The transition through perimenopause and menopause can feel like a whirlwind—physically, mentally, and emotionally. While hormonal shifts are well-known for causing changes in mood, sleep, and cognitive function, research has shed light on the crucial role that gut health plays in these experiences [1].
Recent studies highlight that fluctuations in estrogen levels not only affect reproductive health but also significantly impact gut microbiota, which in turn influences how the brain processes stress and regulates mood [2]. This intricate gut-brain-hormone connection is emerging as a key factor in creating whole-body balance during midlife.
Hormonal Changes and the Gut Microbiome
Emerging research suggests that menopause brings a noticeable shift in gut microbiome diversity. A 2025 study3 found that as estrogen levels decline, the gut microbiome starts to resemble that of men, with reduced diversity and changes that can impact digestion, immunity, and overall health. A study published in Nature also highlighted how hormonal shifts during menopause influence the microbiome across the body—including the gut, mouth, and urinary tract—potentially affecting everything from metabolism to inflammation levels.
How It Affects Metabolic Health During Menopause
The connection between gut health and metabolism becomes even more crucial during menopause. A 2024 study in Gut Microbes revealed that the loss of ovarian hormones can disrupt the gut microbiome, leading to increased inflammation and a higher risk of metabolic diseases. These findings highlight the need to support both microbial diversity and hormone balance to help manage the metabolic shifts that come with menopause.
As we all know, estrogen and progesterone do more than regulate reproductive health—they play a key role in controlling inflammation, neurotransmitter production, and the integrity of the gut lining. So when these hormone levels decline, the gut-brain connection can weaken, leading to:
Digestive Issues and Metabolic Health
Bloating, constipation, and irregular bowel movements (which can also be linked to bowel cancer – read here to learn about Bowel Cancer Awareness) may become more frequent as hormonal changes slow gut motility. Moreover, changes in gut microbiota have also been linked to weight regulation. And this is because a less diverse microbiome can make it harder to metabolise food efficiently, contributing to weight gain and insulin resistance during menopause.
Cognitive Function and Mood Fluctuations
Serotonin, the neurotransmitter that helps regulate mood, is produced primarily in the gut. A disrupted gut can lead to lower serotonin levels, contributing to anxiety and irritability.
Additionally, a 2024 study published in Nature Communications found that the gut microbiome can also predict cognitive function and depressive symptoms in older adults. The research suggests that cognitive dysfunction and depression are unique states with an overall biological effect detectable through gut microbiota.
Brain Fog
An imbalanced gut microbiome can also increase inflammation, which has been linked to decreased mental clarity and memory.
Strategies to Improve Gut Health During Menopause
So, if you want to prevent those things from happening and are now ready to take charge of your nutritional well-being, here are some practical strategies to explore. Change can feel overwhelming, but small, gradual adjustments can make a big difference. Start with these simple steps—one at a time—and build from there.
Embrace an Anti-inflammatory Diet
Focus on polyphenol-rich foods like berries, dark chocolate, green tea, and extra virgin olive oil. A 2024 study highlighted the relationship between habitual polyphenol consumption and beneficial changes in gut microbiota.
Increase Dietary Diversity
Aim for at least 30 different plant-based foods per week to support gut microbiota diversity in a rainbow variety of colours. The “30 plants per week” recommendation stems from research conducted in the American Gut Project, which found that participants who consumed 30 or more different plant foods weekly had more diverse gut microbiomes compared to those who ate fewer varieties. This diversity is crucial for overall gut health and can have far-reaching effects on your overall well-being.
Include Fermented Foods
Incorporate yogurt, kefir, sauerkraut, and miso into your diet to help restore balance in the gut microbiome. If you don’t eat fermented food that much, I recommend that you follow the principle of ‘start low and go slow’ if you want to avoid gas, bloating or abdominal discomfort. What this means is that you start with a very small amount of fermented food, for example, the amount of the fermented food that would cover your thumbnail and gradually increase the amount over the following weeks.
Stay Active
Regular, moderate exercise—especially beneficial for mid-life women—can boost your body’s antioxidant defences and has powerful anti-inflammatory effects. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, combined with strength training exercises at least twice a week. Activities like brisk walking, swimming, cycling, or yoga—which, as we mentioned in our blog, have profound benefits—can be excellent choices for menopausal women.
Manage Stress
Practice stress-reducing techniques like mindfulness, meditation, or yoga to calm your nervous system and support your gut. Chronic stress can reduce gut microbiota diversity and affect gut-brain communication via the vagus nerve.
Here’s a brief expansion on some stress-reducing techniques:
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- Mindfulness: This practice involves focusing on the present moment—such as mindful eating—without judgment. It can help reduce cortisol levels and inflammation. Try incorporating mindfulness into daily activities or through guided meditations.
- Meditation: Regular meditation can lower stress hormones and improve gut health. Even short sessions of 5-10 minutes daily can be beneficial. Apps like Headspace or Calm can provide guided meditations.
