When Perimenopause and Menopause Feel Like a Struggle and Why Your Gut Needs Attention
Perimenopause and menopause don’t just show up; they barge in, turning your world upside down. It seems like one day, you’re managing your life just fine, and then you’re hit with unpredictable periods, relentless hot flashes, and mood swings that make you feel like a stranger in your own life.
Your gut? It could be acting up too—bloating, cramping, and generally throwing everything out of whack. And it’s not just the physical symptoms; it’s the mental fog, the anxiety that creeps in for no reason, and the exhaustion that makes getting through the day feel like a marathon. These changes don’t just affect your body; they infiltrate your work, your relationships, and your sense of self.
The good news is, you don’t have to just ride out this storm. Understanding what’s happening—and how your gut health is at the center of it all—can be your first step toward regaining control. Your microbiome is heavily impacted by the shifts in your hormones during perimenopause, menopause, and post-menopause.
So grab a hot beverage, and let’s dive into how your gut and hormones are in this together—and why understanding their connection can leave you feeling empowered to take charge.
Let’s Break Down the Phases: What You Need to Know
Before we talk gut health, let’s make sure we’re all on the same page about the phases you’re in, so you know exactly what’s going on.
Perimenopause:
This is the “before” phase—the 4-10 years leading up to menopause, when your body starts adjusting to lower estrogen levels. During this time, you might notice irregular periods, mood swings, and some digestive changes. While it can feel a bit overwhelming, it’s an opportunity to tune into your body and start making choices that support your well-being as you transition to the next stage.
Menopause:
The official end of menstruation—12 months without a period. Estrogen levels drop, and along with that, you might experience hot flashes, night sweats, and even some digestive changes. It’s a big shift, but with the right approach, it’s a chance to regain balance and feel more like yourself again.
Post-Menopause:
This is the new phase you step into—no more periods. It’s a fresh chapter, but one where gut issues, brain fog, and inflammation can sometimes show up more than you’d expect. The good news? Taking care of your gut health now can have a big impact on how you feel moving forward.
The Estrobolome – It’s Not Just a Fancy Word
Your gut’s got a little secret—it’s called the estrobolome. It’s a whole squad of microbes in your gut that help break down estrogen, like your body’s own little estrogen “recycling” plant.
The catch? When your estrogen starts dipping during perimenopause and menopause, these microbes start to decline.
Your Faecalibacterium, Roseburia, and Lactobacillus – the good guys that help keep your gut calm and your hormones in check – they start to dip.
When those good bacteria start to dip, your gut doesn’t just sit there looking cute. It gets chaotic and symptoms of Irritable Bowel Syndrome (IBS) start creeping in. Your body struggles to process estrogen like it used to and your gut gets inflamed.
So what’s happening here is basically a vicious cycle: as hormones dip, our gut’s microbial diversity takes a hit, causing the estrobolome to shrink, and before you know it, estrogen levels start to drop even more.
Low Estrogen: It’s More Than Hot Flashes
When estrogen levels decrease, it affects more than just your ovaries. Estrogen plays a role in your brain, bones, and gut, so its decline can be felt throughout your body.
A drop in estrogen can impact the close relationship between your gut and brain, since they rely on each other to function smoothly. When one is off, the other can feel it too.
When the delicate balance between your gut and brain is thrown off it can lead to issues like bloating and constipation.
Furthermore, without enough estrogen, your gut’s protective lining might not function as well as it used to, which can lead to a condition known as “leaky gut.” This means some particles, like toxins and undigested food, can make their way into your bloodstream.
As a result, your immune system might start reacting, which can cause inflammation in the body. While this can feel uncomfortable, it’s an important signal from your body that it needs support to restore balance.
Low Progesterone: The Hidden Troublemaker
Now, let’s throw progesterone into the mix. This hormone usually plays it cool, helping to soothe your gut and calm down your stress levels.
But when progesterone levels dip (like they do during perimenopause), you lose that calming effect. This means bloating, constipation, and digestive issues become more frequent.
Low progesterone acts like a VIP pass for LPS producers to thrive in your gut. These harmful bacterial by-products can trigger inflammation throughout your body, leading to leaky gut and paving the way for a range of other health issues.
