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Can Probiotics Help Menopause Symptoms?

Menopause marks a significant change in every woman’s life. It comes with a wide array of sometimes uncomfortable symptoms and emotions.

Fact checked by Nattha Wannissorn

It also comes with some invisible physical changes you may not have previously considered – in your gut.

Probiotics are known for their beneficial effects on the gut, so could they help menopause symptoms, too?

This article will explore what is happening in your gut as you go through “the change” and whether probiotics may be something you want to try. 

How Does Your Gut Flora Change During Menopause?

Your gut microbiota, comprised of trillions of microorganisms, is dynamic and constantly changing. Its composition changes based on:

And, yes, your hormones. During menopause, your ovarian function starts to slow down, causing your estrogen levels to fluctuate. Conversely, your gut flora affects your hormonal function, processing, and elimination. It’s a dance of both. 

A study explored the relationship between estrogen levels and gut microbiota. Researchers grouped 26 women into low, medium, and high hormone levels. 

Women with the highest estrogen levels had the most diverse microbiota, while those with the lowest estrogen levels had the least diverse microbiota.

Gut microbiota diversity is crucial because it makes your gut flora naturally more powerful at keeping unfriendly bacteria at bay, preventing dysbiosis.

Let’s take a closer look at the major bacteria that are changing. A meta-analysis of three studies found certain bacteria increasing with menopause. Compared to premenopausal women, postmenopausal women have higher bilophila and odoribacter bacteria levels. 

Bilophila bacteria produce hydrogen sulfide gas in the gut. With an increase in bilophila after menopause, too much hydrogen sulfide gas in the gut can cause swelling, gut discomfort, and damage to the gut lining. 

This damage increases the presence of bacteria parts called endotoxins in the blood. Endotoxins can stimulate the immune system, increasing physical discomfort and worsening some menopause symptoms. 

The immune stimulation can also lead to increased osteoclast activity. Osteoclasts are responsible for breaking down old bones so that you can form new bones, which is essential for strong and healthy bones. When osteoclasts work too much, they can weaken and thin out the bones.

Increased odoribacter bacteria in postmenopausal women increase both short-chain fatty acids (SCFAs) and hydrogen sulfide. These are typically good and bad, respectively.

SCFAs are very beneficial postbiotics, such as:

  • Helping the mitochondria burn fat for energy
  • Regulating mood and brain function 
  • Supporting bone building through insulin-like growth factor-1

On the other hand, like bilophila, odoribacter bacteria produce a lot of hydrogen sulfide gas, which is bad. Overall, with both positive and negative effects of odoribacter, the total effects are unknown.

Understanding how your gut microbiota changes during menopause helps us understand how important the connection between hormones and your gut is. Can you support a healthy, balanced gut during menopause? Let’s take a look at the role probiotics may play.  

Can Probiotics Help Manage Menopause Symptoms?

The importance of probiotics to menopause-related symptoms may stem from something called the estrobolome. They are a group of gut microbes that process estrogen. When your gut is healthy, the estrobolome can maintain homeostasis, or balanced, estrogen. 

Dr. Sara Szal Gottfried, MD, says that there are four steps that influence your hormone functions: production, transport, signaling, and destruction. Normal blood tests typically only measure produced hormones being transported in your blood. 

You can have estrogen metabolites that are not detected by blood tests, so it’s possible to test low for estrogen but have estrogen dominance symptoms. 

Some estrogen metabolites processed or destroyed by your gut bacteria may also not show up on tests, but they exist and affect your health. State-of-the-art tests, such as DUTCH, look at several hormone metabolites, including harmful ones. 

An unhealthy gut flora, therefore, could lead to too much or too little estrogen and contribute to estrogen-related issues. 

Therefore, probiotics can be tremendously helpful as part of your overall health plan to support your hormone balance and wellness during this transition. 

But because menopause can be complicated and individual, probiotics will not be an end-all-be-all for menopause self-care.

Hot Flashes

Hot flashes are one of the most tell-tale signs of menopause.  These vasomotor symptoms can occur day or night. While the reason why hot flashes happen isn’t fully understood, we do know that they come with the hormonal fluctuations of menopause. 

