The complexity of women’s lives never ceases to amaze me. And I don’t just mean with their ‘busyness,’ but also their health.
By the time many women find MyMT™ they have tried everything, but they also are in a worse state with health changes, especially joint, gut and heart health changes.
Abdominal distension is a challenge for numerous women as they move through menopause. But alarmingly, many Practitioners don’t understand the link between abdominal distension, waist circumference, changing gut health and hypertension.
As the gut microbiome has been under mounting scrutiny from the scientific community for the past decade, evidence suggests that the gut microbiome plays an important role in the development and pathogenesis of hypertension, or high blood pressure. (AHA, 2021).
With the gastrointestinal tract housing the largest compartment of immune cells in the body, the role that the human microbiome plays in women’s cardiovascular health during the menopause transition, can’t be ignored.
Un-raveling the lifestyle science specific to our menopause transition, took me hundreds of hours of study. Like so many women, I was taking endless supplements as well as HRT, but these weren’t necessarily getting to the heart of the problem – literally!
For example, I didn’t know about the connection between changing gut health in menopause, poor sleep and changing heart health, including hypertension.
We all know that getting a good night’s sleep is crucial to our longer term health, but emerging research also suggests that when it comes to our sleep, blood pressure management and our menopause symptoms, there’s something else as well – the link between our gut health and a condition called vascular or arterial stiffness.
When I talk about this in my live events, numerous women say, “This makes so much sense to me now as to why I’m feeling the way I’m feeling!”
There are many pathologies associated with weight gain and obesity in midlife and older women, but in recent years, the influence of the gut microbiota on both health and pathological states has been emerging in the scientific research.
Changes to the Gut Microbiome Occur During Menopause
The gut microbiome has been implicated in a variety of potential
disease mechanisms including oxidative stress and inflammation that could influence vascular (blood vessel) disease.
The gastrointestinal tract houses the largest compartment of immune cells in the body, so it makes sense that lifestyle factors also shape and are modulated by the microbiome.
In turn these changes may modify a woman’s risk for cardiovascular disease. (Avery et al., 2021).
For the past decade, I’ve been stating that menopause is a cardiovascular and inflammatory event, which may accelerate vascular stiffness. So, when researchers from Kings College, London, discovered that gut microbiome diversity is linked to arterial stiffness in women as they transition menopause, [Menni et al, 2018], this made so much sense, as to why my own gut health changed, and why it also lead to hypertension – a connection that even my Doctor didn’t understand.
Debbie, from the USA, had a similar experience. She didn’t understand why all the exercise she was doing, wasn’t shifting her waist circumference. Nor did she or her Personal Trainer, understand the significance of an increased abdominal circumference and cardiovascular health in women.
I talk about this in the Certified Menopause Weight Loss Coach Course too. For women, a waist size greater than 88 cm (35 inches) is considered substantially increased risk, and even smaller measurements, such as 76.2 cm (30 inches), have been associated with higher risk for cardiovascular events, when adjusted for other factors.
That’s why, it’s time to better understand gut health and the changing nature of gut health in midlife and older women!
Declining Oestrogen Levels and Gut Health
Irritable Bowel Syndrome (IBS) is more prevalent in women transitioning through menopause.
Characterised by abdominal discomfort such as bloating and pain, and changes in bowel function, including diarrhoea, constipation or both, this is a disorder that warrants a Doctor’s visit or a visit to a Gut Specialist.
Declining oestrogen levels during menopause are contributing factors to changing gut health and changes to the microbiome. Oestrogen decline impacts the ‘leakiness’ of the junctions in your gut wall, as well as changing the levels of your microbes in your gut, (collectively called the microbiome).
But other factors impact IBS as well.
These include insomnia, stress, diet, excessive exercise and of course, pelvic surgery. (Yang et al, 2021).
Most importantly, an imbalance in the gut microbial composition and altered microbial function are known to occur in hypertensive animal models and humans with hypertension. [Yang et al, 2025].
