Over the past decade, the gut microbiome has emerged as making an important contribution to human health, with increasing interest into how it may also influence symptoms during and after the menopause transition.
Feelings of melancholy and sadness are known symptoms during the menopause transition as our changing reproductive hormones exert effects on one of our mood hormones, called serotonin. But what many of us don’t realise, is that these effects begin in our gut and with the fascinating connection between nerves in our gut and nerves in our brain, there are inflammatory changes which can contribute to feelings of melancholy and brain-fog.
These inflammatory changes which affect our nerves is known as ‘neuroinflammation’ and our menopause transition is a time of our lives when we become susceptible to these changes.
Age-related neuroinflammation and brain fog are related to our changing gut microbiota (this is the term given to the complex biological system of micro-organisms inside our gut).
‘The gut microbiota has both positive and negative effects on the body and the brain. The scientific literature suggests that the gut microbiome now influences the brain ageing process and the initiation and progression of neuro-degenerative disorders.’ [Alsegiani & Shah, 2022, p. 2407].
Those of you who’ve been reading my newsletters for a while now (thank you), will have read numerous blogs about the link between gut health and menopause hormonal changes. However, this new research brings neuroinflammation to our attention.
Neuroinflammatory changes impact brain fog, anxiety, depression and other emotional and memory challenges that we may experience as we move through menopause. Hence, in exploring how to manage these symptoms in particular, it’s important to consider the gut-brain association and the arrival of alterations in the gut microbiome composition, which may lead to a condition called ‘dysbiosis’.
The microbiome is the community of bacteria that lives in our gut and elsewhere in our body. Researchers now understand that brain health and gut health cannot be looked at in isolation.
“The connection between the brain and gut is because messages are sent up and down the vagus nerve – the major nerve that runs from our brain to our heart, stomach and intestines. The vagus nerve therefore, has a profound influence on the gut microbiota as well as pro-inflammatory markers.
The reason for this, is because the vagus nerve transfers stress cytokines (inflammatory markers) between the gut and the brain. So, stress is the ‘hammer’ which acts on the brain and the gut.
When we keep activating our stress response, then this increases the ‘leakiness’ of the gut. When the gut is leaky, we lose the ability to absorb the nutrients we need for our health and this increases oxidative stress in the body.” [Professor Zoltan Sarnyai, 2019)
I couldn’t agree more! I know from my own experience that when we aren’t sleeping one of the major changes that we experience as levels of our reproductive hormones decline, is insomnia, or interrupted sleep. The catch-22 is, that when we aren’t sleeping our gut isn’t healing properly overnight, so we accumulate pockets of inflammation throughout our digestive system and as researchers have discovered, inflammatory changes impact the brain and nervous system too.
An enormous number of different microbes inhabit our colon and the concentration of these microbes increases gradually from the ileum (small intestine) to the colon (large intestine).
In normal physiological conditions, the density of the human microbiome is highest in the colon but studies indicate that the amounts and types of microbes are influenced by:
- medications/ drugs
- ageing (including menopause).
In these abnormal conditions, fecal microbiome biodiversity is decreased, which then influences a condition called dysbiosis. This term refers to changes in the resident microbe communities. For those of you experiencing changing gut health, such as bloating, diarrhoea or constipation, then studies have shown that gut dysbiosis plays a role in developing and progressing inflammatory changes around the body, including some psychological and autoimmune diseases. [Shreiner et al, 2015]
To me, this has relevance to women transitioning menopause, when our changing oestrogen levels also contribute to gut dysbiosis and leaky gut syndrome, which in turn contributes to your changing moods, emotions, memory and anxiety.
So, how is your gut health?
Do you suffer from Irritable Bowel Syndrome (IBS)? Or diverticulitis? Or do you swing between being constipated and having diarrhea? Maybe your brain feels foggy all the time and you find it difficult to concentrate? Perhaps these changes have just come on during your menopause transition but you have no idea that they might be connected in some way?
If you feel like this, then you aren’t alone.
At least 50% of women on my coaching pages, tell me that they are experiencing gut health issues that have mainly arrived since they went into their menopause transition. Unbeknownst to many of them, our changing gut health as we go into a low oestrogen hormonal environment is impacting on anxiety levels, brain fog and depression too.
‘The increase in GI symptoms around the time of menses and early menopause occurs at times of declining or low ovarian hormones, suggesting that oestrogen and progesterone withdrawal may contribute either directly or indirectly.‘ [Heitkemper & Chang, 2009].
The question is then, how do we try and keep the gut microbiota healthy? Particularly at a time of our lives when we become more vulnerable to a changing gut microbiome and the ensuing neuroinflammatory changes which can then affect our mental and emotional function as well as our hot flushes and our sleep quality.