A large study of 3,302 women monitored hot flashes and blood hormone levels over five years. Women were more likely to experience hot flashes with lower levels of estrogen and higher FSH, indicating they were in perimenopause or menopause. 

Probiotics, particularly those in the Lactobacillus genus, benefit women experiencing hot flashes.

A study of 80 women explored the benefits of Lactobacillus gasseri on mild menopause symptoms. Over six menstrual cycles, participants consumed Lactobacillus gasseri daily and tracked their symptoms using two questionnaires. 

75% of women taking the probiotics experienced significant relief from hot flashes compared to 55% in the placebo group.

In a separate study involving 67 women with perimenopausal symptoms, participants took 100 million CFU of Lactobacillus acidophilus once daily for 12 weeks. Their symptoms were monitored using a menopause quality of life survey.

The group taking the probiotics reported a 66% overall improvement in menopausal symptoms, including hot flashes, compared to a 37% improvement in symptoms among those who did not.

Researchers theorize that probiotics may work in a couple of ways to help minimize hot flashes. Autonomic nerves control the body’s temperature and become imbalanced during menopause. One way probiotics may help is by affecting the activity of the nerves and reducing symptoms.

Another way probiotics may help is by enhancing the effects of a neuropeptide called calcitonin gene-related peptide microbiota (CGRP). Neuropeptides such as CGRP spread throughout the gut-brain system and facilitate communication between the gut and the brain.

Probiotics might work within this system to strengthen the effects of CGRP. By relaxing blood vessels, substances like CGRP may help regulate body temperature. This potentially alleviates the intensity and frequency of hot flashes experienced during menopause.


Sleep can become more challenging as you age, partly due to hormonal changes. In fact, 85% of postmenopausal women report struggling with sleep. [R7] However, there’s limited research on the effects of probiotics on sleep quality. 

One study investigated this by having 66 women consume 100g of probiotic-rich yogurt daily after lunch for six weeks. There were no noticeable effects on sleep. Nonetheless, the participants did experience a significant reduction in stress levels. [R7]

Since stress commonly disrupts sleep, managing it could lead to better sleep quality. Although this study did not demonstrate an improvement in sleep, researchers need to conduct further studies to investigate the relationship between probiotics and sleep quality. 

It may also be that taking probiotics for just six weeks isn’t long enough to significantly improve sleep. 

You may also want to consider taking a supplement like Sleep Breakthrough.

Mood and Wellbeing

As a woman, you already know how strongly and sneakily hormones can affect your mood. Researchers are still discovering how probiotics can influence your mental health. They even have a special name – psychobiotics

Psychobiotics deliver their benefits via the gut-brain axis. Here are some ways we know they can help:

  • Producing neurotransmitters that work through your gut neurons to influence your brain
  • Balancing inflammation and oxidative stress, which can cause bad mood
  • Communicating with your brain via the vagus nerve

A meta-analysis of 15 studies examined the effects of probiotics on mood. Overall, researchers concluded that taking multiple strains of probiotics was most effective in improving mood. 

They also found that taking them as pills or tablets rather than liquid yielded better results. Age also made a difference, with the greatest improvement in those under 60.

The same study above of 66 women unable to find an effect for sleep did find a significant improvement in mood. Participants eating 100g of yogurt containing probiotics daily with lunch reported improved quality of life.

Another study explored the effects of Lactobacillus gasseri on menopause symptoms. Researchers monitored the psychological symptoms of 80 women while they took probiotics for six consecutive menstrual cycles. 

Women experienced significant improvement in occasional psychological symptoms, including:

  • Irritability
  • Sadness
  • Sleep troubles
  • Dizziness

Vaginal Health

While you may think about probiotics as supplements for gut health, they have also proven helpful for vaginal health. Estrogen, gut bacteria, and your vaginal bacteria are tightly linked. 

Estrogen helps keep the female reproductive tract healthy by controlling certain factors like:

  • Thickness of tissue lining
  • Glycogen levels – important for good bacteria growth
  • Mucus production
  • Lowering vaginal pH

Estrogen does this by encouraging the growth of Lactobacilli bacteria, the most abundant microorganism in the vagina, which produce lactic acid. 

As menopause sets in, the decrease in estrogen levels leads to changes in the reproductive tract. This includes a reduction in Lactobacilli bacteria and hormonal and tissue changes.

