Always on the lookout for proven ways to help menopause symptoms? You may have come across probiotics. They’re on the rise, with new claims emerging regularly about their efficacy at this time of life. But is there any evidence that probiotics help with menopause symptoms? Nutritionist Le’Nise Brothers explores the research behind probiotics and explains which are best for menopause symptoms.
Gut health and menopause
Talk about gut health usually focuses on the microbiome – or ecosystem – of trillions of bacteria, virus, fungi, archaea, and other microbes that live in your small and large intestines. But the gut isn’t the only place on the body with a microbiome – you also have microbiomes on your skin, mouth, lungs, vagina, and eyes. Before you throw your soap in the bin with disgust, remember that you need these microbiomes! Your gut microbiome helps you in so many ways, including:
- Supporting food digestion
- Mental health
- Strong immune function
- Hormone metabolism
The food you eat, how you move your body, how you sleep, how often you empty your bowels, even how you manage stress, all have an impact on the health of your gut.
Menopause changes to the gut
There are several changes to your body during and after menopause, including changes to gut and vaginal health. After menopause, your body produces less estradiol, the dominant form of estrogen during your menstruating years. Instead, the balance shifts towards higher levels of estrone, a less potent form of estrogen. This change in hormone production can impact the composition of your gut microbiota.
Your body is prepared for this and has a specific collection of gut bacteria called the estrobolome that help regulate estrone levels in menopause. But there is plenty you can do to help it along too!
What can you eat and drink to improve gut health during menopause?
Despite these hormonal changes, you can support the estrobolome and your entire gut microbiome during menopause and beyond through what you eat and drink, as well as through targeted probiotic supplements.
Fibrous food
You can positively affect the health of your gut at every meal. Think of your gut a bit like a garden – you must fertilize and feed what’s already there and you can also add new plants for greater diversity. You fertilize your ‘gut garden’ when you add foods containing special kinds of soluble fiber, also called prebiotics, such as:
- Fruits and vegetables with the peel on
- Nuts
- Seeds
- Beans
- Oats
- Legumes
Your gut bacteria – the estrobolome – then feed on this fiber, which causes by-products of digestion, including short-chain fatty acids (SCFAs) like butyrate, propionate, and acetate, which are thought to help reduce inflammation and support positive mental health – although this research is ongoing.
Fermented food
You can diversify your ‘gut garden’ by adding fermented food and drink. This includes foods that have living microbes present, also called probiotics, such as:
- Full-fat Greek or natural yogurt
- Sourdough products
- Miso
- Tempeh
- Pickled vegetables
- Kombucha
- Kefir
- Kimchi
- Kvass
- Sauerkraut
What probiotics are best for menopause?
Evidence is still emerging about the role probiotics play in supporting general health in menopause, including improving bone health, mood, and vaginal health.
Not all probiotics are created equally, so it is important to choose probiotic supplement strains that are backed by research. In general, current research points to Lactobacillus as a great all-round probiotic for menopause. Many reputable clinical-grade brands offer probiotics containing Lactobacillus strains.
Probiotics for bone health
A small 2004 study of 20 postmenopausal women found that the group that consumed milk fermented with Lactobacillus helveticus had increased levels of calcium, a mineral that’s important for bone health. This group also had lower levels of parathyroid hormone (PTH), which is responsible for bone resorption and remodeling (a normal lifelong process, but one which can increase and lead to thinning of the bones after menopause).
While these findings are fascinating, we still do not know whether they translate to an actual improvement in women’s bone health, or simply a change in their test results. Your own healthcare provider will be able to advise on the best way for you to preserve your bone density.
Probiotics for vaginal health
The vagina is colonized and kept healthy by a variety of different species of fungi, viruses, and bacteria, mainly Lactobacillus. During menopause, these bacteria are thought to affect a number of vaginal symptoms that are grouped under the name genitourinary syndrome of menopause (GSM). These symptoms may include pain, dryness, loss of lubrication, and painful sex. There are lots of different species of Lactobacillus, although the most common in healthy vaginas include Lactobacillus iners and Lactobacillus crispatus.
Supplementing with vaginal and oral probiotics containing strains of Lactobacillus may support the vaginal microbiome and increase bacterial diversity in the gut. Indeed, small studies have shown that, if taken orally, these may affect vaginal health and reduce vaginal infections. Although initial findings are encouraging, more research is needed in this area.
As the one of the dominant bacteria in the vagina, healthy levels of Lactobacillus can also help prevent urinary tract infections (UTIs). There are multiple different species of lactobacillus, and they help to prevent infections in a number of different ways. The main mechanisms include preventing the bacteria that cause UTIs from ‘sticking’ to the tissues of the vagina and urinary tract, and preventing them from multiplying.
Despite all of these positive findings, we are still learning about the ways the microbiome affects vaginal health. More research is needed about which types of bacteria and which probiotic supplements are most helpful for menopause-related conditions.
If you are struggling with recurrent UTIs, pain, dryness, or other vaginal changes, see your healthcare provider. There are multiple proven treatments for these symptoms, including low-risk vaginal hormone therapy (HT).
Make your visit urgent if you have any blood in your pee, any ulcers or sores that aren’t healing, or any unexpected, heavy, or irregular vaginal bleeding, particularly if it happens after sex.
Probiotics for low mood
Probiotics may have an impact on mental health. A 2016 article found that probiotics did improve depression scores, although a relatively small group of patients was studied and the size of the improvement was not very large. No single specific strain was found to cause this improvement.
This positive effect on mood may be because 95% of serotonin is produced in the gut and serotonin is a chemical that is essential for brain and nervous system function. It is sometimes called the ‘happy’ hormone because of its role in maintaining good mental health.
Research is still ongoing and we have much to learn about the way your gut flora interacts with your mood. If you are struggling with low mood or depression, see your healthcare provider for help rather than only relying on probiotics. They will be able to recommend the best treatments for you – probiotics might be a helpful extra.
Can probiotics help with bloating during menopause?
Possibly. A 2015 meta-analysis including 1,793 patients with irritable bowel syndrome (IBS) found that probiotics have a beneficial effect on bloating.
However, bloating at menopause is not related to IBS as far as we know. It has many different potential causes, some of which are serious. If you notice bloating that is either persistent or keeps coming back, see your healthcare provider in the first instance. They will be able to help you find the cause for your bloating and the correct treatment.
Final word
If you decide to take probiotic supplements, it is helpful to also use fiber and fermented food to support overall gut health.
It is always worth checking in with your healthcare provider if you have specific symptoms. They will be able to help you work out the root cause of your symptoms and suggest appropriate treatment.
Find out more about menopause on our blog or in our symptoms library.
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