Women are always on the lookout for proven ways to help their menopause symptoms. As lifestyle changes, including nutrition, are key to improving your menopause experience, it’s common that evaluating the use of probiotics should come up too. The popularity of probiotics is on the rise, with new claims emerging regularly about their efficacy. But is there any evidence that probiotics help with menopausal symptoms? Nutritionist Le’Nise Brothers explores the research behind probiotics and which are best for menopause symptoms.
Find what you need quickly
-
Gut health and menopause
-
Menopause changes to the gut
-
What can you eat and drink to improve gut health during menopause?
-
How to choose the best probiotic
-
What probiotics are best for menopause?
-
Can probiotics help with menopause bloating?
-
What should I look for in a probiotic for menopause?
-
Final word
Gut health and menopause
Talk about gut health usually focuses on the microbiome, or ecosystem, of trillions of bacteria, virus, fungi, archaea, and other microbes that live in your small and large intestines. But the gut isn’t the only place on the body with a microbiome – you also have microbiomes on your skin, mouth, lungs, vagina and eyes. Before you throw your soap in the bin with disgust, remember that you need these microbiomes! Your gut microbiome helps you in so many ways, including:
- Supporting food digestion
- Mental health
- Strong immune function
- Hormone metabolism
The food you eat, how you move your body, how you sleep, how often you go to the loo, even how you manage stress all have an impact on the health of your gut.
Explore the many benefits of good gut health during menopause with our expert partner
Menopause changes to the gut
There are several changes to your body during and postmenopause, including changes to gut and vaginal health. At menopause, your body produces less estradiol, the dominant form of oestrogen during your menstruating years. Instead, the balance shifts towards higher levels of estrone, a less potent form of oestrogen. This change in hormone production can impact the composition of your gut microbiota.
Your body is prepared for this and has a specific collection of gut bacteria called the estrobolome, which help regulate estrone levels in menopause. There is plenty you can do to help it along too!
What can you eat and drink to improve gut health during menopause?
Despite these hormonal changes, you can support the estrobolome and your entire gut microbiome during menopause and beyond through what you eat and drink, as well as through targeted probiotic supplements.
Food with fibre
At every meal, you can positively affect the health of your gut. If we think of your gut a bit like a garden, you must fertilise and feed what’s already there and you can also add new plants to make the garden look even more beautiful. You fertilise your ‘gut garden’ when you add fibrous food, such as:
Your gut bacteria – the estrobolome – then feed on this fibre, which causes by-products of digestion, including short-chain fatty acids (SCFAs) like butyrate, propionate, and acetate, which are thought to help reduce inflammation and support positive mental health (although research in this area is ongoing).
Fermented food
You can diversify your ‘gut garden’ by adding fermented food and drink. This includes food which have living microbes present, such as:
- Full-fat Greek or natural yoghurt
- Sourdough
- Miso
- Tempeh
- Pickled vegetables
- Kombucha
- Kefir
- Kimchi
- Kvass
- Sauerkraut
How to choose the best probiotic
Not all probiotics are created equally, so it’s important to choose probiotic supplement strains that are backed by research to positively affect specific menopausal symptoms.
When you add new strains through probiotic supplements, you encourage these new strains to colonise the gut and improve the diversity of the intestinal microbiome. This can also help your natural gut flora recover and ‘crowd out’ any pathogenic bacterial strains.
What probiotics are best for menopause?
Evidence is still emerging about the role probiotics play in supporting general health in menopause, including improving bone function, mood and vaginal health.
While we generally do not have enough data to recommend specific strains of bacteria or ways of taking probiotics, studies into the effects of these supplements are ongoing.
Probiotics for bone health
A small 2004 study of 20 post-menopausal women found that the group that consumed milk fermented with Lactobacillus helveticus had increased levels of calcium, a mineral that’s important for bone health. This group also had lower levels of parathyroid hormone (PTH), which is responsible for bone resorption and remodelling (a normal lifelong process, but one which can increase and lead to thinning of the bones after menopause).
