Menopause, Hormones and Gut Health
As a gut health and longevity dietitian, I often work with one of the most common yet overlooked health transitions in women’s lives: menopause.
With so many women experiencing hot flashes, mood swings, weight gain, and gut issues during this phase— we need to address the root cause: the relationship between the gut microbiome and hormonal health.
The Gut-Hormone Connection: What Every Woman Needs to Know
During menopause, hormonal changes can disrupt the gut microbiome, leading to digestive issues like bloating, constipation, and increased gut permeability. Estrogen and progesterone, the key female hormones, play a significant role in regulating gut health. When these hormones decline, so does the diversity of beneficial gut bacteria, affecting digestion, nutrient absorption, and overall health.
Leading women’s health expert, Dr. Sara Gottfried, explains, “We need to understand that women's health continues to decline and needs to be a priority. It helps all of us to devote more research funding to women's health and to develop clinical guidelines that are based on sex differences, rather than assuming that what works in men also works for women.” This highlights the importance of personalized approaches to women’s health, particularly during hormonal transitions like menopause.
PMS and Gut Health: Navigating the Cravings and Chaos
Women with PMS often experience intense sugar cravings—sometimes increasing by more than 200%! These cravings can disrupt blood sugar balance, leading to higher insulin levels and more severe PMS symptoms. Dr. Gottfried advises, “I prescribe foods that optimize insulin and cortisol. That means plenty of protein—aim for your ideal body weight in grams per day (e.g., 130 grams of protein for a 130-pound woman). Also, focus on fiber-rich, non-starchy vegetables like dark leafy greens, purple cabbage, and red bell peppers. Include fermented vegetables, at least four forkfuls per day, to support gut health and hormone balance.”
Key Foods to Include:
Protein: Lean meats, fish, tofu, and legumes help stabilize blood sugar and support hormone production.
Fiber: High-fiber vegetables like kale, spinach, and Brussels sprouts feed beneficial gut bacteria and support estrogen detoxification.
Fermented Foods: Kimchi, sauerkraut, and yogurt provide probiotics that enhance gut microbiome diversity and support hormone balance.
Perimenopause: Why Early Action Matters
Perimenopause, the transition phase before menopause, often begins in the early 40s. Symptoms can be subtle at first, but addressing them early is key to supporting hormonal health. Dr. Gottfried emphasizes, “100% of us go through this process. Find out if you're a good candidate for hormone therapy sooner rather than later. The longer you wait, the less likely the hormone therapy will help save your brain, which in my mind is the most important reason to take bioidentical hormone therapy.”
The gut plays an important role here as well. An imbalanced gut can impair estrogen metabolism, leading to increased symptoms like hot flashes and mood swings. Supporting gut health with a diverse, plant-based diet and targeted probiotics can ease this transition.
The Gender Gap in Health Research: A Call to Action
Despite making up 51% of the population, women are underrepresented in medical research. Dr. Gottfried points out, “Less than 50% of the studies include women. Guideline-based treatments are mostly based on men. For instance, women have a greater risk of vascular damage from prediabetes than men. We must demand more research and use these facts to change our behaviors and reduce our risk of premature aging.”
How to for Optimize Gut Health During Menopause:
Focus on Fiber: Aim for 30-40 grams of fiber per day from non-starchy vegetables, fruits, and whole grains to support gut bacteria diversity.
Increase Fermented Foods: Incorporate at least one serving of fermented foods daily (e.g., kimchi, yogurt) for a probiotic boost.
Eat Protein with Every Meal: Aim for 20-30 grams of protein per meal to stabilize blood sugar and support hormone production.
Consider a Probiotic Supplement: Look for a multi-strain probiotic with Lactobacillus and Bifidobacterium species, which have been shown to support gut health and reduce menopausal symptoms.
Manage Stress: High cortisol from chronic stress can disrupt gut health and worsen hormonal symptoms. Incorporate stress-management practices like yoga, meditation, or deep breathing exercises.
Final Thoughts: Empowering Women Through Gut Health
Understanding the gut-hormone connection is essential for navigating the challenges of menopause. By focusing on personalized nutrition and evidence-based strategies, we can support the gut microbiome and help women feel their best during this transition.
As Dr. Gottfried rightly says, “We must demand more research and develop treatments based on sex differences.” It’s time we prioritize women’s health and recognize the powerful role of gut health in hormonal balance and overall well-being.
If you’re experiencing menopausal symptoms and want to support your gut health, consider booking a personalized Gut Health Evaluation Call for tailored advice and support. Your gut—and your hormones—will thank you.
For further reading, check out my book, You-tarian Diet™, which offers personalized strategies for optimizing gut health and longevity
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