Beta-Glucuronidase: A Hidden Enzyme Stirring Up Trouble
Let’s talk about another troublemaker: beta-glucuronidase. This enzyme can break down conjugated estrogen—the stuff your liver has already packaged up nicely and is trying to kick out of your system.
But instead of letting it leave, betaglucoronidase eats away at it, tossing it back into your bloodstream, keeping those high estrogen levels lingering around like that one guest who won’t leave the party.
You’re probably thinking “but isn’t that extra estrogen beneficial for a woman going through menopause?“. Not exactly. The issue isn’t about estrogen being present—it’s about estrogen in relation to other hormones.
Estrogen Dominance happens when there’s too much estrogen in relation to progesterone.
Even though total estrogen levels are low during menopause, when beta-glucoronidase recycles estrogen back into the bloodstream it can lead to too much estrogen hanging around in the body in relation to progesterone.
This can still create issues like inflammation, gut issues, weight gain, and mood problems. And if you’re struggling with constipation it may lead to a further rise in estrogen levels through reabsorption and re-circulation.
Hormone Therapy: It Can Help – But It’s Not a Silver Bullet
Let’s talk about Hormone Therapy (HT). It works wonders for so many women to ease menopausal symptoms. Unfortunately, HT can have negative affects on your gut too.
HT can alter the microbiome by creating an environment that promotes the growth of opportunistic microbes. Essentially, your gut environment switches to one where more harmful bacteria can thrive.
This shift additionally causes gut imbalances that lead to symptoms of bloating, constipation, diarrhea and an overall inflamed gut.
Ready to Take Control? Here’s How to Thrive
Well, here’s where you take the reins—because, guess what? You’ve got a whole arsenal of tools at your disposal. Let’s talk about ways to support microbial diversity, repair your gut, and keep those hormones in check.
1. Feed Your Microbiome Like a Boss (With Fiber, Prebiotics, and Polyphenols)
First things first: Your gut loves fiber. And I’m not just talking about any fiber. I’m talking about the right kinds of fiber. We’re talking colorful fruits, vegetables, whole grains, nuts, seeds, and legumes. Why? Because these foods act as prebiotics, feeding the good bacteria in your gut that help maintain that estrogen-metabolizing estrobolome. The more diverse your fiber intake, the more diverse your microbiome will be.
Microbial diversity is key. If you’ve been eating the same handful of foods for years, your microbiome is probably a little too cozy in its rut. Break out of your comfort zone and invite new friends to your party.
Focus on a Plant Forward, Mediterranean Style Diet by loading up on a wide variety of plant-based foods. For starters, try to aim for at least 5 different colorful plant foods daily.
2. Probiotics: The Good Bacteria You Need
We all know probiotics are all the buzz, but are you taking the right ones? When you’re navigating menopause, the gut’s balance is everything.
Look for beneficial probiotics that promote gut health like Lactobacillus and Bifidobacterium, which are usually among the first to dip when estrogen drops.
3. Shotgun Stool Testing: The Gold Standard for Gut Health, Interpreted by a Certified Expert
When it comes to stool testing, not all tests are created equal. While many functional medicine practitioners still rely on outdated qPCR stool testing, this method is limited in scope and often misses critical details about your gut health.
Enter shotgun stool testing. This advanced testing analyzes your microbiome at a much deeper level, giving you a comprehensive look at your gut’s entire microbial ecosystem to identify even the most elusive pathobionts, arkea, and yeasts that could be causing you trouble.
Here’s where the magic happens: interpreting these results requires more than just a report from a lab. You need a Certified Microbiome Analyst—someone who truly understands how to decode your results and turn them into actionable insights. That’s where I come in!
With shotgun stool testing, I’ll help you pinpoint exactly what’s out of balance in your microbiome—whether it’s the overgrowth of harmful bacteria, a lack of beneficial microbes, or a gut that’s struggling to metabolize estrogen properly.
Together, we’ll create a customized plan that targets these imbalances and works to restore your gut health, improve your hormone regulation, and relieve those frustrating menopausal symptoms.
It’s precision medicine, designed just for you, to help you feel like yourself again.
4. Don’t Underestimate the Power of Stress Management on Menopause
Listen, stress is a gut-killer. And when you’re navigating perimenopause, menopause, and post-menopause, stress can be both an emotional AND a physical burden.
