Prebiotics and probiotics have something to prove in menopause research

Prebiotics and probiotics hold promise for alleviating menopause symptoms, a recent review asserted. But even with the decades of research in the field, the science is still too immature, the authors concluded. 

This new study was published in the journal Post Reproductive Health. It was conducted by a team of researchers from the University of East Anglia in the UK.

The researchers pointed out that there are differences in the diversity of gut microbiota between men and women, so large-scale studies that only target men or both men and women may lead to incomplete conclusions.

For instance, they mentioned that "a large-scale cohort study of adults from four geographical regions showed that young adult women had greater diversity of gut microbiota than young adult men, but this difference was less pronounced in middle-aged adults."

Similarly, another study found that "the gut microbiota of premenopausal and postmenopausal women differ, with the gut microbiota of postmenopausal women being more similar to that of men of the same age," the new paper stated.

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Changing levels of estrogen play big role in gut microbiome makeup 

The interplay of estrogens that have passed through the liver and into the gut have a big role in the microbiome differences between men and women, the authors said. And the decreasing levels of estrogen during menopause might be one of the reasons why older women’s guts start to resemble those of men of their same age. 

“Menopause significantly impacts gastrointestinal health, influencing appetite regulation, weight management and digestion, all of which are linked to hormonal changes during this stage,” the authors observed. 

The authors noted that both prebiotic and probiotic ingredients have shown promise in positively altering the gut microbiome makeup. To discern how these changes might help menopausal women, the authors assessed 10 studies on prebiotics, seven of which were done on humans. 

The prebiotic interventions in those studies ranged from vegetables (an unspecified addition of 400 grams a day to the diet), flax seeds, corn fiber, black currants and prebiotic-rich yogurt. 

Changes in the prebiotic studies included reduced hot flashes, better maintenance of bone mineral density and a reduction in anxiety and depression, among other observed effects. 

The researchers also looked at six probiotic studies, four of which were done in humans. Among the probiotics assessed were Lactobacillis gasseri CP2305, Levilactobacillus brevis KABP052, Lactobacillus rhamnosus GR-1, Lactobacillus reuteri RC-14, and a multispecies probiotic intervention.   

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The probiotic intervention measures were associated with improvements in urogenital health status and the enhancement of the simplified menopause index score, among other results. The prospects are encouraging but are not yet sufficient to recommend.

Although the results are encouraging, the authors stated that the evidence is not yet fully persuasive. Many women seeking symptom relief are not suitable for hormone replacement therapy (HRT), which is usually the preferred treatment method.

The authors stated that there are still too many unknown factors in the research on prebiotics and probiotics, so they cannot recommend them to patients.

The authors concluded: "Although the emerging evidence indicates that the gut microbiota plays a role in regulating hormone balance and may affect menopausal symptoms, there is still a lot of work to be done to clarify these mechanisms and determine effective interventions based on the gut microbiota. Prebiotics and probiotics provide promising non-hormonal treatment approaches for alleviating menopausal symptoms (such as hot flashes, inflammation, and metabolic symptoms); however, their role in regulating microbial diversity and the relief of menopausal symptoms related to the microbiota still need further exploration."

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Special issue on women’s health 

For more information on the science and marketing behind women’s health supplements, check out SupplySide Supplement Journal’s special digital magazine on the subject.