The Link Between Gut Health and Hormones in Perimenopause (and Beyond)

Gut Health

The Estrobolome

Hormones may be the last thing on your mind when you’re suffering from gut health issues like bloating, diarrhea, reflux, or constipation. But the relationship between the two is very important for your overall health. As you enter perimenopause, you may have noticed more of these signs that something is off. 

Here’s what people don’t talk about when they talk about menopause: the estrobolome.

What is this? It’s the bacteria, and fungi in the gut that influence the estrogen circulating in your system. 

We have trillions of organisms in our gut microbiome and many of them have specific functions. One of those functions is managing our estrogen metabolism. If you don’t have the type of bacteria and fungi that make up the estrobolome, you will not break estrogen down. When it isn’t broken down and metabolized, it can’t be used to do its jobs, which include contributing to cognitive functionmood regulationskin and hair health, and even protecting against heart disease. Finally, if estrogen isn’t metabolized, it gets stored in the body, and that’s when it can become toxic. 

Signs of an Unhealthy Estrobolome May Include: 
  • Digestive issues (bloating, gas, diarrhea, or constipation)
  • Weight changes
  • Food sensitivities
  • Fatigue
  • Skin irritation (yep, it’s true)
  • Autoimmune conditions
  • Hormone imbalance

But here’s what’s really cool about the estrobolome, according to the experts: we actually have a lot of control over its makeup, which in turn can make menopause symptoms easier to manage. The key, of course, is knowing how to manipulate it. For any woman looking to keep a healthy body well into menopause, understanding the relationship between your gut health and hormones is absolutely critical.

How to Love Up Your Gut
  1. Ditch the sugar. Sugar has the tendency to contribute to the imbalance of gut microbes. This goes for artificial sweeteners too. If you find yourself craving sweets, then it’s best to stick to naturally sweet foods like fruit.
  2. Take prebiotics and probiotics (use the code: DrAnna to order). I use MegaPre and Megasporebiotics myself and love both! Prebiotics feed good bacteria.

    The addition of healthy bacteria via probiotics can aid the breakdown of food. Fermented foods such as kefir and soybeans, as well as yogurt, kimchi, and pickled vegetables, are all naturally rich in healthy gut bacteria. However, if you suspect SIBO, fermented foods and some probiotics can make this worse. Look for a soil-based probiotic. These generally have multiple bacillus strains in them. The type of probiotics used should also be rotated every 3-4 months.

  3. Consider food sensitivities. Finding yourself bothered by foods you could always eat before? New sensitivities can pop up during midlife and result in intestinal inflammation and leaky gut. I offer food sensitivity testing in my practice, so if that’s something you’re interested in exploring, let’s talk.
  4. Mind your meds. Gut health is negatively impacted by some medications including stomach acid reducers (PPIs), metformin, antibiotics, and birth control pills.
  5. Develop good eating hygiene habits. What does this mean? Chewing your food well, limiting liquids during meals, eating mindfully, and stopping when you are 80% full.
  6. Avoid environmental pollutants. Pesticides, herbicides, and a number of environmental chemicals are a double whammy; they can negatively shift the microbiome and they also act directly as endocrine disruptors. To support a healthy microbiome, reduce your overall exposure to environmental pollutants by choosing organic foods when you can and avoiding other endocrine disruptors in cosmetics and household products like cleaners.

The Bottom Line

An unhealthy estrobolome can contribute to higher levels of estrogen and more problems with estrogen dominance during perimenopause and menopause. The more your symptoms fluctuate, the more you should be paying attention to your gut health. Notice the effect that different foods have on your GI tract and how your hormone symptoms come and go. A food and/or symptom journal can help sort this out.

Need help? Check out my Connect the Dots program. It’s a 6-month long intensive that includes (12) 1-1 individualized consultations, a DUTCH hormone test, advanced gut health testing using the GI-Map (Microbial Assay Plus) to assess the balance of gut microbes, digestive issues, gut factors that contribute to hormone imbalance, effects of stress, and leaky gut. Email if you have questions or would like information about ways we can work together.

Supplement Recommendations

In this article, I mention the supplements below. Remember, every situation and body is different. For that reason, I recommend working with a healthcare professional to determine the best plan for you. 

If you are not sure where to start, then it’s time that we have a talk! My team can help you develop a plan to manage what you’re experiencing. The first step is to schedule a consultation to discuss your unique situation. From there, we can develop a plan to help you feel your best! Schedule that here.

MegaPre Precision Prebiotic

Use code DrAnna to order.

MegaSporeBiotic Probiotic

Use code DrAnna to order.

Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone-balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at

Also, she offers a membership group, Hormone Harmony with Dr. Anna Garrett, which provides women in midlife with affordable expert guidance and community support.

Dr. Anna is available for 1-1 consultation. Find out more at

Get Chapter 1 of Dr. Anna’s Book—Free!

Perimenopause: The Savvy Sister’s Guide to Hormone Harmony

This book gives you the tools you need to navigate this transition without losing your mind or your mojo.

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