How Menopause Affects Your Gut – And What You Can Do About It

Written by Lucy Sanderson, Nutrition Undergraduate. Edited By Laura Clark

Menopause brings many changes to the body, but one often-overlooked area is the gut microbiome. The trillions of bacteria in your digestive system play a crucial role in metabolism, immune function, and overall well-being. However, as oestrogen levels decline, the balance of gut bacteria shifts – sometimes in ways that can negatively impact health.

1. Loss of Microbial Diversity

Oestrogen isn’t just a reproductive hormone – it also helps maintain a diverse and balanced gut microbiome. When oestrogen levels drop, microbial diversity often declines as well (1). A less diverse gut microbiome has been linked to increased inflammation, digestive discomfort, and metabolic disorders like obesity and insulin resistance (2).

2. Increased Inflammation & “Leaky Gut”

Oestrogen has natural anti-inflammatory properties that help regulate immune function and protect the gut lining (3). Without enough oestrogen, the intestinal barrier can weaken, leading to what’s often referred to as ‘leaky gut’ – increased intestinal permeability.

This allows harmful bacteria and toxins to pass into the bloodstream, triggering inflammation and immune system responses (4). Over time, this can contribute to conditions like irritable bowel syndrome (IBS), autoimmune diseases, and metabolic issues.

What Can You Do?

The good news? You can support your gut health during menopause with a few simple strategies.

What are probiotics and are they helpful in menopause?

A probiotic is a live microorganism that, when given in adequate amounts, confers a health benefit on the host i.e. us! (6)

To meet these criteria, it must be strain specific, and under the umbrella of a particular bacterial species there are numerous strains. Probiotic research is strain-specific – meaning the benefits found for one strain of bacteria (say, a particular Lactobacillus or Bifidobacterium) can’t simply be assumed to apply to a different strain, or even a different dose of the same one.

This is part of why the evidence on probiotics and menopause is still described as promising rather than proven – the studies use different strains, different doses, and different outcome measures, which makes it genuinely hard to say “probiotics help with X” in any concrete way.

A recent example: a pilot study presented at the 2026 British Menopause Society Conference followed 197 women taking a multi-strain probiotic (Symprove) daily for 12 weeks, tracking changes via the Menopause-Specific Quality of Life questionnaire alongside gut, sleep, and symptom measures (5). The unpublished results were striking – 98% of women reported improvements in menopause-related quality of life, with notable gains in bloating and digestive discomfort (78%) and sleep regularity (66%).

We have to remember, this was a single-arm study with no placebo comparison, and the researchers themselves have said placebo-controlled trials with objective markers are still needed to verify the findings, but it’s a promising early signal – and a good illustration of why “probiotics” as a single category is too broad to draw firm conclusions from.

What are prebiotics and are they helpful in menopause?

Probiotics are live bacteria you consume. Prebiotics on the other hand are the fibre those bacteria feed on – found in foods like onions, garlic, oats, and bananas. A fibre-rich, varied diet nourishes our beneficial gut bacteria.

You can also include fermented foods: Foods like yogurt, kimchi, and kefir contain live cultures that can support a healthy gut, even if they don’t meet the technical definition of a “probiotic” (which as we said earlier, requires a specific, well-studied strain at an effective dose).

It’s a good idea to assess our processed foods and sugar intake in relation to everything we eat as an imbalance can feed harmful bacteria and increase inflammation.

Hormone replacement therapy may also form part of the puzzle in helping to preserve gut diversity, which you can discuss with your menopause specialist.

By understanding how menopause impacts the gut microbiome, you can take proactive steps to maintain digestive health and overall well-being. A balanced gut means a healthier, happier you – at any stage of life!

If you’re navigating gut symptoms like IBS alongside menopause, this is exactly the kind of thing worth individualising rather than guessing at from a supplement shelf – you can find out more about 1-1 support here.

References

1. Lephart, E. D., & Naftolin, F. (2022). Estrogen Action and Gut Microbiome Metabolism in Dermal Health. Dermatology and Therapy, 12(7), 1535–1550. https://doi.org/10.1007/s13555-022-00759-1

2. Hur, K. Y., & Lee, M. S. (2015). Gut Microbiota and Metabolic Disorders. Diabetes & Metabolism Journal, 39(3), 198–203. https://doi.org/10.4093/dmj.2015.39.3.198

3. Harding, A. T., & Heaton, N. S. (2022). The Impact of Estrogens and Their Receptors on Immunity and Inflammation during Infection. Cancers, 14(4), 909. https://doi.org/10.3390/cancers14040909

4. Camilleri M. (2019). Leaky gut: mechanisms, measurement and clinical implications in humans. Gut, 68(8), 1516–1526. https://doi.org/10.1136/gutjnl-2019-318427

5. Hancocks, N. (2026, June 25). Menopause specialists spotlight probiotics for women’s wellness. NutraIngredients. https://www.nutraingredients.com/Article/2026/06/25/menopause-specialists-spotlight-probiotics-for-womens-wellness/

6. International Scientific Association for Probiotics and Prebiotics (ISAPP) – definition and consensus statement on probiotics. – The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of gut health – International Scientific Association for Probiotics and Prebiotics (ISAPP)