Menopause marks a major endocrine transition characterized by declining ovarian estrogen and progesterone. These hormonal changes affect multiple systems — including the gut microbiome, the diverse community of bacteria, viruses, fungi and other microbes that influence digestion, immunity and metabolism. For clinicians and people experiencing this transition, understanding microbial contributions can clarify why some menopausal symptoms emerge and suggest non‑pharmacologic strategies. For a focused review of mechanisms and evidence, see [a detailed overview](https://www.innerbuddies.com/blogs/gut-health/the-gut-microbiome-and-menopause). Understanding estrogen metabolism in the gut A subset of gut bacteria known as the estrobolome produces enzymes (notably β‑glucuronidase) that deconjugate estrogens in the intestine and allow their reabsorption into circulation. Changes in the estrobolome therefore alter systemic estrogen availability and can modulate estrogen‑dependent tissues. Reduced estrobolome activity or compositional shifts may contribute to altered hormone levels after menopause and influence symptoms such as hot flashes, vaginal atrophy and bone loss. Microbial changes observed with menopause Population and metagenomic studies report decreases in overall microbial diversity after menopause and a compositional shift toward profiles more similar to male microbiomes. Specific observations include reductions in SCFA‑producing Firmicutes (for example, Ruminococcus) and increases in genera linked to metabolic disturbance (including Prevotella, Dorea and Sutterella). Functional analyses also report changes in pathways for estrogen metabolism, short‑chain fatty acid (SCFA) production and amino‑acid or phenolic‑compound degradation. Implications for health and symptoms These microbial changes may affect several clinically relevant outcomes: - Bone health: the gut microbiota interacts with immune and endocrine pathways that influence bone remodeling; dysbiosis can exacerbate postmenopausal bone density loss. - Cardiometabolic risk: altered microbial metabolism and increased inflammation have been associated with unfavorable lipid profiles, insulin resistance and higher cardiovascular risk after menopause. - Weight and metabolism: shifts toward microbes associated with energy extraction and metabolic inflammation may contribute to midlife weight gain. - Mood and cognition: via the gut–brain axis, microbiome perturbations can influence neuroinflammation, neurotransmitter precursors and affective symptoms reported in midlife. Supporting gut health during menopause Evidence‑based strategies to support a resilient microbiome include dietary diversity (a variety of plant foods and dietary fibers to promote SCFA producers), regular physical activity, minimizing ultra‑processed foods and including fermented or other probiotic‑containing foods alongside prebiotic sources such as onions, garlic and legumes. Where relevant, clinical microbiome assessment and personalized guidance can help tailor interventions — for those interested, a starting resource is the microbiome test. For further context on how nutritional interventions and research projects approach microbiome-driven health solutions see the EU NuTriome initiative (EU NuTriome project) and an accessible primer on gut microbes (what gut microbiota is and why it matters). Summary Menopause and the gut microbiome are linked through hormone‑microbe and microbe‑host pathways that influence metabolic, skeletal and neurocognitive health. Ongoing research will refine causal relationships and intervention strategies; meanwhile, diet, exercise and microbial‑supportive foods remain practical, low‑risk measures to promote gut resilience during the menopausal transition.