Probiotics for Menopause, PMS & Endometriosis: How Your Gut Microbiome Affects Hormone Balance

For years we've been told that hormones are produced by our ovaries and controlled by our brain. Whilst that's true, scientists are now discovering that there's another major player involved in women's hormonal health...

Your gut microbiome.

And I have a very personal story with the positive effect of probiotics in perimenopause and menopause.

The trillions of bacteria living in your digestive system don't just help digest food. They communicate with your immune system, influence inflammation, produce vitamins, manufacture neurotransmitters and even play an important role in regulating oestrogen.

This area of research is exploding, and whilst we're still learning exactly how powerful the gut microbiome is, the evidence suggests that supporting a healthy microbiome may help reduce symptoms associated with PMS, endometriosis and even some of the hormonal changes experienced during perimenopause and menopause.  This was certainly the case for me.

I happened across a probiotic at a work event not long after having a gut parasite that left me with a lot of unlikely and unattractive side effects! I was definitely in perimenopause at this time and only just started to research and understand any of what I’ve included in this blog today.

The outcome of taking a probiotic for a few months?

Healthier and less painful periods (less clotting), reduced gum inflammation, reduced body odour (which the gut parasite created – liver struggling) and reduced hay fever. Taking a specific probiotic was one of the best decisions I’ve made in my menopause journey and why I regularly advise my clients on it as well.

Now science is starting to understand and explain this so I’ve broken it down in today’s blog – Why a probiotic and healthy microbiome will help you have less PMS, reduce Endometriosis and have an altogether better menopause!

Meet Your "Estrobolome" In Hormonal Health

Within your gut lives a collection of bacteria known as the estrobolome.

These bacteria produce an enzyme called β-glucuronidase, which determines how much oestrogen is recycled back into your bloodstream and how much is safely removed from your body. This is important!

When the gut microbiome is healthy and diverse, this recycling system appears to work efficiently, helping maintain healthy hormone balance.

However, when the microbiome becomes disrupted (known as dysbiosis), the balance can shift. Some bacteria produce excessive amounts of β-glucuronidase, allowing more oestrogen to be reabsorbed rather than excreted. This may contribute to what's commonly referred to as oestrogen dominance a state where oestrogen activity outweighs progesterone; something frequently seen during perimenopause.

Symptoms commonly associated with this include:

• Heavy or painful periods

• Breast tenderness

• PMS

• Mood swings

• Bloating

• Fibroids

• Endometriosis symptoms

• Weight gain around the hips and abdomen

  
  

Whilst "oestrogen dominance" isn't an official medical diagnosis, the concept reflects recognised hormonal imbalances that many women experience, particularly during the menopausal transition.

Oestrogen dominance means taking HRT is NOT advised even though you feel you’re in perimenopause. HRT is predominantly oestrogen with progesterone added almost as an afterthought by the NHS. However, at this time Progesterone is what you require but in a natural form as many women have side effects from synthesized progesterone.

The Gut-Endometriosis Connection

Endometriosis affects around one in ten women and has traditionally been viewed purely as a gynaecological condition.

Today, researchers are increasingly recognising it as an inflammatory and immune-related disease in which the gut microbiome may play an important role.

Several systematic reviews have found that women with endometriosis consistently have altered gut and reproductive tract microbiomes compared with women without the condition.

Common findings include:

• Reduced Lactobacillus and Bifidobacterium species

• Lower microbial diversity

• Increased inflammatory bacteria

• Higher activity of β-glucuronidase enzymes

• Greater systemic inflammation

  
  

Researchers believe this combination may contribute to increased oestrogen recycling, chronic inflammation and altered immune responses—all factors known to influence endometriosis.

Whilst probiotics are not a treatment for endometriosis, improving gut health may become an important part of future management and complement any conventional medical care.

One recent randomised pilot trial even found that women taking a specific probiotic strain alongside standard treatment experienced improvements in pain, emotional wellbeing and quality of life, together with reductions in circulating oestradiol levels.

Can Probiotics Help PMS?

Many PMS symptoms aren't caused by high hormone levels—they're caused by how sensitive the body is to hormonal fluctuations.

The gut influences many of the systems involved in PMS because it produces around 90% of the body's serotonin, regulates inflammation and helps control hormone metabolism.

Researchers are now exploring what they call the gut-brain-hormone axis.

When the microbiome is balanced it may support:

• better serotonin production

• lower inflammatory markers

• healthier oestrogen metabolism

• improved bowel function (which also helps eliminate excess hormones)

  
  

Although research specifically on PMS is still emerging, early studies suggest probiotics may reduce menstrual pain, improve mood and reduce inflammatory activity. More large clinical trials are still needed before firm conclusions can be made.

Microbz Women is designed specifically for you whilst you still have a menstrual cycle and include adaptogenic herbs and minerals to support hormone balance at any stage. These include: moringa, valerian root, peony, holy basil, maca root, shatavari root, fennel seed, lady's mantle, korean ginseng, blue cohosh, dong quai, schisandra, shepherd's purse. 