Probiotics are ideal for supporting healthy transition of the vaginal flora during menopause. They promote the growth of beneficial microorganisms both in the gut and vagina.

A study of 544 women explored the effects of oral probiotics on vaginal flora. Over six weeks, participants diligently consumed probiotics daily and underwent thorough gynecological examinations and swab tests at six and 12-week intervals.

The results revealed a significant difference: at the six-week mark, 62% of women who took probiotics had balanced vaginal bacteria, compared to only 27% of those who didn’t take probiotics. 

This trend persisted at the 12-week assessment, with 51% of probiotic users maintaining balanced vaginal flora compared to only 21% in the non-probiotic group.

Other studies show similarly positive results. A study of 72 postmenopausal women examined the effects of Lactobacillus rhamnosus and Lactobacillus reuteri on vaginal flora health and balance. Participants took probiotics for 14 days and underwent vaginal swabs before and after treatment.

Researchers used the Nugent scoring system to measure changes in vaginal health. Women began the study with a score of four to six. 

60% of women taking probiotics experience a reduction in score by at least two grades, indicating improved vaginal health. Only 16% of women who did not take probiotics experienced similar improvement.

Positive effects on vaginal health may also come from methods other than oral probiotics. A study of 70 pre and postmenopausal women explored the effects of probiotic-containing soaps, creams, and gels. Researchers divided the women into a control group and two others:

  • Group 1: used Lactobacillus-containing feminine soap and cream
  • Group 2: used Lactobacillus-containing gel in addition to the soap and cream

Women using Lactobacillus products had fewer bad bacteria and a healthier vaginal environment compared to those who didn’t use these products. Group 2, using all three Lactobacillus products, showed even better results, especially in older women.

Bone Health

After women mature and especially after menopause, declining estrogen means faster loss of bone density and strength. Probiotics may help slow this bone loss. 

A meta-analysis of five studies, ranging from six to twelve months, investigated probiotics’ impact on 497 postmenopausal women. The probiotic strains in the studies consisted of six strains of Lactobacillus and Bifidobacterium.

Researchers assessed bone mineral density through scans of the lower back and entire hip, alongside analyzing specific blood markers associated with bone health. 

Those taking probiotics experienced less bone loss in their lower backs and significantly reduced bone loss markers compared to those who didn’t take probiotics.

A study of 20 postmenopausal explored the effects of drinking milk fermented by Lactobacillus helveticus on calcium absorption. The fermented milk quickly raised blood calcium levels compared to regular milk. This suggests that probiotics might help the body absorb calcium from the intestines. 

Researchers believe probiotics may be helpful for bone health by:

  • Supporting a healthy inflammatory response in both the gut and bone
  • Affecting signals to bone cells like osteoblasts and osteoclasts, which may reduce bone breakdown and increase bone formation.
  • Improving calcium absorption in the gut

Weight Gain

Weight gain is very common during menopause, especially around the midsection. Moreover, menopausal women are 3.5 times more likely than premenopausal women to develop metabolic syndrome. While there is need for more research, studies are showing promise for the beneficial support of probiotics. 

A clinical study of 1632 women aged 20 – 74 years old found that lower gut flora diversity correlates with tendency to gain weight independent of how much they eat. 

So, it’s possible that the decline of gut flora diversity due to low estrogen during menopause partly drives the menopausal weight gain.

A healthy gut flora is crucial for maintaining a healthy weight for the following reasons:

  1. Dysbiosis (when suboptimal flora predominates) can lower your gut’s ability to break down and absorb nutrients. 
  2. Dysbiosis can increase blood lipopolysaccharides. These stimulate your immune system in ways that predispose you for leptin resistance, resulting in poorer blood sugar control and weight gain.
  3. Your gut bacteria helps with hormone balance as they help metabolize and reintroduce hormones. 
  4. Some gut bacteria, like Firmicutes, may encourage your body to extract more calories from food or burn fewer calories.

In a placebo-controlled study of perimenopausal and postmenopausal women, subjects took a multi-strain probiotic for five weeks. Those who took the probiotic experienced an increase in follicle-stimulating hormone (FSH), while body weight significantly decreased.

