Fullscript Academy

The human microbiome is a complex community of microorganisms living in and on our bodies, which plays a crucial role in maintaining women’s hormone health. Understanding this intricate relationship can help you better address and manage hormonal imbalances in your patients.

How the microbiome influences hormone health

In women, the microbiome affects everything from hormone levels to menstrual and reproductive health.

Hormone levels

The gut microbiome is integral to hormone regulation. It helps metabolize and modulate hormones, such as estrogen, through the production of enzymes. For example, certain gut bacteria produce beta-glucuronidase, an enzyme that affects estrogen recycling in the body. An imbalance in these bacteria can lead to either an excess or deficiency of estrogen, which can cause estrogen-related diseases like gynecological cancers and menopausal syndrome. (Hu 2023)

Menstrual health

A balanced microbiome supports regular menstrual cycles by maintaining optimal hormone levels and reducing inflammation. Dysbiosis, an imbalance in the microbiome, can lead to irregular periods, premenstrual syndrome (PMS), and even conditions like polycystic ovary syndrome (PCOS). (Siddiqui 2022)

Experiencing PMS or irregular periods could be due to an imbalanced gut or vaginal microbiome. 

Reproductive health

The vaginal microbiome is crucial for reproductive health, producing lactic acid, which inhibits the growth of yeast, bacteria, and viruses, and supporting healthy pregnancy. (Elkafas 2022) Imbalances in the vaginal microbiome can cause conditions like bacterial vaginosis (BV), which is linked to preterm labor, early and late miscarriage, postabortal sepsis (chills, fever, rapid heart rate, and vaginal bleeding after an abortion), and other pregnancy complications. In women who aren't pregnant, BV has been linked to a greater risk of upper genital tract or sexually transmitted infections. (Lamont 2011)

Dysbiosis and hormonal imbalances

Dysbiosis is a disruption in the balance of the microbiome, which can have significant effects on hormonal health. Dysbiosis can be caused by lifestyle factors like poor diet, stress, antibiotic use, and environmental toxins. (Malesza 2021) (McDonnell 2021) (Rosenfeld 2017) (Szczuko 2021) This imbalance can disrupt normal hormonal function, leading to a range of symptoms and conditions. (Elkafas 2022)

Symptoms of microbiome-related hormonal imbalances can include:

• Anxiety
• Depression
• Difficulty losing weight
• Digestive issues, including bloating, constipation, diarrhea, and abdominal pain
• Irregular menstrual cycles
• Mood swings
• Skin conditions like acne or eczema
• Unexplained weight gain or loss (De Pessemier 2021) (Gomes 2018) (Li 2021) (Mukherjee 2023) (Rogers 2016)

Conditions associated with dysbiosis

Numerous conditions involving hormonal imbalance have been associated with an imbalanced microbiome. Some of the most common examples are listed below.

Endometriosis

Emerging research suggests that dysbiosis may play a role in the development and progression of endometriosis, a condition characterized by the growth of endometrial tissue outside the uterus. 30–50% of endometriosis patients struggle with infertility, showing that dysbiosis can directly affect reproductive health through this condition. (Zizolfi 2023)

Dysbiosis has been linked to a number of reproductive issues in women, including infertility and endometriosis. 

Infertility

Both gut and vaginal microbiome imbalances can impact fertility by affecting hormone levels and increasing the risk of infections that compromise reproductive health. (Venneri 2022)

Polycystic ovary syndrome

Dysbiosis is often observed in women with PCOS, contributing to hormonal imbalances that affect ovulation and increase androgen levels. (Zhu 2022)

Premenstrual syndrome

Imbalances in the gut microbiome can exacerbate symptoms of PMS, such as mood swings, bloating, and cramps. One study found that quantities of certain bacteria were significantly higher in women with PMS, particularly Collinsella, whose numbers are affected by diet. (Okuma 2022)

Microbiome testing

Microbiome testing is an essential tool for understanding and managing hormonal imbalances. By analyzing the composition and diversity of the gut and vaginal microbiomes, healthcare providers can identify imbalances and personalize interventions to restore microbial harmony. Testing can provide insights into a patient’s metabolic activity and bacterial diversity, by identifying beneficial and harmful bacteria levels. It can also help detect inflammatory markers that indicate inflammation or dysbiosis.

Stool testing offered by various specialty lab companies offers a comprehensive analysis of gut health. As part of the evaluation, we’re able to measure beta-glucuronidase, an enzyme linked to estrogen recycling in the body, which can impact estrogen dominance—a common concern in conditions like PMS, endometriosis, and breast cancer. (Hu 2023) Stool testing also provides insights into gut inflammation, digestive efficiency, and short-chain fatty acid production, which are crucial for maintaining a healthy microbiome and supporting hormone regulation.

Supporting the microbiome for healthy hormones

Overall, it’s evident that the human microbiome plays a major role in women’s hormone health. Understanding and supporting the microbiome can lead to significant improvements in women's health, promoting balanced hormones, regular menstrual cycles, and overall reproductive well-being. Microbiome testing offers a helpful tool for personalizing patient treatment strategies and achieving better health outcomes.