The gut microbiome is one of the largest organs in the body (along with our skin) but here’s what blew me away – when I attended the Australasian Society of Lifestyle Medicine conference late last year, researcher, Professor Thomas Borody, reported that the gut is responsible for producing 70% of your energy. With the powerful connection that your gut has with your brain, many symptoms that we experience in menopause, such as foggy brain, depression, anxiety and mood swings, can be linked to the health of your gut micro-biome. I might also add insomnia in there too.
Can you imagine what happens to your energy levels, sleep, health and moods, when your gut isn’t performing to its best?
Knowledge of the gut-brain connection has increased 10-fold over the past decade. This has been due to improved brain research as well as genetic research. Both have opened the door towards understanding gut health and the link to disease, especially the effect of the accumulation of inflammatory changes as we get older.
With menopause heralding in the transition towards our ageing, this is a critical time of life to sleep all night, restore health to our gut and for those of you who need to lose weight, this will also have a positive impact on your anxiety levels and energy.
3 Things You Can Do to Help Manage your GUT HEALTH in Menopause
When we understand the powerful connection between the brain, the gut, the vagus nerve, existing gut inflammation AND menopause, then we need to focus on these three factors:
- Sleep All Night – as I keep saying to women, if you aren’t sleeping, then you aren’t healing. this includes your gut. Our gut is also on a 24 hour circadian rhythm as are all of our major organs, so we need to improve our sleep in order to improve our gut. This is why in both of the MyMT programmes, the first module you receive is called ‘SLEEP ALL NIGHT‘ – in this I teach you how to change your diet, how to sleep all night and how to turn around your hot flushes, night sweats and bladder control, so you aren’t waking up! As well, if you are on anti-depressants or you already have changing gut health, then there is a Gut Health module for you to listen to as well.
2. Learn the difference between PRE-Biotics and PRO-Biotics: Both of work in different ways to keep our gut healthy. I go into more depth in this in my programmes in the optional Gut Health module for all MyMT™ women!
Essentially, we have 3 areas for digestion and absorption – our stomach, our small intestine and our large intestine. So, some of you may have problems at any part of the gut-colon tract. This is why gut-health researchers focus on both pre-biotics and pro-biotics.
It’s also why I suggest that Pre-biotics are more important to sort out first than pro-biotics in mid-life. Pre-biotics come from specialised plant fibre that beneficially nourishes the good bacteria already in the LARGE bowel or colon.
While pro-biotics introduce good bacteria into the gut, pre-biotics act as a fertilizer for the good bacteria that’s already there. They help your good bacteria grow, improving the good-to-bad bacteria ratio. This ratio has been shown to have a direct correlation to your health and overall wellbeing, from your stomach to your brain.
Plant fibres help to promote the growth of many of the good bacteria in the gut and to help alleviate constipation. They contain amylose which also helps to reduce insulin. They are therefore called RESISTANT STARCHES. They don’t get digested in the stomach and small intestine, so they travel further down your gut into your large bowel. They are critical to your on-going health, especially to your brain health.
3. Add Extra Virgin Olive Oil (EVOO) to your diet – at least 20-30 mls daily. Recent data are emerging which demonstrate that the health-promoting benefits of EVOO may also extend to the gut microbiota. For those of us who love the Mediterranean diet, this is good news! An integral component of the Mediterranean diet, extra-virgin olive oil, is obtained via the mechanical extraction of the olive fruit, without the use of heat or solvents. This precious oil is already well known for its nutritional properties and anti-inflammatory compounds, which exert beneficial effects on a number of markers of cardiometabolic health and chronic disease risk such as Altzheimers Disease. Now, the health-promoting properties of EVOO extend to the promotion of gut health too because it helps to extend the microbione diversity. [
Whether you are just entering peri-menopause, or you are already in menopause, understanding that this time of our lives is the biological gateway to our ageing years is important.
With changes going on all around the body, for too long this age and stage of life has been positioned in ‘sickness’. But it shouldn’t be. It needs to be positioned in ‘wellness’ instead.
That’s what I teach you on the MyMT™ online 12 week programmes, (these differ depending on whether weight loss is desired or not). Thousands of women have joined me over the years and feel as if they have taken back control of an important stage of life. I hope you can join me too, as I can’t wait to show you the way through menopause into your healthy ageing years ahead.
Please start with listening to my Masterclass on Menopause which I tell you about in the video below.
Dr Wendy Sweet (PhD)/ MyMT™ Founder & Member: Australasian Society of Lifestyle Medicine.
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