Of interest is the role of salt in causing changes to the gut microbiome. High dietary sodium intake has increased globally and remains a risk factor for hypertension and cardiovascular disease and now, new research, suggests that excess sodium intake disrupts gut microbial balance, characterized by the depletion of Lactobacillus. [Yang et al, 2025].
Improving Gut Health for Menopausal Clients
One of the most abundant proteins in the blood is called glutamine. The role it plays in helping the gut wall to maintain its integrity is as important as the role of sleep on the immune system.
That’s why it is known that numerous supplements for gut health generally have glutamine in them.
Glutamine plays a role in leaky gut syndrome. It is a primary fuel source for intestinal cells, helping to strengthen the gut barrier, reduce inflammation, and aids in repairing the intestinal lining.
The gastrointestinal epithelium is the lining that covers the inside of the intestine. This epithelial covering plays an important role in menopause symptom management as well as in the health of women as they age.
The lining impacts digestion, absorption and secretion serving as a barrier to diffusion of toxins, allergens and pathogens from the intestinal contents in the surrounding tissues.
Any disruption to this barrier causes noxious substances to enter, causing mucosal inflammation and tissue injury.
In fact, with the phenomenal growth in gut health research over the past decade, it is well known that gastrointestinal diseases such as inflammatory bowel disease, irritable bowel syndrome (IBS), coeliac disease and colitis are a result of the loss of the tight junction integrity in the epithelial lining of the intestine.
As such, there is increased intestinal permeability of toxins across this usually, tight barrier. This can contribute to abdominal distension in women, which in turn can contribute to vascular stiffness and hypertension.
The good news is that more recent research suggests that certain nutrients help to preserve this gut-barrier integrity.
One of these nutrients is called glutamine or you may have heard of it as L-glutamine.
The terms glutamine and L-glutamine are often used interchangeably in most of the information you will come across in regard to not only gut health, but also in sports and exercise nutrition.
The difference between the two lies within the chemical structure. L-glutamine has a slightly different arrangement of atoms as a molecule, so differs slightly compared to glutamine, but for the purpose of our needs with gut health in relation to menopause in this article, I will use the term glutamine.
Glutamine in supplement form raises the level of muscosal and plasma glutamine. But so too do food sources of glutamine and there are plant sources as well as animal sources.
Animal sources of glutamine include:
- Salmon and fish
- Meat and chicken
- Eggs
- Dairy products
Plant sources of glutamine include:
- Red cabbage, brussel sprouts
- Celery
- Spinach and Kale
- Chickpeas
- Parsley
- Papaya
- Fermented foods such as Miso
- Wholegrains
Ongoing insomnia and changing gut health as women transition menopause reminds us that we need to support women to adjust their diet and lifestyle, so they accommodate the changes that the body is undergoing.
One of the modules I have in the MyMT™ Practitioner Course, teaches you about the changes to women’s gut health during menopause and the important role of nutrients to help stimulate the production of short-chain fatty acids (SCFAs) – the end products of fermentation.
This is important learning for you, because oestrogen receptors (ERs) are expressed in intestinal epithelial cells, and oestradiol regulates epithelium formation and tight-junction function (Braniste, Leveque et al., 2009). As menopause progresses, and oestrogen levels decline, women may develop more gut inflammation and irritability.
As Practitioners, it’s important that we are aware of the powerful connection between menopause, gut health and hypertension.
I’m looking forward to sharing some of this information with you on both the Certified Practitioner Course and the Menopause Weight Loss Courses (Level 1 and 2).
If your clients are struggling to improve their symptoms, then it would be my privilege to support your learning. I have numerous certified CPD courses for you, no matter your budget or time commitment. Details are on the My Menopause Transformation website under the Practitioner link.
References:
Achamrah N, Déchelotte P, Coëffier M. Glutamine and the regulation of intestinal permeability: from bench to bedside. Curr Opin Clin Nutr Metab Care. 2017 Jan;20(1):86-91. doi: 10.1097/MCO.0000000000000339.
