increasing the variety of plant foods you eat
- including enough fibre, while increasing it slowly if you have a sensitive digestive system
- drinking sufficient fluids
- moving your body regularly
- getting enough sleep where possible
- finding realistic ways to manage stress
- avoiding unnecessary antibiotic use
- including fermented foods if you enjoy and tolerate them.
Probiotic supplements are not automatically necessary, and different probiotic strains may have different effects. Evidence for using probiotics specifically to treat menopause symptoms remains limited. Anyone with a medical condition, a weakened immune system or persistent digestive symptoms should discuss supplements with a qualified healthcare professional.
What we still do not know
Research into the estrobolome is exciting, but it is still developing.
Scientists know that gut microbes participate in oestrogen metabolism, but they do not yet know:
- how much the estrobolome affects menopause symptoms
- whether changing the microbiome produces meaningful changes in circulating oestrogen
- which bacteria or bacterial functions are most important
- whether probiotics or other targeted treatments can reliably improve symptoms
- why women respond differently to the same foods or interventions.
Much of the current evidence comes from laboratory research, animal studies, observational studies and small human studies. These can reveal interesting connections, but they cannot always prove cause and effect.
For now, the most responsible message is that looking after our gut is one useful part of looking after our whole body—not a standalone treatment or a quick hormonal fix.
When digestive symptoms need medical attention
It is important to speak to a GP or another healthcare professional if digestive symptoms are persistent, worsening or affecting everyday life.
Seek medical advice promptly if you experience:
- blood in your stool
- unexplained weight loss
- persistent or severe abdominal pain
- a lasting change in bowel habits
- difficulty swallowing
- repeated vomiting
- symptoms that regularly wake you during the night
- unusual tiredness or suspected anaemia.
These symptoms do not necessarily mean that something serious is wrong, but they deserve proper assessment rather than being dismissed as “just menopause” or “just ageing.”
My reflection
When I first experienced digestive problems, I had no idea they might be happening alongside the hormonal changes of perimenopause. Like many women, I spent years trying to understand what was happening to my body.
I cannot say that hormones caused all my digestive difficulties. Digestive symptoms can have many causes, and each woman’s medical history is different. However, learning about the gut microbiome and the estrobolome helped me understand that our bodies are not made up of separate, isolated parts.
Our hormones, digestion, immune system, brain, lifestyle and overall health continually interact.
This knowledge has not changed my past experiences, but it has helped me make more sense of them. It has also reminded me how important it is to learn from reliable research without being drawn into myths, exaggerated promises or quick fixes.
My goal through 50 & Thriving is not to tell women what they must do. It is to help women understand their bodies, recognise when something needs attention, ask informed questions and feel more confident when discussing their health with healthcare professionals.
If one woman reads this article and thinks, “Now I finally understand a little more about what may be happening in my body,” then sharing what I have learned has been worthwhile.
A gentle reminder
This article is for education and general information. It is not intended to diagnose a medical condition or replace individual advice from a doctor, registered dietitian or another qualified healthcare professional.
References and further reading
Baker, J.M., Al-Nakkash, L. and Herbst-Kralovetz, M.M. (2017) ‘Estrogen–gut microbiome axis: Physiological and clinical implications’, Maturitas, 103, pp. 45–53. Available from: PubMed.
Cuozzo, M. et al. (2026) ‘Gut-brain communication in menopause: Insights into neuroendocrine and microbiome interactions’, Proceedings of the Nutrition Society. Available from: PubMed.
Ervin, S.M. et al. (2019) ‘Gut microbial β-glucuronidases reactivate estrogens as components of the estrobolome that reactivate estrogens’, Journal of Biological Chemistry, 294(49), pp. 18586–18599. Available from: PubMed.
National Institute for Health and Care Excellence (NICE) (updated 2024) Menopause: Identification and Management (NG23). Available from: NICE.
Saravinovska, K. et al. (2026) ‘The impact of estrogen status on the gut microbiome’. Available from: PubMed.
Women’s Health Concern and British Menopause Society (2025) Menopause Wellness Hub: Digestive Health and Menopause. Available from: Women’s Health Concern.