Do Probiotics Support the Menopause Transition – and Postmenopause?

Menopause marks a time of sweeping change across the body. Hormones shift. That, we know, but there are other changes, too – physically, emotionally, spiritually.

Women feel these shifts, but it’s a touchy subject, and rightly so, to put a label on them because doing so suggests something’s wrong. The changes that come with menopause are a natural process in the life course. Menopause is not a disease.

Still, many women today experience menopausal symptoms. Studies suggest that more than 85% of women worldwide experience hot flashes, night sweats, difficulty sleeping, weight gain, mood shifts, forgetfulness and foggy-headedness, dwindling libido, and other symptoms. Bone loss is more likely to occur after menopause. The same is true for vaginal atrophy – thinning of the vaginal wall – which can lead to painful intercourse and stress incontinence (leaking urine during exertion, coughing, sneezing, or laughing). 

Symptoms are language from the body. You might think of them as pleas for care. And you’re not alone if you’re wondering how to honor your body through the changes of menopause and at the same time get relief from symptoms.

Over 50% of women turn to natural approaches to support the menopause transition and postmenopause. This is not surprising. Through the ages, women have intuitively understood the wisdom of the body and partnership with plants, fungi, and friendly microbial flora from fermentation. 

Many women opt for natural supplements to support hormone balance.

Probiotic bacteria can be good self-care partners as well. Their benefits extend well beyond promoting vaginal health and preventing yeast infections, bacterial vaginosis (vaginal infection due to an imbalance of unfriendly bacteria), and urinary tract infections (UTIs).

Probiotic bacteria partner with the body to support digestive health and immune health, which in turn support hormone balance, bone and brain health, even healthy skin and hair.


The friendly bugs in your gut regulate functions across the entire body. Those friendly bugs are often called gut flora or microflora. Microbiota refers to the composition (communities) of gut flora that inhabit the gut. Microbiome refers to the microbiota plus all the compounds and genetic information they pass along to the body. 

It turns out that the gut microbiota shifts in midlife. It tends to become less diverse and abundant for reasons we do not fully understand yet. Even so, recent research has started connecting the dots between these shifts and menopausal symptoms.

Friendly floras exist across the entire body, mostly areas that interact in some way with the world – gut, nose, airways, skin, hair, and vagina. The gut is a vast interface with the world, making up a larger surface area even than skin.

End to end – mouth to anus – the surface area of the inner lining of the gut is nearly 350 square feet. That’s about the size of many Manhattan studio apartments. This interior tube that takes in, digests, and absorbs food and water teems with tens of trillions of friendly microbes that are essential to health and wellbeing. In fact, we can’t be healthy without them. 

Gut bacteria produce essential compounds and regulate vital functions that affect the entire body. They support gut health. They affect the inflammatory response and hormones. And they help with nutrient absorption and metabolism, among a host of other functions. These influences can impact the menopause transition and postmenopausal years. 

Healthy Gut to Keep Inflammation in Check and Ease Menopausal Symptoms

Research shows increasingly that chronic, systemic inflammation is a determining factor in many menopausal symptoms. If this news is new to you, you might enjoy my blog post on unchecked inflammation. Many people are surprised to learn that the gut is a primary source of chronic inflammation across the body. This is especially true with age. 

Inflammation happens in the gut when the composition of microbes shifts and becomes less diverse and plentiful, as tends to happen in midlife. Antibiotics, environmental toxins – which none of us can get away with completely – and overly processed food also prompt shifts in the microbiota. A less diverse and abundant microbiota leads to gut dysbiosis

Gut dysbiosis triggers inflammation along the inner lining of the intestinal wall through a complex sequence of events. When healthy, this wall serves as a barrier between the contents of the intestinal lumen (cavity) and the rest of the body. But inflammation disrupts the tight junctions of the intestinal wall. These junctions would otherwise keep stuff that belongs in the lumen safely inside. When stuff that belongs in the gut leaks into the surrounding tissues, you have a leaky gut. Leaky gut triggers inflammation in those tissues and cascades into far-reaching areas of the body. 

