It’s a little bit difficult to be talking about heat stress during the menopause transition at the start of a South Island winter.
However, for those of you living in the Northern Hemisphere as well as in northern parts of Australia, or those of you who are doing a lot of higher intensity exercise, you may be as curious as I was about recent research that has emerged exploring the connection between heat stress and an inflammatory condition called ‘leaky gut syndrome‘.
Every day I read health screening forms from midlife women who note that they have gut health disturbances. Many are also on menopause HRT but still experiencing hot flushes/flashes, especially as they move into post-menopause. This is partly why I became curious about the relationship between gut health and menopause.
The incidence of inflammatory bowel and leaky gut diseases has been on the rise in many western countries for decades, but it’s only recently that gut researchers have been interested in the menopause transition. In western countries Irritable Bowel Syndrome [IBS] is 4 times more common in women as they reach mid-life.
According to Dr Marek Glezerman, author of ‘Gender Medicine’ which explores the gender differences in health and disease,
“Functional Disorders of the digestive tract, such as Irritable Bowel Syndrome (IBS) is four times more common in women living in Western countries during and after menopause. In Japan, China, India and other parts of Asia, the ratio is the opposite.”
Numerous women find that their menopause transition intersects with changing gut health, as I did myself and this is due to the changes that declining levels of both oestrogen and progesterone have on the gut wall as well as the gut microbiome.
Changing oestrogen levels impact the tiny microvilli that line our digestive system, causing ‘gaps’ to increase between them. This is known as leaky gut syndrome. It can lead to Irritable Bowel Syndrome or IBS in women who are either in or through menopause.
And as if declining oestrogen isn’t enough, it was research on Heat Stress and IBS that piqued my interest – IBS is made worse with heat stress (Lian et al, 2020).
Whether it be the climate, or high-intensity exercise, or temperature changes during menopause, it seems that too much internal heat, contributes to impairment of the intestinal epithelial barrier in our gut and this can lead to a condition commonly known as leaky gut syndrome.
Leaky Gut Syndrome arises when there are gaps that occur in the intestinal barrier along the gut wall. This is problematic because this gut wall barrier of the gastrointestinal tract (GI Tract) is the largest surface of the body that is in contact with the outside environment, so, gaps in this barrier, mean that pathogens can leak through, thus affecting the body’s natural immune response.
It’s interesting therefore, that heat stress contributes to severe intestinal epithelial damage – a caution perhaps for those of you exercising in the heat and for women who experience additional heat stress due to the climate or of course, due to menopause hormonal changes.
Under normal conditions, an intact intestinal barrier prevents the transmission of toxins and other substances which can lead to inflammation and an altered immune system.
Hence, when there are gaps in the tiny junctions, and the integrity of the intestines are compromised, a variety of problems can occur, from inflammatory bowel disease to more serious conditions, such as heart disease and Type 2 Diabetes.
Leaky Gut Syndrome has numerous causes:
Although newer research links heat stress to leaky gut syndrome, stress disorders such as endurance exercise, menopause insomnia, food allergies and certain medications also increase permeability of the gut wall.
For those of you who are regular exercisers and going through menopause, then take note that only 60 min of vigorous endurance training at 70% of the maximum work capacity may also lead to the characteristic responses of leaky gut syndrome. (Ribiero et al, 2021).
But the good news is that leaky gut syndrome can be reversed and it’s why I have a module on Gut Health in the 12 week programmes. If women are going to get on top of their menopause symptoms and/or weight, then they need to have a bit of a focus on their gut health.
Dietary factors can reverse intestinal leakiness and mucosal damage in “stress” disorders (Camilleri, 2019) and I share some of these with you below.
4 Ways to Heal Your Leaky Gut:
- Stop Eating Earlier in the Evening! Your gut operates on a 24 hr circadian cycle. Much of our absorption of nutrients occurs overnight when the body is resting. But this is also when the gut motility slows down, so if you want to heal your gut, then stop eating earlier in the evening so the food has time to be digested and absorbed.
- Increase Vitamin C Intake. It’s only been since 2015, that researchers have begun to understand that oestrogen has a role in helping the gut epithelium or lining to turn over cells regularly. So, as we move through menopause, and oestrogen levels are naturally declining, then it makes sense that this is a vulnerable time for our gut health. Vitamin C helps the gut lining to heal.
- Fibre and Fermented Foods Help your Gut to Heal: The diet strongly influences the functions of the gut as well as the trillions of microbes that reside into the intestines. Studies have shown that dietary components can significantly alter gastrointestinal functions, either in a harmful or helpful way. Among carbohydrates, dietary fibres are recommended for anti-inflammation properties and intestinal barrier regulation. (Aleman et al, 2023).
Probiotics also help repair a leaky gut so adding yoghurt and kefir to your diet is also recommended. Research suggests that the main effects of probiotics are to do with the maintenance of the intestinal wall as well as in the regulation of the transit time of food through the intestines and in the production of short-chain fatty acids which assist in gut health.
- Monitor your Vitamin D levels. Both Vitamins A and D play critical functions in regulating gastrointestinal homeostasis but perhaps the vitamn that affects the female gut the most when levels are low, is Vitamin D. This is because low vitamin D levels impact the absorption of calcium through the gut wall. Vitamins A and D are necessary for the integrity of the epithelium and gut microbiota, They also modulate immune responses at different levels. (Aleman et al, 2023).
One of the main effects of oestrogen is to support our digestive health. In our monthly cycle, oestrogen is cycling up and down, and this meant that the higher levels of oestrogen helped our gut enzymes to work more efficiently.
Leaky Gut Syndrome leads to Irritable Bowel Syndrome, which in turn may impact numerous menopause symptoms – depression, anxiety, weight gain (or loss) and brain-fog, sore joints, hot flushes and of course, menopause insomnia. All these symptoms are affected by changing gut health.
Understanding this connection and then getting on top of it is crucial to your ongoing health during your menopause transition. It’s why, improving gut health is an important part of the world-class 12 week My Menopause Transformation programmes. I hope you can join me sometime.
Aleman RS, Moncada M, Aryana KJ. Leaky Gut and the Ingredients That Help Treat It: A Review. Molecules. 2023 Jan 7;28(2):619.
Camilleri M. Leaky gut: mechanisms, measurement and clinical implications in humans. Gut. 2019 Aug;68(8):1516-1526.
Lian P, Braber S, Garssen J, Wichers HJ, Folkerts G, Fink-Gremmels J, Varasteh S. Beyond Heat Stress: Intestinal Integrity Disruption and Mechanism-Based Intervention Strategies. Nutrients. 2020 Mar 11;12(3):734.
Ribeiro F., Petriz B., Marques G., Kamilla L., Franco O. (2021). Is There an Exercise-Intensity Threshold Capable of Avoiding the Leaky Gut? Frontiers in Nutrition, 8.