Menopause Menu: Probiotics

My “MENOPAUSE MENU” series is dedicated to exploring foods that can be easily assimilated into your diet. Today’s Menopause Menu is all about probiotics. 

Menopause is a normal part of aging with various symptoms ranging from hot flashes, weight gain, and memory loss to depression and anxiety. Some women have found that probiotics help relieve certain menopausal symptoms. How does digestive health tie in with menopause?  A growing body of scientific evidence suggests that menopausal women can benefit from probiotics. 

Probiotics have been established as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.” Only characterized strains with a scientifically demonstrated effect on health may be correctly referred to as probiotics.  Essentially, probiotics are foods or supplements that contain live microorganisms intended to maintain or improve the "good" bacteria (normal microflora) in the body.

Probiotic, prebiotic, synbiotic, antibiotic, psychobiotic? Sounds like something out of a Sci-Fi flick.  Let's break it down:

Probiotics: Probiotics are known by genus, species, and strain. Probiotics come from the Greek word "pro bios" which means "for life". They are the beneficial bacteria found in your digestive tract. We usually think of bacteria as germs that cause diseases, but our bodies are full of bacteria, both good and bad. Probiotics are often called "good" or "helpful" bacteria because they help keep your gut healthy by keeping the balance between good and bad bacteria and replacing good bacteria for example after a round of antibiotics. 

Prebiotics: Prebiotics are dietary substances that nurture a selected group of microorganisms living in the gut. If probiotics are ‘good’ bacteria that are introduced to the gut to grow and thrive then prebiotics are essential ‘food’ for these good bacteria.” Some examples of prebiotic foods are asparagus, artichokes, garlic, and onions. Polyphenols in chocolate also act as prebiotics, enhancing beneficial bacteria that are already in the gut. 

Synbiotics: Synbiotics combine probiotics and prebiotics to magnify the beneficial effects of friendly microorganisms and help them thrive, so they can in turn make nutrients.

Antibiotics: A  medicine or chemical that can destroy harmful bacteria in the body or limit their growth. 

Psychobiotics: Psychobiotics are beneficial bacteria (probiotics) or support for such bacteria (prebiotics) that influence bacteria–brain relationships.  Professor Ted Dinan of University College Cork in Ireland, one of the pioneers in the field, introduced the term psychobiotics in 2012 to describe the specific bacteria that when consumed result in beneficial effects on mood, motivation, and cognition.

There are over 100 trillion bacteria, most of them in the intestines. Think of this bacteria as an intestinal medicine cabinet capable of protecting us from damaging organisms.  They produce neurotransmitters relaying messages from the intestines to the brain, causing the body to react in different ways: 

Menopause-specific benefits

Menopause brings about a reduction in estrogen and one of the functions of estrogen is to keep the gut microbiota balanced. When the balance is thrown off, the environment could lead to recurring vaginal infections. There is research to indicate that probiotics and prebiotics have an effect on vaginal health, bone health, insulin sensitivity, and weight gain.   

Vaginal health 

Recent studies evaluating the efficacy of probiotics for postmenopausal women show that they can be beneficial in the prevention and treatment of two frequently occurring vaginal infections in postmenopausal women, bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC).  This is a well-researched application of probiotic supplementation in the menopausal population and is considered a viable non-pharmaceutical option for vaginal health. 

Bone health

Osteoporosis is one of the highest risk factors for menopausal women. Some studies evaluating the benefit of probiotics demonstrated increased serum calcium levels and reduced bone loss, leading to better bone health.

Vasomotor symptoms (VMS)

A randomized-controlled study evaluating the effects of highly bioavailable red clover isoflavone (RCE) with probiotics treatment to alleviate VMS showed that moderate doses of RCE were more effective and superior to placebo in reducing physiological and self-reported VMS. The research in this area is sparse but promising. 

Weight gain

The relationship between gut microbiota and lack of estrogen appears to be responsible for weight gain and fat deposition during menopause. Studies indicate the supplementation of soy isoflavones increases the concentration of Bifidobacterium, having a balancing effect on the microbiome and minimize weight gain in menopausal women. Additionally, diets high in phytoestrogens seem to minimize weight gain in menopausal women. 

Insulin sensitivity

The intake of the prebiotic, flaxseed mucilage, is known to improve insulin sensitivity and influence the gut microbiome in obese postmenopausal women. 

Warning: Regulation of probiotics varies between regions and is focused on the legitimacy of claims rather than the efficacy and safety of those products. Because of their classification as food/health supplements, they do not have to go through clinical trials as medical drugs do. This allows companies to label their products "probiotic" even if they don't meet the scientific definition of the term. Be sure to research probiotic supplements before purchasing. The best way to consume probiotics is through naturally probiotic foods that can be added to your diet. 

Best probiotic food choices:

Strains of bacteria that may be beneficial for menopausal symptoms are:

Note: This article is intended to provide you with information but should not be taken as medical advice. Each situation is different. Contact your health care provider if you have other health conditions and are interested in exploring probiotics, as there may be interactions with medications or pre-existing conditions that were not explored in this article. 

References: 

(1) Kim, J. M., & Park, Y. J. (2017). Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article. Journal of menopausal medicine, 23(3), 139–145. doi:10.6118/jmm.2017.23.3.139

(2) Jain, D. & Chaudhary, H.S. (2014). Clinical significance of probiotics in humans. International Journal of Nutrition, Pharmacology, Neurological Diseases, 4(1), 11-22.

(2) Davidson, J. (2014). The Psychobiotic Revolution. Psychology Today March/April, 40-41.

(3) Sanders, M.E. (2008). Probiotics: Definition, Sources, Selection, and Uses. Clinical Infectious Diseases, 46:S 58-61.

(4) Vieira, A. T., Castelo, P. M., Ribeiro, D. A., & Ferreira, C. M. (2017). Influence of Oral and Gut Microbiota in the Health of Menopausal Women. Frontiers in microbiology, 8, 1884.

(5) Lambert, M., Thorup, A. C., Hansen, E., & Jeppesen, P. B. (2017). Combined Red Clover isoflavones and probiotics potently reduce menopausal vasomotor symptoms. PloS one, 12(6).