The Gut Microbiome, Menopausal Shift & Aging

I absolutely love the work that I do with gut health. Far beyond its role in digestion, the gut is a complex and dynamic ecosystem that impacts nearly every aspect of our well-being, from immunity to brain function. When we think of peri-menopause and menopause, we don’t usually think of the gut, but we should because emerging research has identified the gut microbiome as a significant player in these hormonal changes, influencing everything from oestrogen balance to inflammation and overall aging. This blog delves into the role of the gut microbiome during this period of change and explores the potential of CoQ10, melatonin, and N-acetylcysteine (NAC) in supporting gut health, aging, and hormonal balance.

The Gut Microbiome and Menopause

Research has increasingly shown that the composition and function of the gut microbiome change significantly during peri-menopause and menopause, influencing the aging process and overall health.

During this time, the natural decline in oestrogen levels can alter the gut microbiome’s balance. For example, studies have found that postmenopausal women tend to have lower levels of beneficial bacteria like Roseburia (which produce butyrate, an anti-inflammatory short-chain fatty acid) and higher levels of potentially harmful bacteria like Tolumonas, which are associated with adverse metabolic outcomes. Additionally, lower levels of Faecalibacterium in menopausal women are thought to be linked to hormonal changes, particularly the reduction in oestrogen levels.

Studies have also observed that postmenopausal women often exhibit lower levels of Akkermansia muciniphila, compared to premenopausal women. This decline in Akkermansia is linked to a reduction in gut barrier integrity and an increase in systemic inflammation, both of which are commonly observed during menopause. Additionally, low levels of Akkermansia are associated with an increased risk of metabolic disorders such as insulin resistance, obesity, and dyslipidemia.

These shifts in microbial populations can contribute to increased inflammation, a common feature of aging, and have been linked to various menopause-related symptoms and conditions, such as weight gain, cardiovascular disease, and osteoporosis.

The gut microbiome also has a very direct influence on oestrogen metabolism. Certain bacteria, such as those with beta-glucuronidase activity, can convert oestrogen from its inactive to its active form, impacting circulating oestrogen levels in the body. This can potentially increase the risk of oestrogen-related cancers, such as breast, ovarian, and endometrial cancers. This is because high levels of active oestrogen in the body can promote the growth of hormone-sensitive tissues and contribute to the development and progression of these cancers.  This makes ascertaining levels of beta-glucuronidase a consideration before starting hormone replacement therapy to ensure that you are detoxing hormones efficiently.  Simple interventions like taking calcium-d-glucurate can help.

It is possible to asses these bacterial populations and beta-glucuronidase activity with the GI Map profile (apart from Tolumonas).  This can make it an essential tool for any functional nutrition protocol for peri-menopause, menopause and aging in general.

CoQ10, Melatonin, and NAC – influence on the gut microbiome, hormones and aging

To mitigate the negative impact that these hormonal changes can have on the microbiome and to support healthy aging, researchers are increasingly exploring the potential of specific supplements to influence the gut microbiome, hormones, and aging processes. Three very cool candidates are CoQ10, melatonin, and N-acetylcysteine (NAC).

Coenzyme Q10 (CoQ10)

CoQ10 is a fat-soluble antioxidant naturally found in the body, particularly in the mitochondria, where it plays a critical role in energy production. As we age, CoQ10 levels decrease, which may contribute to the signs of aging and decreased cellular function.

• Impact on the Gut Microbiome: Studies have shown that CoQ10 supplementation can positively affect the gut microbiome. CoQ10 has been found to increase beneficial bacteria such as Ruminococcus and Lachnospiraceae AC 2044 group, which are involved in the fermentation of dietary fibres into short-chain fatty acids (SCFAs) like butyrate. These SCFAs are crucial for maintaining gut health, reducing inflammation, and supporting the gut barrier’s integrity. By promoting a healthy gut microbiome, CoQ10 may indirectly influence oestrogen metabolism and other hormonal processes, potentially alleviating some menopausal symptoms.
• Impact on Aging and Hormones: As a potent antioxidant, CoQ10 helps protect cells from oxidative stress, a key driver of aging. By enhancing mitochondrial function and reducing oxidative damage, CoQ10 may slow down the cellular aging process. Additionally, CoQ10 supplementation has been shown to improve ovarian reserve, egg quality, and overall reproductive health, suggesting it may help maintain hormonal balance.

Melatonin

Melatonin is a hormone primarily known for regulating sleep-wake cycles. However, its role extends far beyond sleep, acting as a powerful antioxidant and anti-inflammatory agent. Melatonin levels naturally decline with age, which can impact both sleep quality and overall health.

• Impact on the Gut Microbiome: Melatonin has been shown to influence the composition of the gut microbiome. Research indicates that melatonin supplementation can increase the abundance of beneficial bacteria such as Lactobacillus and Bifidobacterium, which are known to support gut barrier function, modulate the immune system, and produce SCFAs. These effects help maintain a balanced gut microbiome, reduce inflammation, and enhance the production of beneficial microbial metabolites that can support hormonal health.
• Impact on Aging and Hormones: Beyond its impact on sleep, melatonin’s antioxidant properties help reduce oxidative stress and protect cellular health, which is particularly important during aging. Studies have demonstrated that melatonin can increase oestrogen levels and improve ovarian function in aging models.

N-Acetylcysteine (NAC)

N-acetylcysteine (NAC) is a precursor to glutathione, one of the body’s most important antioxidants. NAC is widely used for its ability to reduce oxidative stress and inflammation, both of which are central to aging and age-related diseases.

• Impact on the Gut Microbiome: NAC supplementation has been shown to positively impact the gut microbiome by increasing the abundance of beneficial bacteria like Akkermansia and Bifidobacterium while reducing harmful bacteria such as Desulfovibrio. These changes can help restore the gut’s microbial balance, reduce inflammation, and maintain gut barrier integrity, all of which are crucial for managing menopause-related symptoms.
• Impact on Aging and Hormones: As an antioxidant, NAC helps to reduce oxidative stress and inflammation, protecting ovarian and other tissues from age-related damage. In studies on reproductive aging, NAC has been shown to improve oocyte (egg) quality, increase the number of viable eggs, and enhance overall reproductive outcomes, suggesting it can help maintain hormonal health during menopause. Additionally, by supporting a healthy gut microbiome, NAC may indirectly influence oestrogen metabolism and other hormonal processes.

Taking a holistic approach

I continue to find the intersections between the gut microbiome, menopause, and aging fascinating. I wrote a blog earlier this week on oestrogen and depression but decided to post this one first. The thought that we can investigate these imbalances and then modify them through nutritional intervention and targeted supplementation is really exciting.