Annoying Intestinal Health Changes in Perimenopause
Here’s an interesting fact: You are more microbial cells than you are human cells in your body! Every time I read or hear that, it blows my mind. You have several microbiomes actually. In your intestines, on your skin, in your mouth and sinuses, and your vagina. Unfortunately, as you head into perimenopause and then menopause, the decline in estradiol really impacts it for the worse!
It’s annoying and not fair.
A ‘microbiome’ is literally a biome of microbes that live in and on you. It’s full of bacteria, viruses, fungus that are living among us (see what I did there). Ideally they should help and support you like a symbiotic relationship. They can help you make hormones, neurotransmitters, some vitamins, and support your immune system. Unfortunately, when things go awry, you get symptoms! This could include symptoms of a vaginal infection, a sinus infection, or even symptoms in your intestines.
Both estrogens and progesterone have been studied to have protective effects to your microbiomes, especially in your intestines. They help maintain the gut barrier and and protect your gut from injury. One of the ways estradiol does this is by up regulating tight junctions. These act like gates (in a sense) deciding on who should and shouldn’t get through from the inside to the outside of the intestines.
If your gates (and fencing) are well built and sturdy, then it’s way less likely to let problematic things through to the other side. If something slides through the gate that isn’t supposed to be there, your immune system has to get involved. Similar to if someone or something comes through the gate at your house into your backyard, you’re probably going to go investigate and sound an alarm.
Healthy levels of estradiol help up regulate the gates so that they function properly! However, as levels decline, the gates aren’t as good as they used to be. This can create intestinal symptoms such as more gas or bloating, constipation or diarrhea. It can also lead to increased inflammation as the immune system gets involved.
Other things can affect the microbiome negatively such as:
Stress
Infections/parasites
Antibiotics
Environmental toxicants (such as preservatives)
Therefore, it’s also possible that you might be moving into menopause with an already compromised intestinal microbiome!
How can this be supported?
Of course, if you’re a candidate for estrogen therapy, consider it with your practitioner! In animal studies, researchers have found that estradiol therapy IMPROVES gut health and these tight junctions (gates). Observationally, women notice this improvement as well.
Next, make sure you’re looking at your fiber, especially those resistant starches. I’m sure you’ve heard of soluble and insoluble fiber as they can help with regularity and moving things through the intestinal tract. Resistant starches are quite literally starches that don’t get absorbed in the intestines. Some of these starches are then fermented in the large intestines to feed the bacteria there. This is known as a pre-biotic. When the bacteria are fed, they create healthy short-chain-fatty-acids (SCFA) known as post-biotics.
Resistant starches are being studied for their potential lipid, glucose, insulin and inflammation lowering ability as well. All markers that can INCREASE in menopause!
Common foods include green bananas (leaning towards unripe), green banana flour, potato starch, tapioca starch, rolled oats, and white beans. You can also increase the resistant starch content of potatoes by boiling them then letting them completely cool (such as in potato salad). Those cooked then cooled potatoes are known as type 3 resistant starch.
Certain nutrients are being studied with intestinal health and tight junctions such as vitamin D, vitamin A, vitamin D, zinc and glutamine. Talk with your healthcare practitioner about a plan for you!
Lastly, you want to make sure to read labels and evaluate what you are using that has a lot of preservatives or anti-microbial components to them as they affect your microbiomes. Research Microbiologist, Kiran Krishnan and I discuss this in our podcast here. He’s pretty clear that these chemical additives are meant to kill microbes in our make-up, skincare, packaged foods, or on our counter BUT they don’t stop there. They can affect our own body microbes.
If you’re struggling with all sorts of intestinal issues, it may also be time for a more functional evaluation. While it could be the effects of decreasing estradiol, it may also be due to irritating foods, gallbladder or bile issues, infections or an imbalance in the gut microbiome.