Reset your gut for a healthy menopause

Fluctuating hormones in the menopause transition (the time leading up to menopause) often lead to symptoms like anxiety, tiredness, loss of libido, low mood, brain fog, hot flushes, night sweats and so many more. Most women will experience at least one symptom during her menopause journey. For some women the impact on their daily lives is severe and debilitating. Others simply sail through.

Fortunately, the menopause is now being discussed more openly and taken more seriously by health professionals. There’s a greater understanding of how symptoms can be better managed, and it requires a holistic approach.

Hormone optimisation is the cornerstone of symptom management together with simple lifestyle changes that include the introduction of the right kind of exercise, and the addition of more whole foods, while cutting down on alcohol, caffeine, highly processed and sugary foods. Diet and nutrition in menopause are very much in the spotlight, particularly their effects on the health of our gut and the gut microbiome.

What we eat has a huge impact on health and the significance of this has only recently been recognised.

The gut microbiome

The gut microbiota is a community of tens of trillions of micro-organisms including bacteria, fungi, viruses and archaea, cohabiting within the gastrointestinal tract. Bacteria are the dominant group of micro-organisms, and the majority are found in a “pocket” of the large intestine called the cecum. Some of these bacteria are essential for general health, while others can promote disease. The gut microbiome refers to the micro-organisms that inhabit the gut, and their genetic material.

The food we eat determines the balance between the ‘good’ and ‘bad’ bacteria within the gut. A wide variety of fibre-rich fruit and vegetables promote beneficial bacterial diversity. If the ‘good’ bacteria don’t receive the nutrition they need to thrive, the ‘bad’ bacteria will dominate. And when this happens, it can lead to an exacerbation of symptoms that include low energy, tiredness, weight gain and brain fog.

Professor Tim Spector an epidemiologist at King’s College London, describes the gut microbiome as “a vital organ in your body which you need to look after. It affects mood, depression and anxiety, as well as controlling many aspects of the immune system.”¹ Weight control, blood sugar levels, heart and gut health are all influenced by the gut microbiome.

The gut and brain are in constant communication through the ‘dual superhighway’ Vagus nerve. The brain influences intestinal activities, and the gut influences mood, cognition, and mental health.² It’s a two-way process.

Menopause and the gut microbiome

The gut microbiome undergoes many changes throughout life, including the time leading up to the menopause. Symptoms like weight gain, IBS, insulin resistance and digestive problems can often be linked to imbalances in the gut microbiome, during these hormonal changes.

There’s evidence that higher levels of oestrogen and progesterone boost gut bacteria diversity. At the same time, this diversity means more hormones are recycled and sent back into circulation. During the perimenopause and menopause, levels of oestrogen and progesterone fluctuate and decline. Therefore, the job of the gut microbiome in recycling hormones can play a big part in determining the levels of these hormones in your blood.

Health and the gut microbiome

Mood

Around 95% of serotonin (sometimes called the ‘happiness hormone’) in the body is produced in the gut by the beneficial bacteria.² Serotonin affects mood, happiness, anxiety and sleep patterns. So unsurprisingly it’s important to keep the gut microbiome healthy in order to stabilise emotions, energy levels and general wellbeing.

Bones

Your gut microbiome can have an impact on bone health. As oestrogen levels fall, the risk of developing osteoporosis increases, leading to weaker bones and an increased risk of fractures. It’s been found that improving the gut microbiome may help to maintain bone strength.³

Hormones

There is a group of gut microbes which support the metabolism of oestrogen known as the estrobolome. This collection of bacteria helps regulate the production of oestrogen, , which diminishes during menopause. Reduced levels of oestrogen lead to the symptoms described previously.

‘Leaky gut’ (translocation of gut microbes)

Inflammatory foods, long term medication, chronic stress and alcohol consumption promote inflammation within the gut. Beneficial bacterial numbers deplete, while bacteria associated with inflammation increase. Inflammatory substances are released by these bacteria which cause the gut wall to become ‘leaky’.

Whilst having a varied and flourishing gut microbiome is excellent for maintaining health, if inflammation-associated bacteria and inflammatory substances leave the gut and enter the blood stream, this can have a serious negative impact on health.

This translocation of gut microbes and inflammatory substances across the gut wall into the bloodstream is the result of ‘leaky gut’, which happens more frequently during the menopause.⁴ This is linked to many conditions including inflammatory bowel disease (IBD),⁵ heart disease, osteoporosis and type 2 diabetes.

Eating for a healthy gut microbiome

Maintaining a diverse and thriving population of beneficial gut bacteria helps to keep harmful bacteria at bay by competing for nutrients and sites of colonisation. Making just a few simple adjustments to your diet can make a positive change to the balance of your gut microbiome in as little as 48 hours.

Try to:

• Cut back on caffeine and alcohol
• Eat more brightly coloured foods containing fibre, particularly fruit, vegetables, nuts and seeds
• Avoid highly processed food
• Check food labels. Look for numbers, and words you do not recognise, which tell you that it’s processed. If packaged food contains more than three ingredients, with names you do not recognise it’s also likely to be processed and will not be recognised by the gut bacteria
• Include foods which contain isoflavones (found in soy, such as tofu and tempeh) which your gut microbiome can convert into oestrogen-like compounds

Taking a few steps to improve your diet can make a big difference to your menopause journey. Through nutrition women can Thrive and not just Survive!

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Chiza Westcarr is a Nutritional Medicine Practitioner and Menopause Wellness Coach. She has a Master’s degree in Human Nutrition, an Advanced Diploma in Nutritional Medicine and a Bachelor of Health Sciences – Clinical Dermal Therapies. She is preparing to commence a PhD in Menopause Research with a focus on Dementia.

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References

1. Zoe Project https://zoe.com accessed 3rd October 2023

2. Appleton J. The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health. Integr Med (Encinitas). 2018;17(4):28-32.

3. Castaneda M, Strong JM, Alabi DA, Hernandez CJ. The Gut Microbiome and Bone Strength. Curr Osteoporos Rep. 2020;18(6):677-683.

4. Peters BA, Santoro N, Kaplan RC, Qi Q. Spotlight on the Gut Microbiome in Menopause: Current Insights. Int J Womens Health. 2022;14:1059-1072. Published 2022 Aug 10.

5. Linares R, Francés R, Gutiérrez A, Juanola O. Bacterial Translocation as Inflammatory Driver in Crohn’s Disease. Front Cell Dev Biol. 2021;9:703310. Published 2021 Sep 7.