Menopause and Your Microbiome: Unlocking the Power of Strain-Specific Probiotics

Understanding Menopause: More Than an On-Off Switch

By 2030, it is estimated there will be 1.2 billion menopausal women worldwide, with approximately one-third of a woman’s life spent in menopause. Despite its prevalence, many women continue to struggle daily with menopause symptoms and struggle to seek daily relief. 

Menopause is often discussed as a single event, but in reality, it is a gradual transition encompassing three stages: perimenopause, menopause, and postmenopause.

The Perimenopause Phase: The Beginning of Change

Perimenopause typically occurs between the ages of 45 and 55, although it can start much earlier. A useful indicator of when you might experience perimenopause is the age your mother began it. However, recognising perimenopause can be challenging as symptoms vary widely.

Signs to watch for include irregular or delayed periods, shorter menstrual cycles, increased anxiety, hot flushes, brain fog, and mood swings (1).

During this phase, the ovaries gradually reduce hormone production, causing fluctuations in oestrogen and progesterone. The duration of perimenopause differs among individuals but can last from 10 to 15 years (2).

Menopause: The Final Menstrual Period

Menopause is diagnosed after 12 consecutive months without a period, marking the end of perimenopause. At this stage, levels of oestrogen and progesterone drop significantly and stay steady. While symptoms such as hot flushes may lessen or disappear, this hormonal decline raises important long-term health concerns, particularly for bone density and cardiovascular health (3).

 

Approximately 80% of women experience noticeable symptoms during menopause, which can profoundly affect their quality of life (4).

Common Symptoms Across Menopause

Symptoms during perimenopause and menopause can affect multiple systems, including:

• Brain function: Hot flushes, sweating, sleep disturbances, mood changes, depression, anxiety, and cognitive decline.
• Gut microbiome: Loss of microbial diversity.
• Body composition: Weight gain and redistribution of fat to the torso.
• Skin: Loss of elasticity and dryness.
• Urogenital system: Vaginal dryness, itching, burning, and recurrent urinary tract infections.
• Sexual function: Decreased libido and painful intercourse.
• Musculoskeletal system: Joint pain, muscle mass reduction, and bone health decline.

Managing Menopause Symptoms: Beyond Hormone Replacement Therapy (HRT)

Hormone replacement therapy (HRT) is the most common treatment for menopause symptoms (5). Available in tablets, patches, gels, sprays, or implants, HRT supplements deliver oestrogen and/or progesterone to alleviate symptoms and support overall wellbeing.

However, not all women choose or are able to undergo HRT. Many are increasingly seeking natural, long-term alternatives such as botanicals, vitamins, and probiotics.

Why Do Menopause Symptoms Occur?

The symptoms arise primarily because oestrogen levels, produced by the ovaries, gradually decline and signal the end of reproductive years.

Oestrogen is vital for numerous aspects of women’s health and wellbeing (6):

• Essential for reproductive system function.
• Maintains skin elasticity, thickness, and hair quality.
• Supports cognitive function, memory, and mood regulation.
• Protects cardiovascular health by promoting healthy blood vessels and cholesterol.
• Helps maintain bone density and strength.

The Gut-Microbiome-Hormone Axis in Menopause

The gut plays a crucial role throughout the body, and during menopause, the gut-hormone axis comes into play.

Menopause is associated with a reduction in gut microbiota diversity (7,8), which impacts a specialised group of bacteria known as the estrobolome. The estrobolome plays a key role in modulating the body’s oestrogen levels (9).

Changes in the gut microbiota affect oestrogen metabolism, potentially contributing to hormonal imbalance.

At the same time, declining oestrogen levels weaken the intestinal barrier, increasing inflammation and gut permeability—a condition commonly referred to as "leaky gut" (11).

This increased gut permeability can worsen menopausal symptoms such as hot flushes and is linked to bone mineral density loss and systemic inflammation (12).

The gut-oestrogen axis describes this bidirectional relationship (13):

• The estrobolome produces an enzyme called β-glucuronidase (GUS), which breaks down conjugated oestrogens in the gut, allowing them to be reabsorbed into the bloodstream.
• Conversely, oestrogen influences the composition and function of the gut microbiota.

Can Probiotics Support Menopause?

Given the gut microbiome’s role in hormone regulation and the loss of diversity during menopause, probiotics have been proposed as a supportive therapy.

Importantly, probiotics have strain-specific effects, meaning particular bacterial strains are identified for specific roles. Researchers screened 80 bacterial strains to find those with strong GUS activity, which can enhance oestrogen reactivation in the body. One such strain is Lactobacillus brevis KABP™ 052, shown to increase oestrogen levels in the bloodstream.

What Does This Mean for Menopause Support?

Although this research is still emerging, it suggests a promising role for probiotics in menopause support.

While generic multi-strain probiotics may not specifically increase GUS activity, they can help maintain gut microbiome diversity, which is essential for overall gut health—and, by extension, menopausal wellbeing.

Probio7 Advanced: Supporting Gut Health During Menopause 

Probio7 Advanced is a high-strength daily probiotic delivering 10 billion bacteria to the gut microbiome, helping to maintain diversity. It also contains natural fibres to encourage the growth of beneficial bacteria.

Supporting your gut microbiome during menopause is a natural and potentially effective way to manage symptoms and promote long-term health.

Want to learn more about how to support your menopause? You can book a free 1:1 Nutrition Consultation with your team of experts to find how best Probio7 can support you.

References

(1) NHS Choices. Available at: https://www.nhs.uk/conditions/menopause/ (Accessed: 09 October 2025).
(2) Davis, S. R. et al. Menopause. Nat Rev Dis Primers 1, (2015).
(3) Koothirezhi, R., Ranganathan, S. Postmenopausal Syndrome, April 24, 2023.
(4) TUC. Menopause at work. https://www.tuc.org.uk/menopause-work
(5) The North American Menopause Society. Menopause 24, 728–753 (2017).
(6) Chen, P., Li, B. & Ou-Yang, L. Role of estrogen receptors in health and disease. Front Endocrinol (Lausanne) 13, (2022).
(7) Ervin, S. M. et al. Gut microbial β-glucuronidases reactivate estrogens. J Biol Chem 294, 18586–18599 (2019).
(8) Peters, B. A. et al. Menopause Is Associated with an Altered Gut Microbiome and Estrobolome. mSystems 7, (2022).
(9) Nieto, M. R. et al. Menopausal shift on women’s health and microbial niches. npj Women’s Health 3, 1–11 (2025).
(11) Shieh, A. et al. Gut permeability, inflammation, and bone density across menopause. JCI Insight 5, e134092 (2020).
(12) Chen, T. Y. et al. Hot flashes and fatty acid binding protein 2 in postmenopausal women. PLoS One 17, e0276391 (2022).
(13) Baker, J. M. et al. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas 103, 45–53 (2017).