Hormones and the Gut-Microbiome Connection During Menopause: How Bacteria Shape Hormonal Balance

Table of Contents

1. Introduction

2. What is Menopause?

3. Key Hormones During Menopause

4. How Hormones Affect the Gut

5. The Enterohepatic Estrogen Pathway

6. Gut Microbiome: Key Microorganisms

7. Scientific Literature Review

8. Practical Implications

9. Conclusion

1. Introduction

Menopause is a transformative phase in a woman’s life, marked by the end of menstruation and major hormonal shifts. Increasingly, scientific research reveals that this hormonal transition is deeply intertwined with the gut microbiome. The estrobolome—a specific set of gut bacteria involved in estrogen metabolism—plays a central role in maintaining hormonal balance.

This blog explores:

• How estrogen, progesterone, and other hormones influence gut permeability and microbial diversity

• Which bacteria are responsible for metabolizing and regulating estrogen

• Scientific studies supporting these connections

• Actionable strategies to support gut and hormonal health during menopause

2. What is Menopause?

Menopause is clinically defined as the cessation of menstruation for 12 consecutive months. The transitional period before menopause is called perimenopause, marked by fluctuating hormone levels.

Common symptoms:

• Hot flashes

• Night sweats

• Mood swings

• Digestive issues

Menopause isn’t just an ovarian event; it impacts the entire endocrine system and interacts significantly with gut health.

3. Key Hormones During Menopause

3.1 Estrogen

• Produced in ovaries and via peripheral aromatization

• Affects bone health, mood, and cardiovascular health

3.2 Progesterone

• Supports mood, sleep, and menstrual cycle regulation

3.3 Androgens (Testosterone, DHEA)

• Contribute to libido and muscle mass

3.4 FSH & LH

• Rise in response to falling estrogen and progesterone

The breakdown and recirculation of these hormones often involve gut microbial enzymes, particularly β-glucuronidase.

4. How Hormones Affect the Gut

4.1 Gut Permeability

Estrogen promotes tight junction proteins like claudins. Its decline increases intestinal permeability ("leaky gut"), enabling systemic inflammation.

4.2 Immune Modulation

Estrogen is immunomodulatory. Lower levels elevate inflammation, altering gut microbiota composition.

4.3 Motility

Hormonal shifts affect serotonin and gut motility, contributing to constipation or diarrhea in menopausal women.

5. The Enterohepatic Estrogen Pathway

1. Estrogens are conjugated in the liver via glucuronidation or sulfonation

2. Conjugated estrogens are excreted into the gut via bile

3. Gut bacteria with β-glucuronidase deconjugate them

4. Free estrogens can be reabsorbed into circulation

This pathway, mediated by the estrobolome, regulates available estrogen levels.

6. Gut Microbiome: Key Microorganisms

Bacteria	Function
Escherichia coli	Produces β-glucuronidase
Bacteroides spp.	Estrogen deconjugation, bile acid metabolism
Clostridium spp.	Contains β-glucuronidase enzymes
Faecalibacterium prausnitzii	Anti-inflammatory, gut lining integrity
Lactobacillus & Bifidobacterium	Anti-inflammatory, support gut barrier
Ruminococcus spp.	Fiber degradation, hormonal modulation

Balanced activity is essential. Overactive β-glucuronidase may elevate estrogen recirculation risks, while underactivity may contribute to deficiencies.

7. Scientific Literature Review

Schmidt et al., Gut Microbes (2024)

• Postmenopausal women showed lower microbial diversity

• Reduction in secondary estrogens linked to lower Faecalibacterium levels

Baker et al., J Endocrinology (2023)

• Elevated β-glucuronidase in estrogen-deficient women

• Probiotic Bacillus clausii helped normalize hormone metabolism

Rossi et al., Clinical Nutrition (2022)

• Fiber increased Bifidobacterium and reduced inflammatory markers

Summary: Hormonal changes reshape the microbiome, while microbial interventions can stabilize hormone levels.

8. Practical Implications

Nutrition

• High-fiber diet: legumes, whole grains, vegetables

• Prebiotics: inulin, FOS (onions, garlic, chicory)

• Fermented foods: kefir, sauerkraut

Probiotics

• L. reuteri ATCC PTA 6475

• B. longum BB536

• Bacillus clausii

Lifestyle

• Regular movement

• Stress reduction (yoga, meditation)

Medical Options

• Hormone Replacement Therapy (HRT)

• Targeted gut therapies like rifaximin for dysbiosis

9. Conclusion

Scientific evidence clearly links menopause-related hormonal shifts to gut microbiome changes. Through the estrobolome and associated mechanisms:

• The gut helps regulate circulating estrogen levels

• Hormone decline affects gut permeability and microbial diversity

• Diet and lifestyle interventions can restore balance

Supporting your gut health is one of the most powerful tools for managing menopause naturally. With InnerBuddies’ tools, guides, and research-based resources, you're equipped to take control of your hormonal wellness.