Understanding the role of the gut-hormone axis in women’s health

Women’s health and how it can be supported is a hotly debated topic. A new survey from Yakult has found that over 80 per cent of women would like to learn more about how their gut health can impact their overall wellbeing

The research reveals that while 91 per cent recognise the importance of gut health, there is a significant gap in knowledge as nine in 10 women have never heard of the gut-hormone axis. This includes the bidirectional relationship between the gut microbiome and female sex hormones, namely oestrogen and progesterone.

Levels of these hormones fluctuate across various female life stages including during periods, pregnancy, perimenopause and menopause. With the right guidance and information, women can take steps to help support their gut health and ease some of the symptoms associated with these phases.

The Yakult survey found that nearly half (46 per cent ) of women were more likely to have gut issues such as loose stools, constipation and stomach aches during their period. These symptoms are in fact often due to fluctuating oestrogen and progesterone levels.

To help raise awareness about the gut-hormone axis, Yakult has partnered with Dr Mary McCreery, registered dietitian nutritionist. She provides expert tips on how looking after your gut can be a vital tool in helping to maintain a healthy lifestyle throughout the female lifecycle.

The team at Yakult also shares the science behind the changes in women’s gut health over the years and some useful gut health tips to support women during these different phases of their lives.

The menstrual cycle

Periods brings about clear changes to consistency and frequency of stool due to fluctuating levels of the hormones oestrogen and progesterone.

The Yakult survey found that almost half (45 per cent ) of women experience loose stools during their period compared to just 11 per cent during the week of ovulation. Additionally, a third (33 per cent ) also suffer with gas during their period, while only 15 per cent experience it during ovulation. And over a third (34 per cent ) experience bloating during the luteal phase, when the body prepares for pregnancy or the next period.

Throughout the cycle, oestrogen and progesterone levels fluctuate. During the follicular phase (ie, from start of period to ovulation ), these hormones gradually rise, which can slow bowel movements and lead to constipation, gas and bloating for some women. Conversely, during luteal phase (ie, from ovulation to start of period ), oestrogen and progesterone levels will drop and prostaglandins - a group of lipids with hormone-like actions - will rise if the egg remains unfertilised. Collectively, this can cause diarrhoea, cramping and increase pain sensitivity just as bleeding begins. This is where the term “period poop” comes from.

The science

Sex hormone receptors are located in gastrointestinal cells. Fluctuating levels of hormones, specifically oestrogen and progesterone, can be responsible for recurring changes to gastrointestinal function and symptoms throughout the menstrual cycle as both affect the movement of food through the gut. This can manifest as different gastrointestinal symptoms during distinct phases of the menstrual cycle.

“Despite the fact that the majority of women notice changes in their gut while they are on their period, many do not connect these hormone changes with gut health and the potential role it could play in alleviating some of the uncomfortable symptoms," Dr McCreery said. "While gut changes are normal throughout the menstrual cycle, an imbalanced gut could affect sex hormone levels, impacting oestrogen regulation. Recurring changes in the gut microbiome can impact oestrogen levels as gut health and microbial diversity can influence excretion and recirculation of oestrogen, therefore impacting overall hormone balance. Prioritising gut health may help to alleviate some of the uncomfortable symptoms many women experience.”

Support the gut through simple lifestyle changes including enjoying a diverse diet, regular exercise and keeping hydrated. Surprisingly, only a third (36 per cent ) of women have tried eating a more diverse diet to help support their gut. The different gut bacteria thrive on various ‘types’ of plant fibres, so it’s good to change it up with a diverse range of dishes. For example, try adding items such as tins of mixed beans to warming curries, Bolognese, and soups, to boost your intake. These little additions here and there can help boost our plant food intake and in turn, help make for a happier gut.

Get quality sleep and manage stress through techniques such as mindfulness. Sleep is important for gut health as it is linked to increased gut bacteria, as well as reducing the stress hormone, cortisol. Poor sleep quality and length is associated with an increase calorie intake (500+ extra kcals/day ) and a heightened craving for lower fibre, higher sugar foods, which don’t benefit our gut health.

As cycles and symptoms including type, duration, severity, will vary between women, it could be helpful to track gut symptoms while tracking your menstrual cycle to better understand individual cyclical changes and how they impact our gut health - knowledge is power!

 

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