Menopause brings a host of changes to a woman’s body, and for many, the shifts within their microbiome can be some of the most surprising and impactful. As oestrogen levels decline, the trillions of bacteria in the gut, vagina, and even mouth undergo shifts that can affect various aspects of health and well-being.
The Vaginal Microbiome
One of the most noticeable changes happens in the vaginal microbiome. Before menopause, Lactobacillus bacteria dominate, keeping the vaginal environment acidic and protected against harmful microbes. However, as oestrogen drops, the balance shifts. Lactobacillus levels decrease, while other bacteria such as Gardnerella and Prevotella can increase, causing the vaginal pH to rise. This change can lead to dryness, irritation, and a higher risk of infections like bacterial vaginosis. This can affect a woman’s comfort and sexual health.
The Gut Microbiome
The gut health in perimenopause can be challenging as the microbiome shifts. Lower oestrogen levels often lead to a decrease in gut bacteria diversity, increased inflammation, and a “leaky gut,” where the intestinal lining becomes more permeable. This can worsen digestive issues, like bloating and discomfort, and contribute to weight gain—especially around the belly. Shifts in the balance of key gut bacteria, such as changes in the ratio of Firmicutes and Bacteroidetes, may also slow metabolism and increase the risk of heart disease and diabetes. Interestingly, spending time walking in forests or by the sea can boost gut health by exposing the body to beneficial microbes and reducing stress, positively influencing the microbiome. There are several supplements out there geared towards menopause. Look out for those with Bifidobacterium longum or Lactobacillus acidophilus. You may find these helpful.
The Oral Microbiome!
Even the mouth can be affected. Declining oestrogen may lead to dry mouth, changes in salivary composition, and an increased risk of gum disease and other oral issues. This highlights the importance of maintaining good oral health during menopause.
Fortunately, there are ways to support the changing microbiome during this transition. Probiotics and prebiotics found in foods like yoghurt, fermented vegetables, and fiber-rich fruit and veg can help maintain a healthy balance. Interestingly phytoestrogens—natural compounds found in foods like flaxseeds, soy, and chickpeas—can mimic oestrogen in the body and help ease symptoms. There are also oral probiotics solutions which are a great idea especially if you have an established issue. Regular exercise, good sleep, dietary adjustments, and connecting with nature make it possible to support the microbiome and promote overall well-being during this new chapter. Aim for 30g of fiber-rich foods per day and see if that shifts the needle for you.
There are more microbiomes that I’ll go into in future blogs. In the meantime, as always if you would like to talk through any challenges, feel free to contact me.
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