Braniste, V., Leveque, M., Buisson-Brenac, C., Bueno, L., Fioramonti, J., & Houdeau, E. (2009). Oestradiol decreases colonic permeability through oestrogen receptor beta-mediated up-regulation of occludin and junctional adhesion molecule-A in epithelial cells. The Journal of physiology, 587(Pt 13), 3317–3328. https://doi.org/10.1113/jphysiol.2009.169300
Buford T. W. (2017). (Dis)Trust your gut: the gut microbiome in age-related inflammation, health, and disease. Microbiome, 5(1), 80. https://doi.org/10.1186/s40168-017-0296-0
Cristina Menni, Chihung Lin, Marina Cecelja, Massimo Mangino, Maria Luisa Matey-Hernandez, Louise Keehn, Robert P Mohney, Claire J Steves, Tim D Spector, Chang-Fu Kuo, Phil Chowienczyk, Ana M Valdes, Gut microbial diversity is associated with lower arterial stiffness in women, European Heart Journal, Volume 39, Issue 25, 01 July 2018, Pages 2390–2397, https://doi.org/10.1093/eurheartj/ehy226
Deters, B. & Saleem, M. (2021). The role of glutamine in supporting gut health and neuropsychiatric factors. Food Science and Human Wellness, 10(2), 149-154 https://doi.org/10.1016/j.fshw.2021.02.003.
Lenders C., Liu S., Wilmore D., Sampson L., Dougherty L., Spiegelman D., Willett W. (2009). Evaluation of a novel food composition database that includes glutamine and other amino acids derived from gene sequencing data. Eur J Clin Nutr. 2009 Dec;63(12):1433-9. doi: 10.1038/ejcn.2009.110. Epub 2009 Sep 16. PMID: 19756030; PMCID: PMC3249386.
Grenham S., Clarke G., Cryan J., & Dinan, T. (2011). Brain–Gut–Microbe Communication in Health and Disease. Frontiers in Physiology, 2 (94), 1-15. https://www.frontiersin.org/article/10.3389/fphys.2011.00094
Samargandy, Saad PhD, MPH, MBBS1; Matthews, Karen A. PhD2; Brooks, Maria M. PhD1; Barinas-Mitchell, Emma PhD1; Magnani, Jared W. MD, MSc3; Janssen, Imke PhD4; Kazlauskaite, Rasa MD, MSc5; El Khoudary, Samar R. PhD, MPH, FAHA1. Abdominal visceral adipose tissue over the menopause transition and carotid atherosclerosis: the SWAN heart study. Menopause 28(6):p 626-633, June 2021. | DOI: 10.1097/GME.0000000000001755
Skrovanek, S., DiGuilio, K., Bailey, R., Huntington, W., Urbas, R., Mayilvaganan, B., Mercogliano, G., & Mullin, J. M. (2014). Zinc and gastrointestinal disease. World journal of gastrointestinal pathophysiology, 5(4), 496–513. https://doi.org/10.4291/wjgp.v5.i4.496.
Yang T, Maki KA, Marques FZ, Cai J, Joe B, Pepine CJ, Pluznick JL, Meyer KA, Kirabo A, Bennett BJ; American Heart Association Council on Hypertension; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Lifestyle and Cardiometabolic Health. Hypertension and the Gut Microbiome: A Science Advisory From the American Heart Association. Hypertension. 2025 Sep;82(9):e160-e170. doi: 10.1161/HYP.0000000000000247. Epub 2025 Jul 17. PMID: 40671646.
Vinelli V, Biscotti P, Martini D, Del Bo’ C, Marino M, Meroño T, Nikoloudaki O, Calabrese FM, Turroni S, Taverniti V, Unión Caballero A, Andrés-Lacueva C, Porrini M, Gobbetti M, De Angelis M, Brigidi P, Pinart M, Nimptsch K, Guglielmetti S, Riso P. Effects of Dietary Fibers on Short-Chain Fatty Acids and Gut Microbiota Composition in Healthy Adults: A Systematic Review. Nutrients. 2022 Jun 21;14(13):2559. doi: 10.3390/nu14132559. PMID: 35807739
