Abstract This review synthesizes current evidence linking alterations in the gut microbiome to menopausal transition. The gut microbiota plays a crucial role in numerous physiological processes, particularly due to its bidirectional communication with the brain via multiple neural, endocrine, and immune pathways. Menopause-associated oestrogen decline disrupts this axis, influencing not only gastrointestinal function and microbial diversity but also mood, cognition, and inflammation. The estrobolome is a community of gut bacteria capable of modulating circulating estrogen levels. Taken together, research suggests a complex dynamic interplay between the intestinal microbiota and sex hormones, potentially contributing to menopausal symptoms and related comorbidities. Understanding these interactions offers promising avenues for intervention, as dietary strategies (such as isoflavones), lifestyle modifications, and targeted probiotic and prebiotic therapies may help restore balance within the gut-brain axis and optimize brain health by influencing neurotransmitter synthesis, stress responses, and hormonal regulation during and after the menopausal transition. Here, we highlight the importance of an integrative, microbiome-informed approach to midlife women’s health, emphasizing innovative, non-pharmacological strategies to promote long-term well-being in women.
Cuozzo et al. (Wed,) studied this question.