While the word microbe may have you reaching for the cleaning wipes, these tiny organisms also have an important role to play in keeping you healthy.
Read our guide to gut health, microbes, and menopause.
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What is the microbiome?
The microbiome is the ecosystem of microbes that live in, on, and around your body. These include bacteria, fungi, and viruses that live in harmony with your body and help to keep it in good health.
While it may be hard to believe, there are at least as many microbes in your microbiome as there are cells in your body – around 50 trillion!
You may hear these microbes called flora. For example, the bugs that colonize the gut are commonly called gut flora.
Microbe is a general word for all microscopic organisms, including bacteria, viruses, and fungi. You may also hear them called germs – usually with a negative connotation – or micro-organisms.
Why is the microbiome important for gut health?
Microbes live on and in every part of our body – think gut, vagina, lungs, ears, bladder, skin, liver. Some of the microbes that form the microbiome live harmlessly on our bodies and have little effect on our well-being. These are known as commensals. Others, given the right circumstances, can cause illness.
However, some microbes actively work to keep us healthy! This is especially true for those microbes which live in the gut. Here, helpful bacteria can:
- Keep other, potentially harmful microbes in check
- Ferment soluble fiber into easy-to-digest nutrients
- Help process Vitamin K and folic acid
- Regulate the immune system
Helpful bacteria can also boost the levels of estrogen in circulation by ‘recycling’ them from the gut and releasing them back into the bloodstream. You may hear this group of bacteria called the estrobolome.
We are still learning about the microbiome, and this list of functions will likely grow with our understanding of this complex ecosystem.
Needless to say, the microbiome is an important part of a healthy body.
Why is gut health important at menopause?
Menopause happens when your body experiences a dramatic change in the type and amount of hormones it produces. Most menopause symptoms come from the sudden decrease in estrogen.
However, microbes may play a role too. Menopause is known to change your gut microbiome and scientists are still learning about the implications of this.
Mental health and menopause
Although it may be difficult to believe, the microbes in your gut can have an impact on the way your brain works. This is known as the gut-brain axis.
Bacteria living in the gut produce chemicals known as neurotransmitters, which send signals to nerve cells. These signals can affect nerves in the gut, and even those within the brain.
Neurotransmitters play an important role in regulating moods, thoughts, and emotions. In fact, common treatments for depression and anxiety work by boosting the amount of certain neurotransmitters available within the brain, chiefly serotonin.
This is why a healthy microbiome is thought to help maintain good mental health. Research is ongoing as to the extent and importance of this relationship, but boosting your microbiome might be a good way to care for your mental health too.
That isn’t the whole story though. The gut-brain axis works both ways! Just as microbes in the gut can affect the nervous system, the nervous system can affect the microbes in the gut. Stress and anxiety are known to change the composition of the gut microbiome.
While a healthy microbiome may contribute to good mental health, you should still speak to your healthcare provider if you are struggling with any troubling symptoms including anxiety, depression, and mood swings. Other treatment options may work well for you, including antidepressants or hormone therapy (HT).
Weight gain and menopause
Weight gain is very common at menopause. This is mostly related to changes in your metabolism that mean you burn fewer calories each day, and the fact that other menopause symptoms can make healthy eating and an exercise routine more difficult to stick with.
Scientists are now also studying the possible link between menopausal changes to the microbiome and weight gain. Lab studies have shown a link between menopausal changes to the microbiome and increased body fat, slowed metabolic rate, and insulin resistance.
While this by no means proves the link, you could consider a few microbiome-friendly changes to your lifestyle. Many of these – including exercise and a diet rich in whole foods – may also help you to shed weight.
Genitourinary syndrome of menopause
Genitourinary syndrome of menopause (GSM) affects about half of postmenopausal women and includes symptoms like vaginal pain, dryness, tightness, and recurrent urinary tract infections (UTIs).
Studies suggest that there may be some link between symptoms and the types of bacteria found in the vagina after menopause – a population of bacteria that are often positively affected by a healthy gut biome, known as a microbiome axis. However, there is not yet any conclusive evidence and research is ongoing.
While you may choose to include some microbiome-friendly foods in your diet, GSM can be treated effectively with low-risk vaginal hormone therapy (HT). Speak to your healthcare provider for more advice.
Osteoporosis and osteopenia
Thinning of the bones is common during perimenopause and menopause, and it is linked to the reduction in estrogen levels. This condition is known as osteopenia or osteoporosis if more severe, and it can make you more prone to bone fractures.
There is emerging evidence that your gut microbiome could contribute to healthy bones. Some studies have even suggested a link between changes to the microbiome and thinning of the bones, although this is still being investigated.
If you have osteoporosis, your healthcare provider may recommend treatment to preserve your bone density. Speak to them for further advice about your options.
How can you build a healthy microbiome?
A healthy lifestyle is a great foundation for a healthy microbiome. This includes eating enough probiotic and prebiotic foods, as well as getting enough exercise.
Probiotics
Probiotics are helpful bacteria found in certain foodstuffs. These commonly include yogurts and yogurt drinks, kombucha, sauerkraut, and kimchi, among others.
These helpful bacteria contribute to your microbiome by adding more ‘good’ bacteria to the gut. There is some evidence that specific probiotics can help with symptoms of irritable bowel syndrome (IBS) and certain types of constipation. Some studies suggest it may even be helpful in inflammatory bowel disease like ulcerative colitis.