A longer, 12-week study of 81 menopausal women explored the effects of a multi-species probiotic powder on body fat and gut permeability. They took either a low dose (2.5 billion CFU), a high dose (10 billion CFU), or a placebo.

Both the low and high doses of probiotics were beneficial compared to placebo. Those taking probiotics decreased their waist size and subcutaneous fat.

It’s important to note that the above studies done with menopausal women only contained overweight subjects. More research is needed to determine whether the same results would occur with normal weight women. 

Check out this article to learn more about taking probiotics for weight loss. 

What is the Best Probiotic for Menopause?

Taking a multi-strain probiotic helps build gut diversity and may alleviate menopause symptoms. Some particular probiotic strains that have shown effectiveness in managing menopause symptoms include:

  • Lactobacillus gasseri and Lactobacillus acidophilus: beneficial for managing a wide range of menopause symptoms, including hot flashes
  • Lactobacillus rhamnosus: supports bone and vaginal health
  • Lactobacillus reuteri: supports vaginal health and flora balance
  • Lactobacillus helveticus: aids bone health by promoting calcium absorption 
  • Lactobacillus plantarumsupports bone health and mood
  • Bifidobacterium longum: supports bone health and promotes mood balance

Including these probiotic strains in your daily regimen may help alleviate menopause symptoms and improve overall well-being. You can get all of the beneficial strains mentioned in the studies in our high-quality probiotics:

  • Biome Breakthrough: contains L.rhamnosus, L.gassieri, and L.helveticus along with IgY Max, Bovine Collagen, and Bovine Bone Broth designed to heal your gut and weed out the suboptimal bacteria. It’s also a synbiotic that improves the survival of these bacteria strains and gut flora diversity.
  • P3-OM: a patented super-strain of L. plantarum
  • Cognibiotics: contains L. rhamnosus, L. reuteri, L. helveticus, L. plantarum, and B. longum,  along with other probiotics and a Chinese herbal blend to boost your mood and wellbeing. 

You can further support your body during menopause by maintaining proper nutrition. Find out more about nutrient factors and the best diet for menopause on our blog. 


Understanding how menopause impacts gut health offers insights into holistic wellness strategies. Incorporating probiotics into your daily routine may alleviate menopausal symptoms, from hot flashes to mood swings and bone health issues. 

In addition, consider increasing foods that improve your gut flora diversity, such as dietary fiber, polyphenols (in colorful fruits and vegetables), and omega-3 fatty acids.

By nurturing the symbiotic relationship between your gut and menopausal transition, you empower yourself to navigate this journey with vitality and resilience. 

