The Link Between Microbiome, Menopause & Metabolic Health- Estrogen

Posted by Ben White on نوفمبر 10, 2017

The diversity of the microbiome has profound implications for metabolic health. The micro-organisms we host in our gastrointestinal tract maintain gut integrity, break down complex carbohydrates to improve energy extraction from food, produce vitamins and minerals, aid in digestion and absorption, ferment dietary fibres and protect us against pathogens. Maintaining a delicate balance in the diversity of the host-microbiome relationship is crucial for disease prevention and healthy ageing.

Studies on the microbiome are emerging as a new and exciting frontier of science. However, how the microbiome interacts with the endocrine system to modulate metabolic health is still one of the less explored avenues in microbiome research. This blog aims to shed light on the intertwined roles of gut microbiota and estrogen on metabolic health for women as they transition into menopause.

Estrogen, Microbiome and Metabolic Health

Estrogen and the microbiome regulate weight gain and lipid deposition independent of each other. By increasing the density of small intestinal villi capillaries, gut microbiota influence gastrointestinal physiology and gut motility, and thus promote caloric extraction from the diet. Studies in humans show that a drastic reduction in the diversity of gut microbes — also called dysbiosis — is enough to cause functional changes related to weight gain [1]. Unfavourable alterations in the composition of the microbial make-up can trigger a wide range of physiological disorders, including low-grade inflammation, metabolic disorders, excess lipid accumulation and loss of insulin sensitivity.

Estrogen, in proper amounts, is also recognised as a key element in preserving metabolic health — keeping weight down, reducing abdominal fat and improving glucose tolerance. Recent studies illuminate another, less recognised role of estrogen in metabolic health: its relationship with the gut.

How Estrogen Protects the Gut

Estrogen Is Protective for Microbial Diversity

Adequate estrogen levels are important for a multitude of functions outside of its reproductive role. Specific to the microbiome, estrogen and estrogen-like compounds prevent the loss of and promote growth and proliferation of beneficial bacteria [2]. Animals treated with estrogen have significantly higher microbial diversity than controls [3]. Research shows that microbial diversity is key for maintaining a healthy metabolic profile [1]. The study by Turnbaugh (2009) specifically illuminates how dysbiosis can preferentially turn on genes and inappropriately activate pathways involved in sugar and carbohydrate metabolism in overweight but not in lean individuals.

Estrogen Helps Maintain the Integrity of the Gut

Cells that line the gut comprise a barrier, so that large molecules — food particles, digestive enzymes, cytokines — stay where they ought to: inside the gastrointestinal tract. A healthy and diverse microbiome ensures that the gut barrier maintains its integrity. So does estrogen. Sufficient estrogen levels are needed to form the epithelial layer of the gut and keep it healthy, elastic and impervious to the contents of the gut [4]. Gut barrier integrity is critical in the context of metabolic health because any changes to intestinal permeability are likely to be detrimental to a healthy weight profile and may play a role in T-cell activation leading to food sensitivities, adipose inflammation and autoimmune diseases.

Estrogen Decreases Inflammation

Estrogen also decreases pathogenic populations of bacteria and reduces lipopolysaccharide (LPS)-induced inflammation. LPS, produced by Gram-negative bacteria, can impair the lining of the gut, cross into the rest of the body and elicit a strong immune response. Estrogen working against enteric pathogens is yet another example of its protective functions on the gut.

How the Microbiome Regulates Free Estrogen Levels

Disturbances in the microbiota composition in dysbiosis can impair the process of deconjugating estrogen, resulting in reduced circulating free estrogen levels.

The gut microbiome impacts estrogen levels through the secretion of β-glucuronidase, an enzyme which deconjugates estrogen to its free, biologically active form available for tissue uptake [4]. It is the free fraction of estrogen hormone that has activity at the level of estrogen receptors ERα and ERβ, giving rise to subsequent physiological downstream effects. Specific to metabolic health, estrogen is key for keeping weight down, reducing abdominal fat and improving glucose tolerance.

Characterised by diminished microbial diversity, dysbiosis is an event that may lead to an inflammatory response and metabolic profile that is detrimental to health [1]. Disturbances in the microbiota composition in dysbiosis can impair the process of deconjugating estrogen, resulting in reduced circulating free estrogen levels.

The Menopause Connection

Why Menopause Amplifies the Problem

Lack of estrogen and alteration of the gut microbiota are important in driving metabolic issues in menopause. Although the formula for the optimal composition of the gut microbiota may be individual, a balanced community is crucial for cultivating homeostasis of estrogen-modulated physiology. Maintaining physiological levels of estrogen with the help of hormone replacement therapy becomes even more important in menopause when dysbiosis events are suspected.

For perimenopausal patients experiencing decreases in basal metabolic rate with concurrent gastrointestinal health issues, a combination of estrogen replacement therapy together with digestive support might have a profound impact on restoring gut health and improving metabolic function.

To understand where your estrogen, progesterone and testosterone levels stand as you approach or navigate menopause, our Menopause hormone testing page explains which tests are most relevant to your stage of life and how to interpret your results in context.

Testing Your Hormone Levels

A convenient and non-invasive way to assess the bioavailable fraction of hormones available for tissue uptake is through saliva hormone testing. Saliva measures the free, unbound fraction of hormones — the biologically active portion that actually reaches your tissues. Routine testing, done as part of a hormone replacement programme, can help you achieve your best metabolic health during menopause.

For women concerned about weight gain, abdominal fat and metabolic changes during menopause, our Weight Management Profile Test measures the key hormones linked to fat storage and metabolism — including cortisol, estradiol, testosterone, progesterone and DHEA — in a single at-home kit.

References

Turnbaugh PJ, et al. A core gut microbiome in obese and lean twins. Nature. 2009;457:480–484.
Chen KL, Madak-Erdogan Z. Estrogen and Microbiota Crosstalk: Should We Pay Attention? Trends Endocrinol Metab. 2016;27:752–755.
Benedek G, et al. Estrogen protection against EAE modulates the microbiota and mucosal-associated regulatory cells. J Neuroimmunol. 2017;310:51–59.
Baker JM, et al. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas. 2017;103:45–53.

Originally by Dr. Kate Placzek, ZRT Laboratory. Reproduced with permission. Last reviewed: May 2026.

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