Most people in menopause (officially defined as the ceasing of menstruation) are familiar with the fact that this life stage is related to a change in hormone levels. Hot flashes, trouble sleeping, digestive issues, changes in mood, anxiety and depression…they’re all connected to changes in progesterone, estrogen, and testosterone levels. But what many don’t know is that a major key to managing many of the symptoms menopause creates lies in the gut. Here’s what people don’t talk about when they talk about menopause: the estrobolome, bacteria and fungi in the gut that influences the estrogen circulating in your system.

It’s such an important topic that two leading hormonal health experts, Mindy Pelz, DC, and Aviva Romm, MD, have devoted sections to the estrobolome in their respective new books, The Menopause Reset ($16) and Hormone Intelligence ($19). “We have trillions of organisms in our gut microbiome, and many of them have specific functions. One set of functions that a specific group [of gut bacteria] has is managing our estrogen metabolism,” Dr. Romm says. This group—of about 60 different types of gut bacteria and fungi—is collectively known as the estrobolome.

Here’s what’s really cool about the estrobolome, according to the experts: We actually have a lot of control over its makeup, which in turn can make menopause symptoms easier to manage. The key, of course, is knowing how to manipulate it.

Inside the estrobolome

A major role of the estrobolome is managing estrogen metabolism. “If you don’t have the type of bacteria and fungi that make up the estrobolome, you will not break estrogen down,” Dr. Pelz says. That’s important, she explains, because if estrogen isn’t broken down and metabolized, it can’t be used to do its jobs, which include contributing to cognitive function, mood regulation, skin and hair health, and even protecting against heart disease.

“What’s even worse is that if estrogen isn’t metabolized, it gets stored in the body, and that’s when estrogen can become toxic,” Dr. Pelz says. “If your cells don’t use it, it’s stored in tissue, and that can lead to cancer. The estrobolome is important because it [transforms] estrogen into its usable form.”

She goes on to explain that there are three major sex hormones that change during menopause: progesterone, testosterone, and estrogen, and that progesterone and testosterone both decline during menopause, while estrogen levels go up and down. “Estrogen levels stay high if you’re not breaking it down, and that leads to menopause symptoms including more anxiety, irritability, anger, and depression,” she says. This can cause a rise in cortisol levels, which in turn can make someone more insulin resistant, causing progesterone and testosterone to tank. “It’s a vicious cycle,” says Dr. Pelz.

Furthermore, doctors and scientists still aren’t exactly sure what happens in the estrobolome during menopause, says Dr. Romm. But what is known is that if your estrobolome is thriving with all the glorious bacteria and fungi that break estrogen down, it won’t cause the tsunami of hard-to-manage symptoms. Just like the microbiome as a whole, the key is maintaining a balance. “An imbalance of the estrobolome happens when there’s a lack of diversity of healthy organisms,” Dr. Romm says. Remember, the estrobolome includes about 60 types of bacteria and fungi—the more types you have the better. Which brings us to the next vital piece of information: how to help your estrobolome thrive.

How to increase the good bacteria and fungi in the estrobolome

If you want to nourish your estrobolome, the best action you can take is to look after your gut health as a whole, according to both doctors. “Eating a wide variety of plants instead of the same ones over and over will really help increase the diversity of the bacteria and fungi,” Dr. Romm says.

The reason why Dr. Romm and Dr. Pelz are such strong advocates of eating a range of plants is because they have fiber, polyphenols, and pre- and probiotics, all of which up diversity in the gut, which includes diversity in the estrobolome. Fruits, vegetables (including fermented vegetables), nuts, seeds, spices, and herbs are all foods that are good for the gut and estrobolome. “You have to feed the good bacteria in your gut to navigate menopause,” Dr. Pelz says. “If you don’t, it’s going to be a rocky ride.”

Meanwhile, Dr. Romm says eating healthy fats is important, too—foods like avocado, fish, nuts, and olive oil are good options. “Healthy fats produce short-chain fatty acids, which help protect the gut lining from inflammation,” Dr. Romm says. If the gut lining isn’t in tact, she says it can lead to digestive issues.

Both doctors says it’s also important to know what foods have a negative effect on the microbiome and estrobolome. You can probably guess the culprits: processed foods and sugar can all kill the types of bacteria and fungi you want in high amounts.

Watch the video below for more tips on what to eat for gut health:

Dr. Romm says that the fact that people in menopause can control their estrobolome through their diet should be encouraging. She says that many people view menopause symptoms as something that’s completely out of their hands that they just have to “deal with,” but that’s absolutely not true. “You can actually change the bacteria makeup in your gut—and estrobolome—quickly too, just in a matter of weeks,” she says, adding that someone should be able to feel the effects of this that quickly as well.

Besides filling up on a diverse range of plant-based foods, Dr. Romm says getting consistent good, quality sleep also has a positive effect on the estrobolome. “When we’re not sleeping well, the microbiome and estrobolome don’t function as well,” she says. This advice can sound like a cruel joke when menopause symptoms are exactly what is keeping many up at night, and because of this, her advice is to do the best you can and not to obsess too much.

The estrobolome shows just how real and important the gut-hormone connection is and having this information is a vital tool for managing menopause. Neither expert sees menopause as something to fear or dread; it’s just a stage of life. Now that you know how to show your estrobolome some love, it will help make navigating it easier. Or, as Dr. Romm puts it: “It really can be as simple as eating more plants!”

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