The Role of the Gut in Hormone Balance

Updated: Apr 26

One surprising fact that you may not know is that your hormones and your menstrual cycle are influenced by your gut, specifically the balance of bacteria called the microbiome. In this article we will be speaking specifically about estrogen, although the gut microbiome also impacts thyroid hormones, testosterone, progesterone, insulin and cortisol.

One thing that I learned years ago, is that the quickest way to get relief from annoying PMS symptoms such as bloating, irritability, acne, mood swings, food cravings and more, is to go straight to the gut flora first. And now, we have lots of evidence to back up the mechanism about how it works.

How the gut microbiome regulates estrogen

Let’s start with the pathway that your body uses to clear out estrogen, when all systems are functioning optimally:

  1. Estrogen is first sent to the liver where it is deactivated.

  2. It then passes into bile to be excreted into the intestines.

  3. Estrogen ideally stays inactivated, where it then exits the body though the stool.

When the gut microbiome is out of balance, certain bacteria which are now termed the “estrobolome” produce an enzyme called beta-glucuronidase that reactivates estrogen so that it goes back into circulation. Similarly, if you are chronically constipated estrogen is not being eliminated very effectively and is also being reabsorbed. Both of these situations create an excessive load of estrogen.

What happens when estrogen is out of balance

When estrogen is out of balance, and specifically being recirculated, we end up with an excess of estrogen, also called estrogen dominance that can cause many symptoms of hormone imbalance: heavy periods, painful periods, difficult PMS, breast tenderness, bloating and weight gain. It can also contribute to the long-term risk of conditions such as uterine fibroids and breast cancer.

How the microbiome gets out of balance

Our gut microbiome gets out of balance quite easily, from poor nutrition (excess sugar, processed foods, gluten and dairy), eating GMO foods, regular alcohol intake, frequent use of antibiotics (even if it was in early childhood), chronic high stress levels, and even the use of oral contraceptives.

I would extend this to say that almost 100% of us have an imbalance in our microbiome that is passed on generationally, and I’ve written several times about how these imbalances are associated with so much more than digestion: weight, skin, mood, behaviour, energy, pain, autoimmunity and more.

Steps to create balance in the gut

The good news is that there are many ways you can create balance in the gut microbiome to help your estrogen metabolism.

Here are a few:

  1. Eat more vegetables and increase fibre intake: Fibre from vegetables especially helps to create a healthy microbiome, and reduce beta-glucuronidase activity.

  2. Reduce sugar and alcohol, both of which negatively affect your microbiome and how you clear out estrogen.

  3. Take a probiotic: Even simple probiotics such as Lactobacillus acidophilus can improve your estrogen metabolism by decreasing the activity of bega-glucuronidase.

  4. Get help with clearing out the ‘bad bugs’ – yeast, bacteria and parasites. With the right nutrition plan, anti-microbial supplements and a good probiotic we can very easily restore balance to the gut microbiome in a way that can profoundly help your hormone balance.

The bottom line

The take-home message from this short article is that your hormone balance is much more than what the amount of estrogen that your ovaries produce. The way you clear and eliminate estrogen makes a huge impact on your hormonal health and symptoms. If you’re struggling with any condition associated with estrogen dominance: heavy periods, painful periods, endometriosis, PCOS, breast cancer, uterine fibroids, hormonal acne, difficult PMS – don’t forget to look at the gut!

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