It is important to note that, while probiotics can be helpful for specific illnesses, they are just one part of the treatment plan. You should still see your healthcare provider if you have any new or worrying symptoms including a change in the quality of your bowel movements, bleeding with bowel movements, abdominal pain, or unintentional weight loss.
Prebiotics
Prebiotics are foods that nourish your microbiome. They usually contain types of soluble fiber that may stimulate the growth of helpful bacteria in your gut.
Some good sources of prebiotic fiber include:
- Oats and barley
- Wholegrain cereals
- Wholewheat flour
- Bananas, apples, and berries
- Artichokes, asparagus, onion, leek, and garlic
You may notice that these are all generally healthy choices, but they are not always straightforward for everyone. Prebiotic foods can cause increased flatulence because of increased bacterial activity in the gut. If you have any pre-existing bowel conditions including IBS, introduce these foods slowly and with caution to minimize any discomfort.
Some studies show that prebiotics can increase the proportion of specific desirable bacteria in the gut, but there are very few clinical trials that show an actual improvement in health as a result of consuming prebiotics.
Exercise
Moderate exercise has also been found to contribute to a healthy gut microbiome. This is in addition to the other positive effects that exercise can have at the time of menopause.
Read more here on the best exercise for menopause.
Would hormone therapy (HT) boost your gut microbiome?
We do not yet know whether HT can improve your microbiome. Research has found that this does happen in rats, but human studies are needed to confirm this happens in people too.
Like all medications, HT comes with certain risks, so it is not used solely to enhance the gut biome as this is (so far) unproven.
However, HT is an effective treatment for many symptoms of menopause including hot flashes, poor sleep, and mood changes. While HT is not suitable for everyone, it may be a useful part of your treatment plan. Speak to your healthcare provider to find out more.
Read more about the risks and benefits of HT.
Do antibiotics affect the microbiome?
While antibiotics are life-saving in many cases, they can also alter the balance of bacteria in the gut. Antibiotics kill off some good bacteria in your gut as well as those that cause nasty infections. For this reason, it is important to use antibiotics only when necessary and as advised by your healthcare provider. Stick to your healthcare provider’s recommendations – don’t avoid them if you need them.
When should you see your healthcare provider?
Don’t assume that any medical issues will be cured by a change in your diet. While a microbiome-friendly diet can be helpful, your symptoms need to be assessed properly.
This is particularly important if you experience:
- Abdominal pain
- Any change to your bowel habits (diarrhea or constipation)
- Bloating or abdominal swelling
- Nausea or vomiting
- Blood in your stools
- Urinary changes
- Irregular bleeding
- Weight loss
- Any other changes or concerns
Final word
The microbiome is the ecosystem of microbes that live in, on, and around your body. These include bacteria, fungi, and viruses that live in harmony with your body and help to keep it in good health.
While it may be hard to believe, there are at least as many microbes in your microbiome as there are cells in your body – around 50 trillion!
You may hear these microbes called flora. For example, the bugs that colonize the gut are commonly called gut flora.
Microbe is a general word for all microscopic organisms, including bacteria, viruses, and fungi. You may also hear them called germs – usually with a negative connotation – or micro-organisms.
Find out more about menopause on our blog or in our symptoms library.
- Sender, R., Fuchs, S., Milo, R. Are we really vastly outnumbered? Revisiting the ratio of bacterial to host cells in humans, Cell, 164(3): p337-340
- Quigley E. M. Gut bacteria in health and disease, Gastroenterology & hepatology, 9(9): 560–569
- Peters, B. A., Santoro, N., Kaplan, R. C., & Qi, Q. Spotlight on the Gut Microbiome in Menopause: Current Insights. International journal of women’s health, 14, 1059–1072
- Becker, S.L., Manson, J.E. Menopause, the gut microbiome, and weight gain: correlation or causation?, Menopause: 28(3): p327-331
- Łaniewski, P., Herbst-Kralovetz, M.M. Connecting microbiome and menopause for healthy ageing, Nat Microbiol 7, 354–358 (2022)
- Rettedal, Elizabeth A., et al. The gut microbiome is altered in postmenopausal women with osteoporosis and osteopenia, JBMR plus 5.3 (2021): e10452
- Guandalini, S et al. VSL#3 Improves Symptoms in Children With Irritable Bowel Syndrome: A Multicenter, Randomized, Placebo-Controlled, Double-Blind, Crossover Study, Journal of Pediatric Gastroenterology and Nutrition, 51(1): 24-30
- Ford, A C et al. Efficacy of Prebiotics, Probiotics and Synbiotics in Irritable Bowel Syndrome and Chronic Idiopathic Constipation: Systematic Review and Meta-analysis, The American Journal of Gastroenterology. 109 (10): 1547–61
- Tursi, A. et al. Treatment of relapsing mild-to-moderate ulcerative colitis with the probiotic VSL#3 as adjunctive to a standard pharmaceutical treatment: a double-blind, randomized, placebo-controlled study, The American journal of gastroenterology, 105(10), 2218–2227
- Hutkins, R. W., et al. Prebiotics: why definitions matter, Current opinion in biotechnology, 37, 1–7
- Clauss, M., Gérard, P., Mosca, A., & Leclerc, M. Interplay Between Exercise and Gut Microbiome in the Context of Human Health and Performance, Frontiers in nutrition, 8, 637010
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