- Yoga: Combining physical postures, breathing exercises, and meditation, yoga can reduce stress and support gut health. Gentle forms like Hatha or Yin yoga may be particularly suitable for menopausal women.
- Deep breathing exercises: Simple techniques like diaphragmatic breathing or the 4-7-8 method can activate the parasympathetic nervous system, promoting relaxation and supporting digestive function.
- Progressive muscle relaxation: This technique involves tensing and relaxing different muscle groups, helping to release physical tension associated with stress.
Prioritise Sleep
Aim for 7-9 hours of quality sleep each night. Poor sleep, often linked to sleeplessness, is a common challenge for menopausal women and can disrupt the gut microbiome and elevate cortisol levels. Research has shown that even short-term sleep deprivation can alter the composition and diversity of gut bacteria. This disruption can lead to increased inflammation and compromised gut barrier function.
Moreover, inadequate sleep can elevate cortisol levels, our body’s primary stress hormone. Cortisol follows a natural circadian rhythm, typically being lowest around midnight and peaking in the morning. However, sleep deprivation can alter this pattern, leading to elevated cortisol levels throughout the day. This sustained increase in cortisol can have several negative effects:
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- It can promote insulin resistance and the accumulation of abdominal fat.
- It can further disrupt the gut microbiome, as stress hormones like cortisol can alter the gut environment.
- It can lead to increased inflammation in the body.
Quality sleep is a cornerstone of good health, and by prioritising sleep, you’re not only supporting your gut health but also promoting overall physical and mental well-being.
Consider Probiotics
Recent research suggests that specific probiotic strains may help manage menopausal symptoms by supporting gut health and mood regulation.
Closing Thought
The latest research emphasises the critical role of the gut-brain-hormone connection in managing menopausal symptoms and promoting overall health. By understanding and nurturing this connection through diet, lifestyle changes, and potentially targeted probiotic interventions, women can better navigate the challenges of menopause and support their long-term well-being.
As we learn more about the gut microbiome’s role in menopause, we gain new opportunities to support our well-being in ways that feel right for our bodies during this significant life transition.
The future holds exciting possibilities for personalised approaches that could make this transition smoother and more empowering. While research continues to evolve, one thing is clear—you don’t have to navigate these changes alone. Small, mindful choices today can help you feel your best through menopause and beyond.
References:
[1] Caracciolo, B., et al. (2014). Cognitive decline, dietary factors and gut-brain interactions. Mechanisms of Ageing and Development, 136-137, 59-69.
[2] Pasinetti, G. M., et al. (2018). The Role of the Gut Microbiota in the Metabolism of Polyphenols as Characterized by Gnotobiotic Mice. Journal of Alzheimer’s Disease, 63(2), 409-421.
[3] Bello, M. G. D., et al. (2025). Menopausal shift on women’s health and microbial niches. Nature Reviews Microbiology, 23(1), 23-37.
[4] Cross, T. W. L., et al. (2024). Gut microbiome responds to alteration in female sex hormone status and exacerbates metabolic dysfunction. Gut Microbes, 16(1), 2295429.
[5] Geerlings, S. Y., et al. (2024). Gut microbiome predicts cognitive function and depressive symptoms in older adults. Nature Communications, 15(1), 1-14.
[6] Zamora-Ros, R., et al. (2024). (Poly)phenol-related gut metabotypes and human health: an update. Food & Function, 15(3), 1234-1256.
[7] Cryan, J. F., & Dinan, T. G. (2012). Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nature Reviews Neuroscience, 13(10), 701-712.
[8] Cattaneo, A., et al. (2017). Association of brain amyloidosis with pro-inflammatory gut bacterial taxa and peripheral inflammation markers in cognitively impaired elderly. Neurobiology of Aging, 49, 60-68.
[9] Purdue University. (2024). Purdue Nutrition Science researcher uncovers connection between hormones, gut microbiome, and metabolic dysfunction commonly seen in postmenopausal women. Purdue University News.
[10] Heiman, M. L., & Greenway, F. L. (2016). A healthy gastrointestinal microbiome is dependent on dietary diversity. Molecular Metabolism, 5(5), 317-320.
[11] Marco, M. L., et al. (2017). Health benefits of fermented foods: microbiota and beyond. Current Opinion in Biotechnology, 44, 94-102.
[12] Monda, V., et al. (2017). Exercise Modifies the Gut Microbiota with Positive Health Effects. Oxidative Medicine and Cellular Longevity, 2017, 3831972.
[13] Karl, J. P., et al. (2018). Effects of Psychological, Environmental and Physical Stressors on the Gut Microbiota. Frontiers in Microbiology, 9, 2013.
[14] Smith, R. P., et al. (2019). Gut microbiome diversity is associated with sleep physiology in humans. PLoS ONE, 14(10), e0222394.
[15] Parida, S., & Sharma, D. (2020). The Microbiome-Estrogen Connection and Breast Cancer Risk. Cells, 9(6), 1477.
[16] Vieira, A. T., et al. (2020). The role of probiotics and prebiotics in inducing gut immunity. Frontiers in Immunology, 11, 2611.
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