The relationship between menopausal syndrome and gut microbes Original paper

What was studied?

This original research article examined the relationship between menopausal syndrome (MPS) and gut microbiome composition, a focus central to understanding microbiome signatures relevant to menopausal health. The study compared microbial communities between women with MPS and healthy menopausal controls, using 16S rRNA sequencing to identify taxonomic and functional differences. Because the role of gut bacteria in estrogen metabolism is well established, the authors investigated whether specific microbial signatures—including Bifidobacterium animalis, Aggregatibacter segnis, and Acinetobacter guillouiae—showed associations with estradiol levels. These bacteria appear recurrently in microbiome studies exploring hormonal regulation, making them highly relevant as candidate biomarkers for a microbiome signatures database. The study found clear microbial dysbiosis in MPS, suggesting that altered gut ecology may contribute meaningfully to symptom severity and systemic metabolic changes.

Who was studied?

The researchers evaluated 101 women aged 40–60 years, including 77 individuals diagnosed with menopausal syndrome and 24 healthy menopausal controls. All participants were recruited from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine between 2020 and 2021. The groups were matched on age, menopausal status, BMI, and cardiometabolic risk factors, minimizing confounding. Diagnosis of MPS was based on clinical symptoms and hormonal markers, such as elevated FSH and LH with reduced estradiol. Stool samples were collected and frozen at −80°C until analyzed. This well-defined cohort allowed the study to distinguish microbiome differences linked specifically to menopausal symptoms rather than aging or metabolic disease.

Most important findings

The study found 14 microbial species differing significantly between groups. Women with MPS exhibited enrichment of Bifidobacterium adolescentis, Bifidobacterium longum, Bacteroides ovatus, Lactobacillus ruminis, Veillonella dispar, and Eubacterium biforme. In contrast, healthy controls showed higher levels of Bifidobacterium animalis, Aggregatibacter segnis, Acinetobacter guillouiae, Clostridium celatum, Ruminococcus albus, and Bacteroides coprophilus. Notably, estradiol strongly and positively correlated with B. animalis, A. segnis, and A. guillouiae, while FSH and LH were negatively correlated. Functional predictions revealed 50 enriched KEGG pathways in MPS, especially metabolic routes related to cardiomyopathy, carbohydrate metabolism, and calcium signaling. These align with known comorbidities such as obesity, diabetes, and cardiovascular disease. The heatmap highlights significant correlations between symptom scores and species like Ruminococcus torques and Blautia obeum, linking microbial composition directly with symptom severity.

Key implications

The study strengthens evidence for a gut–hormone axis in menopause, suggesting that declining estrogen may shift microbial composition in ways that worsen symptoms and increase cardiometabolic risk. Bifidobacterium animalis, in particular, emerges as a promising beneficial species due to its correlation with estradiol and its known metabolic benefits. Microbial functions enriched in MPS mirror disease pathways observed clinically, implying a mechanistic contribution rather than mere association. These findings support the potential value of microbiome-targeted strategies—such as probiotics, diet modulation, or fecal microbiota transplantation—in reducing symptom burden and preventing long-term complications in menopausal women.

Citation

Liu Y, Zhou Y, Mao T, et al. The relationship between menopausal syndrome and gut microbes. BMC Women’s Health. 2022;22:437. doi:10.1186/s12905-022-02029-w