Peters, B. A., Santoro, N., Kaplan, R. C., & Qi, Q. (2022). Spotlight on the Gut Microbiome in Menopause: Current Insights. International Journal of Women's Health. https://doi.org/10.2147/IJWH.S340491
Peters BA, Santoro N, Kaplan RC, Qi Q. Spotlight on the Gut Microbiome in Menopause: Current Insights. International Journal of Women's Health. 2022. doi:10.2147/IJWH.S340491
Peters, Brandilyn A., et al. "Spotlight on the Gut Microbiome in Menopause: Current Insights." International Journal of Women's Health, 2022.
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Menopause is associated with lower gut microbiome diversity
A review of 10 human studies suggests that gut bacteria are less varied and more like men's after menopause. Five out of 10 studies found lower variety after menopause or with lower estrogen. Three found a closer match to men.
Key Findings
Ten human studies examined menopause or female sex hormones and gut bacteria. Five reported lower α-diversity after menopause or with lower estrogen.
Three studies found that the gut microbiome of women after menopause was more similar to men's than the gut microbiome of women before menopause was.
In a US Hispanic/Latino cohort, women after menopause (n = 1027) had a less diverse gut microbiome than women before menopause (n = 295), and it looked more like men's.
Several studies found less Firmicutes and Ruminococcus, and more Butyricimonas, Dorea, Prevotella, Sutterella, and Bacteroides, after menopause or with lower estrogen.
No study has followed the same women through the menopausal transition to track gut microbiome change.
Interpretation
The paper is a narrative review of cross-sectional studies, which compare different women at one point in time. Most of the studies adjusted or matched for age. The findings are associations. The authors write that small samples in many studies likely hindered agreement between results. They add that the health effects of the bacteria that shifted are not yet clear.
RRM Context
Restorative reproductive medicine treats the loss of ovarian hormones as a change that reaches the whole body. The review describes gut bacteria that can return estrogens and progesterone to the blood. This may help set hormone levels after menopause. The authors list the effect of menopausal hormone therapy on gut bacteria as an open question.
Our editorial summary of this paper, not the article's abstract.
Abstract
The gut microbiome is an important contributor to human health, shaped by many endogenous and exogenous factors. The gut microbiome displays sexual dimorphism, suggesting influence of sex hormones, and also has been shown to change with aging. Yet, little is known regarding the influence of menopause - a pivotal event of reproductive aging in women - on the gut microbiome. Here, we summarize what is known regarding the interrelationships of female sex hormones and the gut microbiome, and review the available literature on menopause, female sex hormones, and the gut microbiome in humans. Taken together, research suggests that menopause is associated with lower gut microbiome diversity and a shift toward greater similarity to the male gut microbiome, however more research is needed in large study populations to identify replicable patterns in taxa impacted by menopause. Many gaps in knowledge remain, including the role the gut microbiome may play in menopause-related disease risks, and whether menopausal hormone therapy modifies menopause-related change in the gut microbiome. Given the modifiable nature of the gut microbiome, better understanding of its role in menopause-related health will be critical to identify novel opportunities for improvement of peri- and post-menopausal health and well-being.
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