Herbs support a healthy menstrual flow and can reduce clotting and heavy bleeding as well as ease PMS and relieve PMDD.

It also includes the beneficial bacteria: lactobacillus rhamnosus, lactobacillus acidophilus, and bifidobacterium.

A Probiotics Role in Perimenopause and Menopause

During perimenopause, fluctuating hormone levels don't just affect the gut—the gut also affects hormone availability. As oestrogen levels begin to decline, the diversity of the gut microbiome also changes. At the same time, a less diverse microbiome may reduce the body's ability to regulate and recycle oestrogen efficiently.

This creates a two-way relationship:

Hormonal changes alter the microbiome, while changes in the microbiome may influence hormonal symptoms.

A 2025 systematic review found that probiotics may improve:

• hot flushes

• vaginal dryness

• psychological symptoms

• vaginal microbiome health

• overall menopausal symptom scores

Researchers concluded that probiotics appear to be a safe adjunct that may complement other lifestyle measures and, where appropriate, hormone replacement therapy.

Choosing the Right Probiotic to reduce menopause symptoms

Not all probiotics are created equal.

Different bacterial strains perform different functions, so simply buying the cheapest probiotic on the supermarket shelf is unlikely to provide the same benefits as a carefully formulated multi-strain supplement.

One company I've been particularly interested in is Microbz.

Their formulations are built around research into the gut microbiome and include carefully selected strains chosen to support microbial diversity and overall gut health rather than simply providing very high bacterial counts.

What also impressed me is their educational approach. Rather than promising miracle cures, they focus on rebuilding a resilient microbiome through evidence-based science; something that aligns closely with what we currently understand from the research.

For the microbiome to thrive it also needs:

• plenty of plant diversity (aim for 30 different plants/seeds/nuts each week)

• adequate fibre

• fermented foods where tolerated

• good sleep

• regular movement

• stress management

• limiting ultra-processed foods

Probiotics with adaptogenic herbs for hormonal health - Microbz

Advancement In Menopause Research – The Gut Microbiome Link

The science linking the gut microbiome and women's hormones is one of the most exciting developments in menopause research. We now know that the bacteria living inside us influence inflammation, immune function, neurotransmitters and oestrogen metabolism; all of which play important roles in PMS, endometriosis and the menopause transition.

Whilst probiotics won't replace medical treatment, growing evidence suggests that supporting your microbiome may become an important piece of the hormonal health puzzle.

Sometimes looking after your hormones starts by looking after the tiny organisms looking after you.

Did you know: Bacteria has lived for 100s of millions of years without us but we can’t survive 24 hours without bacteria!

Taking a probiotic was my #1 change to improve my perimenopause symptoms. When the trend is that women become more prone to allergies when going through menopause my immunity has gotten better and my lifelong hay fever was gone within the year of taking Microbz.

I recommend:

Microbz Women – if you’re still menstruating / and if heavy periods/ post menopause but still feel you have oestrogen-based symptoms.

Microbz Detox – if you’re experiencing Night sweats or post menopause but have heat symptoms/ mood swings. Taje this one for 3 months and return to other.

Microbz Sustain -  for post menopause and maintaining health. This is the one I’m now on.

Microbz have a range of probiotics depending on your needs plus animal support and cleaning products too. Go chemical free at home cleaning with probiotics!

Meet Andrea

Andrea is a shiatsu and chinese medicine practitioner who uses the principles of chinese medicine in a completely practical way to help you resolve your symptoms naturally and for good. If you live locally you can book in for wonderfully relaxing Shiatsu for Menopause where we start to relieve your symptoms on the same day. Otherwise Andrea does online indepth consultations where you'll leave with an actionable plan to follow. Andrea is also passionate about doing workplace talks and is passionate about getting this message out to as many women as possible: Give your body what it wants to create the hormones that it needs!

References

Baker JM et al. Investigating the effects of probiotics during the menopause transition: A systematic review and meta-analysis. Maturitas. 2025.

Weber I et al. Relationship between the gut microbiome and endometriosis and its role in pathogenesis, diagnosis and treatment: A systematic review. Ginekologia Polska. 2023.

Human Reproduction Open. Microbiome dysbiosis and endometriosis: A systematic scoping review of current literature and knowledge gaps. 2025.

Crestani B et al. Gut Microbiota Alterations and Reproductive Tract Dysbiosis in Endometriosis: A Systematic Review. Medicina. 2026.

López-Moreno et al. Probiotic supplementation improves quality of life and modulates oestradiol in women with endometriosis: a randomised double-blind pilot trial. European Journal of Contraception & Reproductive Health Care. 2026.

Di Pierro F et al. Efficacy of Lactiplantibacillus plantarum PBS067, Bifidobacterium animalis BL050 and Lacticaseibacillus rhamnosus LRH020 in post-menopausal women. 2024.

The Microbz website also provides educational resources explaining the role of the microbiome in overall health and the rationale behind its strain selection, which may be useful background reading alongside the published scientific literature.

KNOWLEDGE . PAUSE . FLOURISH