Recent research has started to identify a link between systemic inflammation and common menopausal symptoms. Hot flashes, night sweats, depression and mood swings, menopausal weight gain, cognitive issues, and even skin and hair changes have been linked to unchecked systemic inflammation. As it turns out, estrogen provides natural anti-inflammatory protection. During midlife and in the postmenopausal years, those protections wane. Addressing inflammation from a primary source – the gut – can thwart systemic inflammation that would otherwise have protection from estrogen.  Nourishing digestive health and a diverse, abundant microbiota can support a healthy gut, menopause, and the entire arc of life, for that matter. 

This approach goes beyond the view that estrogen is the cause of menopausal symptoms. This view sees estrogen as but one of many changes along the life course and recognizes the bodily stress of living in a stressed world. 


Healthy Gut for Healthy Hormone Balance

A diverse and abundant microbiota supports a healthy hormone balance. This is especially important during the menopausal transition when the balance of hormones fluctuates. There are a host of hormones that the microbiota-human cell interconnections regulate. These include estrogen, progesterone, stress and feel-good hormones, and even insulin, which is vital for healthy metabolism. 


For estrogen to be available in active form across the body, it needs to be ‘unbound’. Microbes produce compounds that unbind estrogens. When the microbiota becomes less plentiful and diverse, levels of ‘bound’ estrogens go up. These bound estrogens are not usable by the body. Studies correlate a link between bound estrogens and the incidence of estrogen-related cancers – breast, cervical, uterine, and ovarian. 

Unbound estrogens help microbes proliferate, which helps to then unbind estrogen, and so on, in a beautiful synergy that is a hallmark between friendly bacteria and the human body.   


In a similar way, friendly gut flora help regulate progesterone. Progesterone, in turn, fosters the proliferation of certain microflora. One of those families of microbes is Bifidobacteria. Bifidobacteria produce calming and feel-good hormones. When their counts decline, you may experience anxiety and irritability or depression. 

As women get older and progesterone declines, they tend to have less of this family of bacteria. Replenishing Bifidobacteria with high-quality probiotic strains can help regulate progesterone and support the proliferation of more Bifidobacteria. Prebiotics can further enhance the proliferation of Bifidobacteria and the hormones and functions they regulate. 

Feel-good Hormones


Serotonin is a calming, feel-good neurotransmitter. The gut produces 95% of serotonin during a dynamic dance between microbes and special cells along the gut barrier. Gut microflora plays a central role in that production. Serotonin is also involved in temperature regulation. During and after the menopause transition, serotonin plays a role in the severity of hot flashes and night sweats. SSRIs are often prescribed to treat these symptoms. But nourishing the gut microbiota can also help.


GABA (Gamma Aminobutyric Acid) is a calming neurotransmitter. It helps with gastrointestinal motility, too. It is not uncommon to feel anxious or irritable or have difficulty sleeping when GABA is low. Constipation may become an issue, too. Bifidobacteria produce GABA. Since Bifidobacteria is often lower in middle age, restoring this family of bacteria can boost GABA production, which may, in turn, balance mood and sleep.  


Dopamine is partially responsible for reward behavior. This neurotransmitter also plays a role in feeling sated during a meal. This satiation is not so much a feeling of fullness as it is the sense of I’ve had enough. Sugar, alcohol, overly processed foods, and other addictive substances can short-circuit the dopamine response and stimulate the desire for more. Certain Bifidobacteria and Lactobacillus strains have been shown to support dopamine production. 

Epinephrine and Norepinephrine

Epinephrine and norepinephrine are excitatory neurotransmitters. They are involved in the “fight-flight-freeze” response. Excitatory neurotransmitters provide the energy to get you through the day. But excitatory hormones can go into overdrive and keep the body in a fight-flight-freeze response. This happens during a stress cycle. Excitatory hormones trigger the proliferation of microfloras that produce them. As with dopamine, nourishing the gut with Bifidobacteria and Lactobacillus strains of probiotics can offset this excitatory tendency and restore calm while also supporting healthy energy. 


Cells become less sensitive to the actions of insulin with age. Insulin is necessary for healthy glucose (sugar) metabolism. It also supports healthy fat metabolism. Gut dysbiosis can disrupt insulin signaling and contribute to weight gain and even obesity. It can also challenge liver and brain health. A healthy microbiota helps to counter insulin resistance.

