The women that I work with most often complain about two main areas — their menstrual health and their gut health. If we consider the gut as a hub of activity in our body that impacts all of the other systems, it’s easy to see how the menstrual cycle could be effected by the gut health. Collections of bacteria live all throughout our body, with distinct compositions and functions, constituting what is termed the human microbiota (Fernandez et al., 2018). Balanced gut health ensures that what we consume is broken down and used properly. This includes everything from food-stuffs to hormones.
The Gut Microbiome
The gut microbiota is a community of microorganisms — fungi, bacteria, and viruses — that make their home in the gastrointestinal tract (Chen & Madak-Erdogan, 2016). The microbiome is comprised of all the genetic material of the microbiota that make their home in the gut (Fernandez et al., 2018). Balance here is essential to the maintenance and health of the intestinal lining, so the composition of the microbiome in the gut is important in producing the right environment (Baker et al., 2017).
Life in our bodies is varied and vast. The constellations of bacteria that make their home inside of us not only interact with our bodies, but also help guide a number of functions of our health and wellness. In symbiosis with the human body, the gut microbiota assist with (Chen & Madak-Erdogan, 2016):
- Fermentation of dietary fibre
- Nutrient digestion and absorption
- Protection against pathogens
- Metabolism of exogenous and endogenous compounds (Fernandez et al., 2018)
Estrogen is a steroid hormone that has a number of roles in the body, and may interact with the gut microbiome to influence metabolism, weight gain, and distribution of fat in the body (Chen & Madak-Erdogan, 2016). While estrogen-like compounds get metabolized by the microbiota, some of those same compounds feed certain kinds of bacteria (Chen & Madak-Erdogan, 2016) that comprise the estrobolome (Baker et al., 2017). The gut microbiome secretes a specific enzyme that allows estrogen to bind to receptors, thus impacting estrogen levels and resulting in a biologically active compound that exerts various effects on the body (Baker et al., 2017).
Some of the estrogens that are metabolized are called phytoestrogens. Phytoestrogens such as quercetin and resveratrol might support the suppression of inflammation, prevention of oxidative stress, and metabolism and detoxification of carcinogenic substances (Chen & Madak-Erdogan, 2016). They are first metabolized by enzymes released in the gut, and are thus able to activate genes and exert epigenetic effects that have an impact on both reproductive health and neural development (Baker et al., 2017). There are several types of estrogen receptors, and phytoestrogens bind to the weak ones and, in effect, prevent other estrogens that could be potentially harmful from binding (Baker et al., 2017).
We have seen that balance in the gut and estrobolome is essential, so what happens when the gut gets thrown out of balance? Dysbiosis is the term for this imbalance, and it is characterized by low diversity of gut bacteria and ratios of specific bacteria that have a number of negative outcomes (Baker et al., 2017).
- Low diversity resulting from imbalance leads to inflammation and gut permeability (Baker et al., 2017)
- Can lead to increased levels of circulating estrogens due to low gut diversity, which is associated with increased risk of breast cancer (Fernandez et al., 2018)
- May result in low circulating estrogen, which may be a primary influence of obesity (Baker et al., 2017)
- Can result in dysfunction in the estrobolome, leading to inflammation and insufficient metabolism of estrogen (Baker et al., 2017)
5 Ways to Support Gut Health (and overall wellness)
When it comes to the menstrual cycle, gastrointestinal symptoms are a common complaint prior to menstruation (Bernstein et al., 2014). During the luteal phase, symptoms of chronic disease may worsen and result in bloating, PMS, or disruptions in sleep (Draper et al., 2018).
- Eat lots of fibre! Remember that the bacteria in the gut help to create an optimal environment for supporting the intestinal lining. Some of the bacteria in the gut produce Short chain fatty acids (SCFAs), and specifically a metabolite called butyrate (Baker et al., 2017). This substance is like food for the epithelial cells of the gut lining, and supports it further by offering anti-inflammatory and immunomodulatory effects (Baker et al., 2017).
- Eat different kinds of plants. Diversity in the diet leads to diversity in the gut microbiome, and this results in both a lot of diverse kinds of enzymes that can then contribute to the balance and health of the gut microbiome (Baker et al., 2017).
- Eat phytoestrogens. Consumption of phytoestrogen has been shown to reduce the risk of cancer in bodily tissues, reduce the risk of lung cancer, and lower risk of breast cancer (Baker et al., 2017)
- Eat probiotic foods. Choose foods and supplements with the bacteria named Lactobacillus and Bifidobacterium. Using probiotics (to support the development of bacterial colonies) as well as prebiotics (the substances that feed bacteria), can help with weight gain, leaky gut, and inflammation caused by obesity (Chen & Madak-Erdogan, 2016).
- Eat serotonin boosting foods. It is possible that serotonin may mediate symptoms like depression, pain, and gut motility (Bernstein et al., 2014). The changes that occur with serotonin in the luteal part of the menstrual cycle are associated with symptoms of PMS like increased appetite, cravings, and increased food consumption (Draper et al., 2018).
- Eggs, pineapple, organic soy, salmon, nuts and seeds, turkey
Baker, J. M., Al-Nakkash, L., & Herbst-Kralovetz, M. M. (2017). Estrogen–gut microbiome axis: Physiological and clinical implications. Maturas, 103, 45-53. http://dx.doi.org/10.1016/j.maturitas.2017.06.025
Bernstein, M. T., Graff, L. A., Avery, L., Palatnick, C., Parnerowski, K., & Targownik, L. E. (2014). Gastrointestinal symptoms before and during menses in healthy women. Alimentary Pharmacology and Therapeutics, 36(2), 135-144. https://doi.org/10.1111/j.1365-2036.2012.05155.x
Chen, K. L & Madak-Erdogan, Z. (2016). Estrogen and microbiota crosstalk: Should we pay attention? Trends in Endocrinology & Metabolism, 27(11), 752-755. doi: 10.1016/j.tem.2016.08.001.
Draper, C. F., Duisters, K., Weger, B., Chakrabarti, A., Harms, A. C., Brennan, L., Hankemeier, T., Goulet, L., Konz, T., Martin, F. P., Moco, S., & van der Greef, J. (2018). Menstrual cycle rhythmicity: Metabolic patterns in healthy women. Nature, 8, 1-15. DOI:10.1038/s41598-018-32647-0
Fernandez, M. F., Reina-Perez, I., Astorga, J. M., Rodriguez-Carrilo, A., Plaza-Diaz, J., & Fontana, L. (2018). Breast cancer and its relationship to the macrobiotic. International Journal of Environmental Research and Public Health, 15(8), 1-20. .doi: 10.3390/ijerph15081747.