Headshot of NHS GP Dr Dawn Harper smiling at the camera

What’s the menopause got to do with your gut?

Did you know that oestrogen and progesterone influence many aspects of wellbeing including gut function and the microbiome?

In recent years scientists have found that hormones play a part in shaping our gut microbiome. With October being Menopause Awareness Month, we asked NHS GP Dawn Harper to share her experience on what she’d seen in her clinic.

“I was interested to read the results of a recent survey carried out by Symprove showing that over a third of women questioned had experienced changes in their gut during the menopause. The most common symptoms were bloating, increased gas production and abdominal pain. These symptoms are commonly associated with Irritable Bowel Syndrome (IBS).

It is widely accepted that menstruating women who suffer with IBS often experience a flare of symptoms in the days before a period, suggesting hormonal changes can affect gut health. There is preliminary research looking into the role the trillions of bacteria that form our gut microbiome could play in the production of oestrogen. I find this fascinating as it could mean that looking after your microbiome might influence the severity and duration of menopausal symptoms.

For the first ten years of my General Practice career, I was the only female partner in a seven-doctor practice and as such, I saw a lot of women’s health issues. In the 1990’s, I couldn’t do a surgery without seeing a menopausal woman wanting to discuss whether to take HRT. Then, at the turn of the century, newspapers were full of scary headlines following the results of the Million Women Study and the Women’s Health Initiative, and overnight, women stopped coming in to have those conversations, which was a real shame.

We know that three in four perimenopausal women develop symptoms, some of them severely, and it’s not HRT or nothing, but the public were so frightened about HRT, that women were undoubtedly staying away from the GP surgery and suffering through the menopause in silence. Thankfully, the pendulum is swinging back, and I am now seeing perimenopausal women in most surgeries. For some HRT can be life changing, but it’s not for everyone and I am seeing an increasing interest in alternative remedies and self-help through lifestyle changes.

We have known for a long time that the gut brain axis is a two-way conversation and there is a lot of ongoing research into the role of probiotics in managing mental health problems like depression and anxiety, also common symptoms of the menopause. And there is ongoing research looking into the complex connections between lifestyle, hormones, metabolism, and health. It’s an exciting and rapidly growing area of medicine and one that I am watching with great interest.”

5 ways to look after your microbiome through the menopause

1. Eat with your microbes in mind

What kind of things should we feed our gut microbes to keep them happy? Lots of plant-based foods! Think wholegrains, nuts, seeds, fruit (including fresh, frozen, dried, and canned) and veggies, legumes and pulses, herbs, and spices. Focusing on these foods will ensure plenty of fibre and naturally occurring prebiotics, as well as vitamins, minerals, and phytochemicals. If you enjoy fermented foods, have them too! Dig into our gut-loving recipes to get inspired for dinner tonight.

2. Create a sleep routine

We know that our gut microbiome has its own sleep-wake cycle. And that when it comes to sleep, consistency is important, you should aim for 7-9 hours per night. Our resident Gastroenterology Dietitian has shared her top sleep tips here to help you create the ultimate sleeping conditions.

3. Get moving

Exercise has been shown to have a positive effect on the composition of the gut microbiome and what it produces. From incorporating a walk outside in nature into your day or giving one of Hayley Madigan’s GRIT workouts a go, here are six easy ways to include more movement into your day.

4. Find time to unwind

Think of little ways to prioritise rest and relaxation. Psychotherapist Anna Mathur has some great advice on how to help ease anxiety this autumn

5. Speak with your GP

Changes in your poo or gut symptoms which don’t go away after a week or two should always be discussed with your G.P., as they can be a sign of an underlying condition.

More help and resources

We’ve partnered with Harley St at Home - nutrition professionals dedicated to supporting women with menopause. Read more about the partnership.

*Survey carried out by OnePoll in September 2023.