How Can Menopause Change Your Gut Microbiome?

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A decline in sex hormones after menopause may leave women with a mix of gut bacteria that more closely resembles what’s seen in men, and a new study suggests that this change may also be associated with an increased risk of cardiometabolic diseases in some women.

Post-menopausal women are at an increased risk of what’s known as cardiometabolic syndrome — which includes heart disease as well as metabolic disorders like type 2 diabetes — because of changes in their bodies that accompany decreased sex hormone production. Previous research suggests that as women go through menopause, they are more likely to experience cardiometabolic risk factors like:

A few studies have also linked menopause to changes in the gut microbiome, which is the collection of bacteria and other microorganisms that live in the digestive system. But most of these studies involved only a handful of participants, and the results have been mixed.

The new study takes a fresh look at this connection, examining data from blood and stool samples to look at differences in the gut microbiome of 295 premenopausal women, 1,027 post-menopausal women, and 978 men.

Post-menopausal women in the study had less diversity in the types of microorganisms in their gut than premenopausal women did, and this decreased variety was more similar to what was seen in men, according to the research article about the study, published in mSystems in April 2022.

“We think that because of decreases in estrogen and progesterone during menopause, the bacteria that normally metabolize these hormones become depleted, resulting in decreased diversity of the gut microbiome,” says lead study author Brandilyn Peters, PhD, an assistant professor of epidemiology at Albert Einstein College of Medicine in the Bronx, New York, who researches the dietary and environmental determinants of the human microbiome.

“The health effects of these changes are not yet clear, but reduced gut microbiome diversity is usually considered harmful for health,” Dr. Peters says.

Declining Estrogen During Menopausal Transition Leads to Changes in Gut Bacteria

Compared with premenopausal women, post-menopausal women had lower levels of several types of organisms in the gut, including Escherichia coli and Shigella spp., Oscillibacter sp. strain KLE1745, Akkermansia muciniphila, Clostridium lactatifermentans, Parabacteroides johnsonii, and Veillonella seminalis. After menopause, women also had higher levels of Bacteroides sp. strain Ga6A1, Prevotella marshii, and Sutterella wadsworthensis.

Menopause-related changes in the gut microbiome were also associated with worse cardiometabolic risk profiles, the study found. In particular, increased levels of Sutterella wadsworthensis after menopause were associated with higher blood pressure, the analysis found.

One limitation of the study is that researchers relied on women to accurately report whether they had gone through menopause and when — a process that varies in length, may or may not include hot flashes, and can only be diagnosed in retrospect, when a woman hasn’t had a period for 12 consecutive months.

Another drawback is that all of the study participants were Hispanic, and it’s possible that the results might be different among other racial or ethnic groups, the study team notes.

“We know that the gut microbiome differs between populations of different cultural backgrounds, yet there can be similarities when it comes to the effects of an exposure, for example diet, or a disease on the gut microbiome across different populations,” Peters says. “We expect that some of our findings, but perhaps not all, may apply to other populations, and this is something that needs further study.”

The Gut Microbiome Is Crucial for Your Health

The results add to a growing body of evidence suggesting that the gut microbiome plays a pivotal role in shaping our health. Earlier research has found the gut microbiome influences digestive health and can play a role in a wide range of conditions, such as:

  • Arthritis
  • Obesity
  • Depression
  • Cardiovascular disease

“It is well established that human gut microbiota metabolically interacts with sex hormones,” says Jiyoung Ahn, PhD, a professor of population health and associate director of the Perlmutter Cancer Center at the NYU Grossman School of Medicine in New York City.

The new study findings “provide important evidence that menopause-related gut microbiome changes were associated with adverse cardiometabolic risk in post-menopausal women, indicating the gut microbiome contributes to changes in cardiometabolic health during menopause,” says Dr. Ahn, who wasn’t involved in the study.

Although what we eat can influence the makeup of our gut microbiome, more research is needed to determine whether there might be any specific foods women may want to eat or avoid to promote a specific mix of organisms in the gut after menopause, in order to support optimal cardiometabolic health. “It is premature to provide specific recommendations based on this study,” Ahn says.