With International Women's Day (IWD) just around the corner, we are taking a deeper look at some of the invisible connections that affect female health.
IWD is a global day celebrating all women and largely focused on accelerating gender equality. Women’s health has a vital place in the IWD movement as ultimately, healthy, happy and balanced women are more likely to thrive.
Some of the most common health concerns facing women relate to digestive discomfort, hormones, stress and mental wellbeing. When we look below the surface of these issues there is an invisible connection and this connection can be easy to miss. For many women, suboptimal gut and microbiome health can quietly affect hormone balance, resilience to stress, mood and more. It can be a missing link to achieving whole body wellness.
Optimising gut health can be a powerful way to help women stay balanced, grounded and resilient. Gut health is so important because the microbiome has many functions, including:
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Aids the production and regulation of hormones and neurotransmitters.
- Facilitates absorption of essential nutrients.
- Supports healthy oestrogen levels in the body.
As women, we have unique physiology and our bodies are programmed differently to men. This may explain why many general health concerns affect women differently or more frequently, such as stress symptoms, mental wellbeing, skin appearance and digestive complaints.
🤍 The Gut-Hormone Connection 🤍
Your gut does more than digest food. Amongst other things, it also metabolises hormones and helps regulate levels of oestrogen in your body.
This is important as gut health and hormone balance go hand-in-hand. For some women, poor digestive function and microbiome balance can be an underlying factor exacerbating hormonal imbalances. On the other hand, hormonal fluctuations in women strongly affect digestive comfort – leading to bloating, discomfort and irregularity.
- Understanding Oestrogen – the Basics.
Oestrogen is a key female hormone and master regulator that significantly impacts women's wellbeing and regulates menstrual cycles. In women, oestrogens are primarily made in the ovaries then circulated throughout the body.
- Understanding Oestrogen Metabolism.
The female body clears out excess oestrogen through the liver, kidneys and digestive tract, and it’s important that this process works well to avoid build up and to balance hormones.
Oestrogen made in the ovaries eventually circulates to the liver where it is inactivated via complex processes that convert oestrogen into inactive forms that can be excreted through our digestive and urinary tracts when we go to the bathroom (in stools and urine).
Once the inactivated oestrogen is transported from the liver to our gut, it can be excreted through bowel movements or re-activated by gut bacteria and reabsorbed through the gut to re-enter the body.
- Understanding Oestrogen – the Influence of Gut Health.
The subset of intestinal bacteria in our gut that metabolise oestrogen are known as the ‘estrobolome’. They produce a specific enzyme (β-glucuronidase) that converts oestrogen in the intestines from its inactive form to its active form. This reduces oestrogen excretion and results in reabsorption of the reactivated oestrogen – increasing circulating oestrogen.
When the gut microbiome is healthy, it helps regulate healthy oestrogen metabolism. Here the estrobolome is producing optimal levels of β-glucuronidase which minimises reabsorption of excess oestrogen from the gut allowing healthy elimination to optimise hormone balance.
If there is a microbiome imbalance (gut dysbiosis) with too much gut bacteria that produce β-glucuronidase, oestrogen clearance is impaired and excess oestrogen re-enters the body. This is a problem as the impaired oestrogen metabolism can contribute to oestrogen dominance and disrupt the delicate balance between the female sex hormones oestrogen and progesterone.
Constipation and slow transit time can also affect your ability to excrete oestrogen through the gut, leading to poor oestrogen clearance and higher oestrogen levels. Regular bowel movements are therefore key to healthy hormone metabolism.
Evidence-based strategies to support oestrogen metabolism through your gut:
- Consume more fibre rich plants by eating a wide variety of wholefoods (like flax, fruits and vegetables). Fibre nourishes healthy gut bacteria, keeps you regular, influences oestrogen metabolism and decreases the activity of β-glucuronidase in the gut.
- Limit excess alcohol. Drinking too much can alter the microbiome and increase β-glucuronidase activity, making it harder to maintain estrogen balance.
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Moderate, regular exercise has been shown to benefit the gut microbiota, and these gut changes help sustain a more balanced hormonal profile. It also has added benefits of improving stress responses [lowering excess cortisol by supporting Hypothalamic– pituitary–adrenal axis (HPA) axis function] and promoting gut motility to keep you regular.
