July 20, 2026
Menopause is the natural stage of life when the ovaries make less of the hormone oestrogen.1 In recent years, researchers have started to look at how this change is linked to the gut microbiome – the community of bacteria that live in the gut.2 This article looks at what current research does and does not show about menopause, gut health and these bacteria.
Can changes in oestrogen during menopause affect gut bacteria?
Research suggests that the fall in oestrogen during menopause is linked to changes in the gut bacteria.3 Some of these bacteria help the body manage oestrogen. They make an enzyme that switches oestrogen back into an active form, so the body can take it up and use it again. This group of bacteria and their genes is called the “estrobolome”.3
Some studies have found that, after menopause, the gut tends to hold a smaller range of different bacteria than before.2 The mix of bacteria also shifts to look more like the mix typically seen in men.3
Oestrogen helps keep the gut lining strong. As oestrogen levels fall during menopause, the gut lining can become leakier which may let bacteria pass into the body and cause low-level inflammation.3 This relationship between oestrogen and the gut bacteria seems to work both ways: oestrogen affects the bacteria, and the bacteria affect how much oestrogen the body keeps.1
What is the relationship between the gut microbiome and menopause symptoms?
Research links changes in the gut bacteria not only with menopause symptoms but also with the severity of symptoms.3 Menopause symptoms vary from woman to woman. They can include hot flushes, night sweats, mood changes, brain fog, sleep problems and changes in bone health.3
A study has found that women with menopause symptoms tend to have an imbalance of gut bacteria than menopausal women without symptoms.3 After menopause, changes in the gut microbiome and its functions may negatively affect metabolism and bone health, potentially contributing to a higher risk of certain diseases.3 The decrease in helpful bacteria means less oestrogen is recycled. This has been linked to changes in blood fats, memory and bone strength.1
Problems with memory and “brain fog” are often reported during menopause, and whether gut bacteria play a part has been flagged as a question for future research.3 Most current research focuses on the link rather than proving cause and effect, and it is hard to separate the effects of menopause from the effects of getting older.3
Can probiotics or fermented foods help during menopause?
Early research suggests that probiotics and some foods (prebiotics) may help support the gut bacterial diversity during menopause, but the evidence is still limited.3 Probiotics are live bacteria that may bring health benefits when eaten in adequate amounts.2
Prebiotics and probiotics may help ease certain menopausal symptoms by supporting healthy gut bacteria.3 Prebiotics – food parts such as fibre that feed helpful bacteria – have also shown promise for some symptoms.3
Plant foods such as soya contain natural compounds called phytoestrogens. The benefits of soy phytoestrogens may depend on gut health. Some women have specific gut bacteria that convert soy compounds into equol, a substance with stronger estrogen-like effects. Studies suggest these women may experience greater relief from hot flashes.2 Fermented foods such as yoghurt have also been tested in studies for menopausal symptoms.3
Hormone replacement therapy is often the first treatment offered for menopause symptoms. However, it is not suitable for everyone. Some women cannot use HRT because of certain medical conditions. Others may choose not to use it because they have experience side effects of prefer alternative treatment options 3 Findings so far are mixed, and any benefit often depends on a strain-specific type of bacteria. Larger studies are still needed to confirm whether probiotics help, so they are not yet an established treatment.2
Does menopause increase the risk of conditions such as IBS?
It is not clear that menopause raises the risk of developing irritable bowel syndrome (IBS), although symptoms may feel more severe after menopause.4,5 IBS is a long-term gut condition that causes belly pain and changes in how often or how easily a person passes stools.4 IBS is more common in women than in men.4
One study looked at people with IBS. Women who had gone through menopause reported more severe symptoms than younger women with IBS. Older and younger men showed no such difference.4
After menopause, some women also report more bloating, gas and constipation than before.4 But research on whether menopause itself brings on or worsens IBS is limited, and the results so far are mixed.5 Hormonal changes may act through the gut–brain axis to affect how the gut moves, how sensitive it feels, how well its lining holds up, and how active its immune system is. 5 Probiotics have been studied for IBS, but a recent expert review from the American Gastroenterology Association found there was not enough strong evidence to recommend them.5 If gut symptoms are troubling you or do not go away, a healthcare professional can help you understand what is causing them and what might help.
What dietary approach best supports gut health during menopause?
A diet rich in plants and fibre can help support gut bacteria during menopause.3 Gut bacteria feed mainly on fibre from plant foods.3 Eating more fibre has been linked with steadier gut bacteria and a lower menopause symptom burden.2 A Mediterranean-style diet of vegetables, fruit, beans, nuts and wholegrains has been linked with improvements in hormone-related and heart-health measures around menopause.2 Plant foods also supply phytoestrogens (plant-based compounds that are structurally similar to estrogen, which have been studied for their potential therapeutic roles in women’s health, and a plant-rich, low-fat diet has been linked with milder hot flushes in some studies.2 There’s no single ‘ideal’ gut microbiome for women in perimenopause, but a more varied and greater diversity of gut bacteria is linked with better oestrogen balance — while a less varied microbiome is tied to the inflammation behind many perimenopausal symptoms.2
Conclusion
Menopause brings a drop in oestrogen, which research increasingly links with changes in gut bacteria — and the two appear to influence each other.1 This connection has prompted interest in whether supporting the gut could help with menopause. Non-hormonal options like prebiotics and probiotics show early promise for easing symptoms such as hot flushes, inflammation and metabolic changes — but the science is still young, and more research is needed to confirm how well they work.1
FAQ
Q1: Why might my digestion change during menopause?
Lower oestrogen can affect how the gut works and is often linked with symptoms such as bloating, constipation and stomach pain.3
Q2: Does HRT affect gut health?
It may. Hormone replacement therapy (HRT) supplies exogenous oestrogen that the body loses at menopause. In one study, women taking HRT had more varied gut bacteria – closer to the balance seen before menopause – than women not taking HRT. This is an early finding, and more research is needed.2
Q3: Are probiotic supplements worth taking during menopause?
Some small studies suggest certain probiotics may help, but the evidence is limited and depends on the exact type of bacteria.2 Talk to a healthcare professional before starting any supplement.
Q4: What can I eat to ease menopause symptoms?
Diets high in fibre, low-fat, and plant foods have been linked with a lower menopause symptom burden, and so have foods with a lower glycaemic index (those that raise blood sugar more slowly). For fibre, this may be partly because of its effect on gut bacteria.2
Q5: When should I see a doctor about gut symptoms during menopause?
If you have ongoing or worrying gut symptoms, such as lasting pain, bloating or a change in your normal bowel habits, a healthcare professional can help you find out what’s going on.
This article was written with the assistance of generative AI technology and reviewed for accuracy.
References
