Gastrointestinal Disturbance and Metabolic Issues During Menopause

Posted by Laura O'Rourke on

By Dr Anita Sturnham, GP 
An internationally renowned doctor specialising in dermatology and anti-ageing medicine  


There is a strong link between our gut health and our hormonal health. We know that the gut microbiome and oestrogen influence each other, as we have receptors for oestrogen in our digestive tract. Interestingly, studies have also identified bacteria within the gut microbiome called the ‘estrobolome’ that are thought to process oestrogen and its metabolites. We also have oestrogen-metabolising enzymes in our gut called beta-glucuronidases which can convert oestrogens into their active forms so that they can enter the blood circulation and reach other tissues in the body. They can also recirculate hormone metabolites which are no longer of use to our body, which can cause issues. 

Declining oestrogen in perimenopause can impact the microbiome and result in changes in our metabolism and ability to process oestrogen as well as influence overall circulating oestrogen levels. With this in mind, any diet or lifestyle change that can modify the estrobolome may be beneficial through menopause and beyond to reduce the risk of oestrogen-related issues. For this reason, I often recommend taking a good gut friendly live bacteria to support gut microflora, digestive enzymes to improve absorption and encourage women to increase their intake of cruciferous vegetables such as broccoli, which contain indole-3 carbinol, which is further broken down to diindolylmethane (DIM), and is thought to support sex hormone clearance in the liver once we have finished using the hormones. 

Both Oestrogen and Cortisol hormones can have a strong influence on gut health. When oestrogen levels are low, levels of cortisol can rise. Cortisol is our protective ‘stress hormone’. Rising Cortisol levels can switch off the release of stomach acid and also slows the movement of digested food into the small intestine. Our production of digestive enzymes also slows. This can result in issues with the absorption of micronutrients but also impair the gut immune system and we may see elevated levels of opportunistic organisms in the gut. Women often experience abdominal discomfort, digestive issues, bloating and flatulence. Taking digestive enzymes, a good gut friendly live bacteria and avoiding processed foods can help to alleviate issues. Phytoestrogens can also be helpful. 

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