🧠 The Gut-Stress-Mental Wellbeing Connection 🧠
Mental wellbeing is not just a matter of the mind. The gut-brain axis is a powerful pathway that deeply connects gut health and brain health, influencing mental wellbeing, mood, cognition and stress. This bi-directional axis carries messages to and from the gut and brain allowing both systems to communicate.
Extensive evidence now shows that our gut microbiome is involved in much of the gut-brain axis communication. In fact, our microbiome is so important that researchers are increasingly coining it the microbiome-gut-brain axis. Through this microbiome-gut-brain axis connection, stress can have huge impacts on our gut, and gut health can affect our resilience to stress, as well as mood and mental state.
- How Stress Impacts Gut Health.
Persistent or excessive stress can impact the gut in an unpleasant way. Research has clearly shown that higher levels of stress hormones (such as norepinephrine, epinephrine, and cortisol) can bind to receptors in our gut and send signals that:
- Promote unfriendly bacteria and reduce healthy beneficial bacteria.
- Change the gut microbiome leading to dysbiosis and leaky gut (poor barrier permeability).
- Inhibit digestive secretions, reduce blood flow to the gut and reduce nutrient absorption.
- Affect gut motility, either causing less or more frequent visits to the bathroom.
- Induce intestinal inflammation and bloating.
Stress-related comfort eating can add to the problem. Researchers have found that high-sugar diets result in gut inflammation and dysbiosis due to changes in intestinal flora.
- How Gut Health Impacts Stress and Mental Wellbeing.
A healthy gut microbiome promotes better stress responses and mental wellbeing. This is especially relevant to women who are more likely to be affected by digestive issues, stress symptoms and mood disturbances.
Research suggests that women feel the symptoms of stress more and experience more of the symptoms of stress than men (due to hormonal biological differences). This has important implications as higher long-term stress levels in women are linked to poor mood, digestive symptoms, weight gain, low energy levels and hormonal complaints.
But how do our gut bacteria influence stress and mental wellbeing?
The intestinal bacteria making up our gut microbiome produce signalling molecules that traverse the microbiome-gut-brain axis from our digestive tract through the nervous system, vagus nerve, circulatory system, or immune system to the brain. Here they can affect mood, cognition, and behaviour.
- The microbiome produces neurotransmitters and hormones like serotonin, GABA (gamma-aminobutyric acid) and dopamine (our gut is home to 90% of our total serotonin). These regulate emotions, thoughts and mood – contributing to mental wellbeing.
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Microbiome imbalances can drive inflammation throughout the body and brain, disrupting neurotransmitter balance and stress hormones. When the gut bacteria balance is off, our intestinal barrier can become weak and inflammatory substances (such as lipopolysaccharides and cytokines) unwelcomely pass through our gut into the body where they can activate the HPA axis, increase cortisol and make stress symptoms worse.
- Beneficial gut bacteria metabolites modulate the stress response. Lactobacillus and Bifidobacterium have been shown to reduce cortisol levels and promote GABA, an inhibitory neurotransmitter that helps counteract stress. These friendly bacteria produce beneficial metabolites that influence brain function and mental wellbeing. When these bacteria feed on dietary fibre in our gut, they make short-chain fatty acids (SCFAs) like butyrate, acetate and propionate. These SCFAs maintain gut integrity, reduce inflammation and cross the blood-brain barrier where they help regulate mood and stress.
For centuries, wholistic medicine has believed that stress and mental wellness is deeply connected to the gut - that good health begins in the gut. Modern science now supports this connection with recent research unravelling the complex mechanisms that unite our gut, brain, stress and emotions.
About the Author | 📑
Hi, I’m Abbie – a naturopath, nutritionist, herbalist, wellness and nature lover.
Graduating from university almost 20 years ago, I have spent my career supporting brands to develop and market effective and compliant health products through my companies Regulatory Training Direct and Natural Product Centre.
Despite not working in clinical practice, naturopathic principles are a huge part of my life. Nutrition is an essential cornerstone to health, and I love cooking nourishing tasting meals that help my family look, feel and perform at our best.
I currently live in a small seaside town in Australia with my husband and beloved fur-baby. We spent years living abroad so my home cooking tends to be globally inspired intuitive fusions with a naturopathic twist.
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