The Estrobolome: What does it have to do with women’s hormone health?

We tend to think of our reproductive and digestive systems as two entirely separate systems, but the truth is that these two systems can greatly influence one another! In fact, our gut health appears to play a central role in many women’s reproductive conditions through the estrobolome.

What is the estrobolome?

There are microbes present in your gut that have the specific role of supporting your oestrogen metabolism and ensuring the right amount of oestrogen is present in your body. This important system is referred to as the estrobolome. When our gut microbiota is healthy, then this system can work optimally by ensuring we have the right amount of oestrogen circulating in our body. However, when our gut is out of balance, it can disrupt the regulation of the estrobolome.

How can the gut impact women’s health conditions?

Endometriosis

An imbalanced gut microbiota can also disrupt the estrobolome and lead to higher levels of circulating oestrogen.  When there are high levels of oestrogen for a prolonged period of time it can play a role in the development of endometriosis [1]. In fact, women with endometriosis have been shown to have more disrupted microbiotas compared to healthy women [2]. Excess oestrogen may also contribute to symptoms including irregular periods, headaches, acne, bloating, weight management issues, headaches, and other digestive symptoms.

PCOS

Gut dysbiosis has been associated with the development of PCOS [3] and has been shown to be related to symptoms of PCOS including insulin resistance, high levels of androgens, chronic inflammation and metabolic syndrome. Interestingly, studies done on PCOS rats have also found that restoring the gut microbiota decreased androgen levels and increased oestrogen levels [3].

Menopause

Low oestrogen levels can cause low libido, loss of bone density, interfere with sleep, mood, and cause vaginal dryness. Do any of these symptoms sound familiar? During perimenopause, oestrogen levels fluctuate and eventually decline, which in turn affects the estrobolome and can lead to a decline in gut health and contribute to these common symptoms of perimenopause [4].

What can women do to support their hormonal health?

As mentioned, the connection between your gut and your estrobolome is a two-way street. Fortunately, the gut microbiota is continuously changing in response to our environment. This means that you can influence the health of your gut with a variety of factors within your control, with the most well-studied influencing factor being your diet! In fact, research shows that improved gut health may alleviate many oestrogen-driven disease states [5].

Feed your Gut microbes with Fibre

Feed your gut microbes with plenty of fibre-rich foods, like plants! Aiming for more than 25g of fibre daily is a great target but be sure not to increase your intake too quickly as it could lead to unwanted gut symptoms. Try to Include a variety of vegetables, fruits, whole grains, legumes, nuts, seeds, and spices so that you are nourishing your gut with a wide range of prebiotics, fibre, and other beneficial plant compounds!

Include Phytoestrogens

 Phytoestrogens are plant compounds that have oestrogen-like properties. They can either have an oestrogen-like effect or an anti-oestrogen effect depending on levels of circulating oestrogen. While research is conflicting and not conclusive, there is some evidence that phytoestrogens may help to improve menopausal symptoms, particularly hot flushes [6]. Nonetheless, sources of phytoestrogens also happen to be healthy plant foods and include tofu, tempeh, soy milk, edamame, flaxseeds, sesame seeds and chickpeas. Including these foods can help support a healthy gut microbiota!

Focus on your Lifestyle

 Getting adequate sleep, adequate exercise and managing your stress are often-overlooked components of gut health. Try to schedule in time for yourself whether it’s taking a yoga class, going for a walk with a friend, carving out time to meditate, or simply spending time with loved ones.

The Bottom Line

Our gut health and reproductive health and interconnected. The state of our gut can both contribute to several women’s health conditions, but also be a key factor in the management of these conditions. If you’re struggling to manage symptoms associated with perimenopause, PCOS, endometriosis, or other women’s health conditions, know that you’re not alone and that there is help available to you! Our friendly Accredited Practising Dietitians can help you with a personalised dietary plan that suits your individual needs, lifestyle, and goals to help you feel your best.

References

[1] Qin R, Tian G, Liu J, Cao L. The gut microbiota and endometriosis: From pathogenesis to diagnosis and treatment. Front Cell Infect Microbiol. 2022 Nov 24;12:1069557. doi: 10.3389/fcimb.2022.1069557. PMID: 36506023; PMCID: PMC9729346.

[2] Jiang I, Yong PJ, Allaire C, Bedaiwy MA. Intricate Connections between the Microbiota and Endometriosis. Int J Mol Sci. 2021 May 26;22(11):5644. doi: 10.3390/ijms22115644. PMID: 34073257; PMCID: PMC8198999.

[3] Guo Y, Qi Y, Yang X, Zhao L, Wen S, Liu Y, Tang L. Association between Polycystic Ovary Syndrome and Gut Microbiota. PLoS One. 2016 Apr 19;11(4):e0153196. doi: 10.1371/journal.pone.0153196. PMID: 27093642; PMCID: PMC4836746.

[4] Peters BA, Lin J, Qi Q, Usyk M, Isasi CR, Mossavar-Rahmani Y, Derby CA, Santoro N, Perreira KM, Daviglus ML, Kominiarek MA, Cai J, Knight R, Burk RD, Kaplan RC. Menopause Is Associated with an Altered Gut Microbiome and Estrobolome, with Implications for Adverse Cardiometabolic Risk in the Hispanic Community Health Study/Study of Latinos. mSystems. 2022 Jun 28;7(3):e0027322. doi: 10.1128/msystems.00273-22. Epub 2022 Apr 13. PMID: 35675542; PMCID: PMC9239235.

[5] Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas. 2017 Sep;103:45-53. doi: 10.1016/j.maturitas.2017.06.025. Epub 2017 Jun 23. PMID: 28778332.

[6] Chen MN, Lin CC, Liu CF. Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric. 2015 Apr;18(2):260-9. doi: 10.3109/13697137.2014.966241. Epub 2014 Dec 1. PMID: 25263312; PMCID: PMC4389700.