While these findings are fascinating, we still do not know whether they translate to an actual improvement in women’s bone health, or simply a change in their test results. Your own doctor will be able to advise on the best way for you to preserve your bone density. For many women this means weight-bearing exercise, a healthy diet and lifestyle (including quitting smoking and reducing alcohol intake).
Probiotics for vaginal health
The vagina is colonised and kept healthy by a variety of different species of bacteria, mainly Lactobacillus. During menopause, these bacteria are thought to have an effect on a number of menopausal symptoms including those of genitourinary syndrome of menopause (GSM), which may include pain, dryness and painful sex. There are a number of different species of Lactobacillus, although the most common in healthy vaginas include Lactobacillus iners and Lactobacillus crispatus.
Find out more about painful sex and vaginal discomfort during menopause.
Supplementing with vaginal and oral probiotics containing strains of Lactobacillus may support the vaginal microbiome and increase bacterial diversity in the gut. Indeed, small studies have shown that that if taken orally these may affect vaginal health and reduce vaginal infections. Although initial findings are encouraging, more research is needed in this area.
As the dominant bacterial genus in the vagina, healthy levels of Lactobacillus can also help to prevent infections including urinary tract infections (UTIs). There are multiple different species of lactobacillus, and they help to prevent infections in a number of different ways. The main mechanisms include preventing the bacteria which cause UTIs from ‘sticking’ to the tissues of the vagina and urinary tract, and preventing them from multiplying.
Despite all of these positive findings, we are still learning about the way the microbiome affects vaginal health. Specifically, more research is needed about which types of bacteria and which probiotic supplements are most helpful for menopause-related conditions.
If you are struggling with recurrent UTIs, pain, dryness or other vaginal changes, book in with your doctor. There are multiple proven treatments for these symptoms, including low-risk vaginal HRT. Make your visit urgent if you have any blood in your pee, any ulcers or sores which aren’t healing, or any unexpected, heavy or irregular vaginal bleeding, particularly if it happens after sex.
Probiotics for low mood
Probiotics may have an impact on mental health. A 2016 meta-analysis (a review of multiple different studies) found that probiotics can improve depression scores, although a relatively small group of patients was studied (183 cases and 182 controls). However, no single specific strain was found to cause this improvement.
This positive effect on mood may be because 95% of serotonin,is produced in the gut. Serotonin is a chemical which is essential for brain and nervous system function, and is sometimes called the ‘happy hormone’ because of its role in maintaining good mental health.
However, research is still ongoing and we have much to learn about the way your gut flora interacts with your mood. If you are struggling with low mood or depression, see your doctor for help rather than relying on probiotics. They will be able to recommend the best treatments for you – and probiotics might be a helpful extra.
Can probiotics help with menopause bloating?
Possibly. A 2015 meta-analysis including 1793 patients with IBS found that probiotics have a beneficial effect on bloating.
However, bloating at menopause has many different potential causes, some of which are serious. If you notice bloating which is either persistent or keeps coming back, see your doctor in the first instance. They will be able to help you find the cause for your bloating and the correct treatment.
What should you look for in a probiotic for menopause?
In general, the research points to Lactobacillus as a great all-round probiotic for menopause. There are many reputable clinical grade brands that offer probiotics with Lactobacillus strains.
Final word
If you decide to take probiotics, it’s helpful to also use fibre and fermented food to support overall gut health.
It’s always worth checking in with your doctor if you have any specific symptoms. They will be able to help you work out the root cause of your symptoms and recommend appropriate treatment – which may well include probiotics.
Brotman, R.M., Shardell, M.D., Gajer, P., Fadrosh, D., Chang, K., Silver, M., Viscidi, R.P., Burke, A.E., Ravel, J. and Gravitt, P.E. (2014). Association between the vaginal microbiota, menopause status and signs of vulvovaginal atrophy. Menopause (New York, N.Y.), [online] 21(5), pp.450–458. doi:10.1097/GME.0b013e3182a4690b.