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  1. Yang M, Wen S, Zhang J, Peng J, Shen X, Xu L. Systematic review and meta-analysis: Changes of gut Microbiota before and after menopause. Dis Markers. 2022;2022:1-10. doi:10.1155/2022/3767373
  2. Shin JH, Park YH, Sim M, Kim SA, Joung H, Shin DM. Serum level of sex steroid hormone is associated with diversity and profiles of human gut microbiome. Res Microbiol. 2019;170(4-5):192-201. doi:10.1016/j.resmic.2019.03.003
  3. Andrews R, Lacey A, Roach H, Tomlinson R, Kidd EJ, Bache K. Evaluating the effects of probiotics on menopause-specific health outcomes: A systematic review & Meta-analysis. Published online 2023. doi:10.31219/
  4. Randolph JF Jr, Sowers M, Bondarenko I, et al. The relationship of longitudinal change in reproductive hormones and vasomotor symptoms during the menopausal transition. J Clin Endocrinol Metab. 2005;90(11):6106-6112. doi:10.1210/jc.2005-1374
  5. Sawada D, Sugawara T, Hirota T, Nakamura Y. Effects of Lactobacillus gasseri CP2305 on mild menopausal symptoms in middle-aged women. Nutrients. 2022;14(9):1695. doi:10.3390/nu14091695
  6. Lim EY, Lee SY, Shin HS, et al. The effect of Lactobacillus acidophilus YT1 (MENOLACTO) on improving menopausal symptoms: A randomized, double-blinded, placebo-controlled clinical trial. J Clin Med. 2020;9(7):2173. doi:10.3390/jcm9072173
  7. Shafie M, Homayouni Rad A, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. The effect of probiotics on mood and sleep quality in postmenopausal women: A triple-blind randomized controlled trial. Clin Nutr ESPEN. 2022;50:15-23. doi:10.1016/j.clnesp.2022.06.005
  8. Zhu H, Tian P, Zhao J, Zhang H, Wang G, Chen W. A psychobiotic approach to the treatment of depression: A systematic review and meta-analysis. J Funct Foods. 2022;91(104999):104999. doi:10.1016/j.jff.2022.104999
  9. Barrea L, Verde L, Auriemma RS, et al. Probiotics and prebiotics: Any role in menopause-related diseases? Curr Nutr Rep. Published online 2023. doi:10.1007/s13668-023-00462-3
  10. Mei Z, Li D. The role of probiotics in vaginal health. Front Cell Infect Microbiol. 2022;12. doi:10.3389/fcimb.2022.963868
  11. Vujic G, Jajac Knez A, Despot Stefanovic V, Kuzmic Vrbanovic V. Efficacy of orally applied probiotic capsules…: a double-blind, randomized, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol. 2013;168(1):75-79. doi:10.1016/j.ejogrb.2012.12.031
  12. Petricevic L, Unger FM, Viernstein H, Kiss H. Randomized, double-blind, placebo-controlled study of oral lactobacilli to improve the vaginal flora of postmenopau
    sal women. Eur J Obstet Gynecol Reprod Biol. 2008;141(1):54-57. doi:10.1016/j.ejogrb.2008.06.003[/custom-reference]
  13. Yoshikata R, Yamaguchi M, Mase Y, Tatsuyuki A, Myint KZY, Ohta H. Evaluation of the efficacy of Lactobacillus-containing feminine hygiene products on vaginal microbiome and genitourinary symptoms in pre- and postmenopausal women: A pilot randomized controlled trial. PLoS One. 2022;17(12):e0270242. doi:10.1371/journal.pone.0270242
  14. Yu J, Cao G, Yuan S, Luo C, Yu J, Cai M. Probiotic supplements and bone health in postmenopausal women: a meta-analysis of randomised controlled trials. BMJ Open. 2021;11(3):e041393. doi:10.1136/bmjopen-2020-041393
  15. Narva M, Nevala R, Poussa T, Korpela R. The effect of Lactobacillus helveticus fermented milk on acute changes in calcium metabolism in postmenopausal women. Eur J Nutr. 2004;43(2):61-68. doi:10.1007/s00394-004-0441-y
  16. Szydłowska I, Marciniak A, Brodowska A, et al. Effects of probiotics supplementation on the hormone and body mass index in perimenopausal and postmenopausal women using the standardized diet. A 5-week double-blind, placebo-controlled, and randomized clinical study. Accessed March 7, 2024.
  17. Menni C, Jackson MA, Pallister T, Steves CJ, Spector TD, Valdes AM. Gut microbiome diversity and high-fibre intake are related to lower long-term weight gain. Int J Obes (Lond). 2017;41(7):1099-1105. doi:10.1038/ijo.2017.66
  18. Krajmalnik-Brown R, Ilhan ZE, Kang DW, DiBaise JK. Effects of gut microbes on nutrient absorption and energy regulation. Nutr Clin Pract. 2012;27(2):201-214. doi:10.1177/0884533611436116
  19. Szulińska M, Łoniewski I, van Hemert S, Sobieska M, Bogdański P. Dose-dependent effects of multispecies probiotic supplementation on the lipopolysaccharide (LPS) level and cardiometabolic profile in obese postmenopausal women: A 12-week randomized clinical trial. Nutrients. 2018;10(6):773. doi:10.3390/nu10060773
  20. Chen Q, Wang H, Wang G, et al. Lactic acid bacteria: A promising tool for menopausal health management in women. Nutrients. 2022;14(21):4466. doi:10.3390/nu14214466
  21. Siroma TK, Machate DJ, Zorgetto-Pinheiro VA, et al. Polyphenols and ω-3 PUFAs: Beneficial outcomes to obesity and its related metabolic diseases. Front Nutr. 2022;8. doi:10.3389/fnut.2021.781622
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