Does the gut microbiota influence cardiometabolic risk after menopause?

Menopause marks a period of major changes in a woman’s body, far beyond the end of fertility. The decline in female hormones, particularly estrogen, leads to profound metabolic changes. These transformations increase the risk of disorders such as excess cholesterol, insulin resistance, and cardiovascular diseases. Weight gain, especially around the abdomen, and subtle but persistent inflammation further worsen this situation.

The gut microbiota, this community of microorganisms that inhabit our intestines, plays a key role in these upheavals. It participates in digestion, regulation of the immune system, and fat metabolism. After menopause, its composition often changes, with reduced diversity and an increase in certain less beneficial bacteria. These changes can disrupt the balance of fats in the blood, promote inflammation, and impair the intestinal barrier. Substances such as lipopolysaccharides, derived from bacteria, then pass more easily into the bloodstream and worsen inflammation, further disrupting lipid metabolism.

Estrogens directly influence the composition of the microbiota, and conversely, certain bacteria can alter estrogen levels in the body. This bidirectional relationship is called the “estrobolome.” After menopause, the decline in estrogen can therefore unbalance the microbiota, which, in turn, affects metabolic health.

Fortunately, diet offers ways to restore a favorable balance. Mediterranean, vegetarian, or DASH diets, rich in fiber, vegetables, fruits, and healthy fats, improve the lipid profile and reduce inflammation. Dietary fibers, for example, nourish bacteria that produce short-chain fatty acids, which are beneficial for metabolism. Probiotics, found in certain fermented foods, and prebiotics, such as fibers, can also help restore a healthier microbiota.

Omega-3s, polyphenols, and phytoestrogens, found in flaxseeds, soy, or berries, also show positive effects on cholesterol and inflammation. These compounds act in part by modulating the microbiota and reducing fat absorption.

However, each woman responds differently to these interventions, depending on her microbiota, lifestyle, and initial health status. Further research is needed to refine these approaches and tailor them to each individual. Integrating microbiota analysis into medical monitoring could, in the future, enable more precise and effective nutritional recommendations to preserve cardiometabolic health after menopause.

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DOI: https://doi.org/10.1007/s13668-026-00752-6

Title: The Role of Gut Microbiota in Postmenopausal Women: Implications for Lipid Metabolism and Targeted Nutritional Interventions

Journal: Current Nutrition Reports

Publisher: Springer Science and Business Media LLC

Authors: Claudia Reytor-González; Ludovica Verde; Giuseppe Annunziata; Náthaly Mercedes Román-Galeano; Raquel Horowitz; Martina Galasso; Giovanna Muscogiuri; Evelyn Frias-Toral; Daniel Simancas-Racines; Luigi Barrea