Han, S., Lu, Y., Xie, J., Fei, Y., Zheng, G., Wang, Z., Liu, J., Lv, L., Ling, Z., Berglund, B., Yao, M. and Li, L. (2021). Probiotic Gastrointestinal Transit and Colonization After Oral Administration: A Long Journey. Frontiers in Cellular and Infection Microbiology, 11. doi:10.3389/fcimb.2021.609722.
Hummelen, R., Macklaim, J.M., Bisanz, J.E., Hammond, J.-A., McMillan, A., Vongsa, R., Koenig, D., Gloor, G.B. and Reid, G. (2011). Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness. PloS One, [online] 6(11), p.e26602. doi:10.1371/journal.pone.0026602.
Kwa, M., Plottel, C.S., Blaser, M.J. and Adams, S. (2016). The Intestinal Microbiome and Estrogen Receptor–Positive Female Breast Cancer. JNCI: Journal of the National Cancer Institute, 108(8). doi:10.1093/jnci/djw029.
Kwak, Y.-K., Daroczy, K., Colque, P., Kühn, I., Möllby, R. and Kallner, H.K. (2017). Persistence of Lactobacilli in Postmenopausal Women – A Double-Blind, Randomized, Pilot Study. Gynecologic and Obstetric Investigation, [online] 82(2), pp.144–150. doi:10.1159/000446946.
Messaoudi, M., Lalonde, R., Violle, N., Javelot, H., Desor, D., Nejdi, A., Bisson, J.-F., Rougeot, C., Pichelin, M., Cazaubiel, M. and Cazaubiel, J.-M. (2010). Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. British Journal of Nutrition, [online] 105(5), pp.755–764. doi:10.1017/s0007114510004319.
Narva, M., Nevala, R., Poussa, T. and Korpela, R. (2004). The effect of Lactobacillus helveticus fermented milk on acute changes in calcium metabolism in postmenopausal women. European Journal of Nutrition, 43(2), pp.61–68. doi:10.1007/s00394-004-0441-y.
Oliphant, K. and Allen-Vercoe, E. (2019). Macronutrient metabolism by the human gut microbiome: major fermentation by-products and their impact on host health. Microbiome, 7(1). doi:10.1186/s40168-019-0704-8.
Reid, G. (2008). Probiotic Lactobacilli for Urogenital Health in Women. Journal of Clinical Gastroenterology, 42, pp.S234–S236. doi:10.1097/mcg.0b013e31817f1298.
Terry, N. and Margolis, K.G. (2017). Serotonergic Mechanisms Regulating the GI Tract: Experimental Evidence and Therapeutic Relevance. Handbook of experimental pharmacology, [online] 239, pp.319–342. doi:10.1007/164_2016_103.
Vieira, A.T., Castelo, P.M., Ribeiro, D.A. and Ferreira, C.M. (2017). Influence of Oral and Gut Microbiota in the Health of Menopausal Women. Frontiers in Microbiology, [online] 8. doi:10.3389/fmicb.2017.01884.
Wallace, C.J.K. and Milev, R.V. (2021). The Efficacy, Safety, and Tolerability of Probiotics on Depression: Clinical Results From an Open-Label Pilot Study. Frontiers in Psychiatry, 12. doi:10.3389/fpsyt.2021.618279.
Try our menopause clinic
The latest
The news may have you believe you can now buy your HRT from your pharmacist. Spoiler alert! That’s not quite right as it’s not for all HRT. Find out more here.
Do antibiotics, D-mannose or cranberry juice treat UTIs? Why do UTIs happen after sex during menopause and how can you minimise infections? Find out…
Black cohosh, devil’s claw, red clover, evening primrose oil and flax seeds – do these natural supplements for menopause work and are they worth the money?
If you are under 55 or not postmenopausal, you still need contraception to prevent pregnancy. You also need it to prevent STIs.
Hormonal changes during menopause may contribute to constipation. Nutritional therapist Jo Lyall explains how to prevent this uncomfortable condition.
Could GLP-1 drugs like Wegovy and Ozempic help menopausal weight gain? We explore who can take these drugs and if they can relieve other menopause symptoms.
Hormonal changes and life milestones make low mood common during menopause. Here’s when to get help and what treatment can help bring back your usual self.
