Gut Health & Midlife: The Missing Link Behind Hormones, Mood, and Energy
What you are experiencing is not just a gut feeling; it’s physiology
Twenty-five years ago, I ran my first Women’s Health Workshops in Denmark — while raising small children and working on my PhD. At that time, estrogen was described mainly as a sex hormone — the molecule that orchestrated menstrual cycles, fertility, and reproduction.
But science is rewriting that story.
We now know that estrogen is a whole-body hormone, influencing nearly every organ system — not just the ovaries and uterus, but also the brain, heart, bones, muscles, skin, immune system, and gut.
It’s not just our hormones that are changing in midlife — it’s the way our whole body communicates.
This is why midlife can feel so unpredictable. As estrogen begins to fluctuate, many women experience a mix of physical, emotional, and cognitive changes that seem unrelated — until we zoom out and see the common thread: the gut.
The Estrogen–Gut Connection
Before menopause, estrogen quietly helps your gut thrive.It supports microbial diversity, keeps the gut barrier strong, and helps calm inflammation.
During perimenopause, those rhythms begin to shift. As estrogen rises and falls unevenly like a rollercoaster, the gut microbiome seems to mirror that instability.
In simpler terms:
Hormonal fluctuations disrupt gut balance.
Gut imbalance alters hormone metabolism.
Both feed inflammation, creating a feedback loop that affects mood, metabolism, and energy.
What We Know — and What We’re Still Learning
Over the past decade, we’ve learned a lot about the conversation between estrogen and the gut microbiota but it’s still an evolving field with some puzzle pieces missing.
We know that:
Certain gut bacteria (the estrobolome) help recycle and regulate circulating estrogens.
The loss of microbial diversity during perimenopause is linked to greater inflammation and more intense symptoms.
The gut–brain axis connects microbial activity with mood and cognitive function (more about this in an upcoming blog).
What we don’t yet fully know is how strong these links are, or whether specific changes in the gut actually cause particular symptoms of perimenopause.
But even with some mysteries left to solve, our understanding offers valuable clues about how our everyday choices like the food you eat, how you move, rest, and manage stress can support a more balanced, resilient midlife.
The Remarkable Gut
Here’s the good part: the gut is remarkably adaptable.
Even though our hormones may be less gut supportive in midlife, we have the opportunity to counterbalance this. Within days to weeks, your microbiome can begin to rebalance when given the right support.
As always, there’s no need for drastic cleanses or perfection, just consistent, nourishing choices that stabilise both your gut and your hormones.
Try some of these gentle shifts:
Feed your microbes Eat a colourful variety of plants: vegetables, fruits, pulses, nuts, seeds, and whole grains.
Add fermented foods Kefir, yogurt, miso, sauerkraut, or kimchi help replenish beneficial bacteria.
Manage stress Breathing, walking, or yoga lower cortisol, which otherwise disrupts gut balance.
Prioritise sleep Deep rest allows the gut lining to repair and inflammation to calm.
Move daily Physical activity boosts circulation to the gut and supports metabolic flexibility.
Small steps, done regularly, truly matter.
To Wrap It Up
What you are experiencing is not just a gut feeling; it’s physiology. Your gut is not a bystander in midlife- it’s a key player. By nurturing it, you’re supporting hormone balance, calming inflammation, and rebuilding emotional steadiness from the inside out.
For more support, guidance and tools, you can also explore our services, including our Feasting while Fasting Program that helps to reset your gut, balance hormones and boost your mood-all in 5 days. We start again on Nov 16.
With health and happiness,
Dr. Malin Garemo
Registered Dietitian (MSc), PhD (Nutrition)