When your body is stressed out, it affects your gut’s ability to process food, absorb nutrients, and keep that estrogen balance in check. Yoga, meditation, exercise outdoors, gardening, can all help bring your body back into balance. Stress management is the unsung hero of gut health.
5. Food Sensitivity Testing: Your Secret Weapon for Gut Health and Menopause Relief
Food sensitivities could be the silent culprit behind your gut issues and the struggles you’re facing during menopause. And no, I’m not just talking about the occasional bloating after a big meal. I’m talking about those chronic, nagging issues that don’t seem to have a real explanation—constipation, diarrhea, gas, the constant low-grade gut inflammation, and not to mention those stubborn cravings that feel like they hit harder as your hormones shift.
This is where food sensitivity testing comes in like your new best friend. By identifying which foods are triggering your body, you can craft an individualized diet that specifically targets your inflammation, helping to calm your gut and support your body.
You don’t have to go it alone. Working with a Registered Dietitian Nutritionist can make all the difference. I’ll help you take your test results and turn them into a realistic and sustainable lifestyle change that you can actually stick to—for the long haul.
6. Micronutrient Testing: The Missing Piece in Your Gut and Hormonal Health Puzzle
You’re likely familiar with the importance of vitamins and minerals, but did you know that certain micronutrients play a critical role in your gut health and menopausal symptoms? Micronutrient testing can provide a deep dive into what you’re actually deficient in.
Take Vitamin D, for example. It’s not just important for bone health; it’s also crucial for the health of your vaginal epithelium. In fact, studies have shown that low Vitamin D levels are linked to bacterial vaginosis (BV), a common issue during menopause. Having a deficiency in Vitamin D can leave you more susceptible to infections and irritation.
Other micronutrients—like Magnesium, B vitamins, and Zinc—play pivotal roles in everything from immune function and inflammation reduction to the regulation of estrogen and progesterone. A deficiency in these nutrients could be exacerbating your menopausal symptoms, making it even harder to find balance.
By getting your micronutrient levels tested, you can pinpoint where your body might be falling short, then work with a qualified professional (hello, Registered Dietitian!) to implement dietary and supplementation strategies that address those gaps, boost your overall health, and help support a smoother hormonal transition.
Wrapping It Up: Take Charge of Your Gut, Take Charge of Your Life
So, here’s the bottom line: Hormonal shifts during perimenopause, menopause, and post-menopause don’t have to be a gut-wrenching nightmare. With the right approach—targeted diet changes, personalized testing, and strategic supplementation—you can restore balance to your microbiome and feel like yourself again.
Because when you take care of your gut, your hormones—and your whole body—will thank you!
Here’s the Best Part: I’ve Got Your Back in Finding Your Way to True Vitality
No more guessing games, no more randomly eliminating foods and hoping for a miracle.
I’m here to help you design a clear, customized path to wellness that’s built specifically for your body. We’ll pinpoint the exact foods causing your gut issues, then work together to create a plan that heals and restores balance. This isn’t a one-size-fits-all approach—it’s a solution tailored to you.
Ready to uncover the true cause of your gut inflammation and start your life changing gut healing journey? My program is custom-built and reserved only for those who’re ready to go all in. Schedule a digestive assessment with me to get started on your path to lasting wellness.
References:
- Riddle, M., & Mowry, L. (2015). The microbiome and menopause. Menopause, 22(6), 642-647.
- Shapiro, J. M., & Armstrong, J. L. (2017). Gut microbiota and estrogen: Interactions and implications for menopause. Journal of Clinical Endocrinology & Metabolism, 102(3), 990-999.
- Zeng, J., Li, X., & Wang, J. (2018). Estrogen and its impact on gut health. Frontiers in Endocrinology, 9, 255.
- Gupta, R., & Kumari, S. (2020). Hormone therapy and the microbiome: Effects and implications. Menopause Review, 19(4), 173-181.
- asilyev, M. P., & Zhang, X. (2020). “The Role of Food Sensitivities in the Pathogenesis of Irritable Bowel Syndrome.” Nutrients, 12(8), 2464.
- Chen, L., et al. (2018). “Shotgun metagenomic sequencing of the human microbiome reveals the novel composition of human gut microbiota.” Scientific Reports, 8(1), 13537.
- McNulty, H., et al. (2012). “Micronutrients and gut health.” The American Journal of Clinical Nutrition, 95(2), 331-337.