Healthy Gut for Healthy Bones 

Calcium stores in bones become depleted during midlife and later years. Half of women over 50 will have an osteoporosis-related bone fracture in their lifetime. But bone loss is not only a menopause phenomenon, although postmenopausal estrogen loss is a factor. The National Osteoporosis Foundation reports that over 54 million women and men over 50 have or are at risk of osteoporosis. Even with all the current medical treatments to promote bone health, the number of osteoporosis-related bone fractures is on the rise in the US. Chronic systemic inflammation is at play.  

Bone inflammation contributes to bone loss. There is a growing body of research supporting the use of prebiotics to support bone health. Even so, recent pre-clinical studies show that certain Lactobacillus strains of probiotics can prevent inflammation-induced bone loss. The gut is known to be key for healthy absorption of calcium and vitamin D absorption.

Probiotics for Menopause and the Years Beyond 

Research has blossomed over the past 10 years on the gut microbiome and the potential benefits of probiotics. It’s safe to say that probiotics are having a heyday moment. Even so, many women wonder how to choose the best probiotics for menopause. Not all probiotic supplements are created equally. But let’s back up and clarify what a probiotic is. 

Probiotics are friendly microbes taken in supplement form to add diversity and abundance to the existing gut microbiota and provide health benefits to the host. While foods such as kraut, kimchi, and yogurt may contain beneficial microbes, technically speaking, these foods are not probiotics. Probiotics are formulated specifically in supplement form to confer health benefits by adding diversity and abundance to the existing gut microbiota. 

A good-quality probiotic contains multiple types of friendly flora with a balance of Bifidobacterium and Lactobacillus strains. Even better, the probiotic contains prebiotics, too. Prebiotics are food for probiotic strains. They are made from plant fibers that the human body cannot break down without the support of existing gut flora. Microfloras eat what we can’t digest. From that, they multiply, adding abundance to the friendly flora already populating the gut. 

A probiotic-prebiotic blend is called a synbiotic. Many products labeled “probiotic” are, in fact, synbiotics. But not all probiotics contain the prebiotic “food” for resident gut bacteria. It used to be that we thought prebiotics were just food for friendly flora. As research expands, we are beginning to understand their role in overall health. This is especially so with bone health. 


Choose a probiotic that contains multiple species of Bifidobacteria and Lactobacillus strains, as well as prebiotics. The label should include the following: 

Genus name

This is the first word you see to identify a probiotic strain. It is italicized, typically, and most commonly reads as Lactobacillus, Lactoplantibacillus,  or Bifidobacteria, but you might also see Bacillus, among others. The first letter in the genus name is capitalized. You might see several Lactobacillus strains in a single probiotic. The same is true for other genus names on the label. Don’t be concerned if the genus name is abbreviated as “L.” or “B” and so on.  

Species name

This is the second word, following the genus name and is also italicized, typically. The species name is not capitalized. You might see species such as plantarum, reuteri, gasseri, rhamnosus, longum, infantis, and so on. Occasionally, you may see two of the same species in a list of probiotics. What differentiates those two species is the strain. 

Strain name

Strain names are not in italics. They may be a group of letters, numbers, or both, and occasionally a trademark sign. Strain names indicate the specific lab-produced variants of each species. 

For the prebiotics, you might find the letters FOS (fructooligosaccharides); GOS (galactooligosaccharides), and so on. Or you might see inulin or the names of plant fibers, such as chicory, asparagus, or garlic. Others might be listed as well. 

Lastly, remember to take probiotics daily while doubling down on your commitment to a whole-food diet, rich in colorful plants. Probiotics are not pharmaceuticals. They are partners in your health that may take four to six weeks to show benefits.  

Synbiotics add not only numbers of beneficial bacteria but variety, too. Both diversity and abundance are vital for a flourishing microbiome. 

That’s why we created FLOURISH, a natural synbiotic supplement, to quiet troublesome menopause symptoms for you to enjoy your best life. 

How does FLOURISH do this? 

FLOURISH mimics the microbiome of young adults. Their microbiomes tend to be the healthiest because they are most diverse and abundant. This means FLOURISH restores your microbiome to a time it was healthiest and happiest for a healthier, happier you today, tomorrow, and every day. 

With a healthy microbiome, you can enjoy relief from hot flashes and night sweats, balanced moods, steady energy, restful sleep, and smooth, radiant skin. 

Dial back the troublesome symptoms of menopause and lean wholly into the second half of life – starting today.

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