LEPT Nutrition

THE MENOPAUSE GUT CONNECTION

Menopause, Lower Estrogen & the Gut Microbiome: What Do We Actually Know? 🦠

As we move through menopause, estrogen levels decline.

But could those hormonal changes also influence the community of microbes living in our gut?

Possibly—but the answer isn't as simple as social media sometimes makes it sound.

🦠 WHAT DOES THE RESEARCH SHOW?

Some studies have found differences in the gut microbiome between pre- and postmenopausal women.

Researchers are investigating changes in:

🌿 Microbial diversity
🦠 The types and relative abundance of different bacteria
🧬 Microbial functions, including estrogen metabolism
🔥 Metabolic and inflammatory pathways

But here's the important part:

The findings aren't consistent.

A recent systematic review and meta-analysis found no significant overall differences in microbial diversity or the major bacterial groups Firmicutes and Bacteroidetes between women with lower estrogen levels and premenopausal women.

Why is it so difficult to get a clear answer?

Because your microbiome is influenced by MUCH more than estrogen.

🥗 Diet
💊 Medications and antibiotics
🏃 Physical activity
😴 Sleep
🧠 Stress
🎂 Age
⚖️ Metabolic health
🌍 Geography and environment

So we shouldn't assume that every microbiome change around menopause is caused by falling estrogen.

AND THEN THERE'S THE ESTROBOLOME...

The relationship may also work in BOTH directions.

Estrogen may influence the gut environment, while certain gut microbes possess enzymes involved in estrogen metabolism and recirculation.

That's the fascinating gut–estrogen relationship researchers are continuing to investigate.

🌿 WHAT CAN WE DO NOW?

We don't need to wait for every piece of the science before looking after our gut.

Focus on the foundations:

🥦 Plenty of fibre-rich plant foods
🫘 Legumes
🌾 Wholegrains
🥜 Nuts and seeds
🫐 A variety of colourful plants
🏃 Regular movement
😴 Good sleep where possible

Not because these foods will “balance your estrogen.”

Because they form part of a dietary pattern that supports gut and overall health through midlife.

The menopause–microbiome connection is exciting. But emerging science should never become an excuse for exaggerated promises.

Next in :
🌿 Can food influence the estrobolome?

Lorraine English | Clinical Nutritionist
Specialising in Menopause & Gut Health
LEPT Nutrition

MUSHROOMS ON TOAST — GOOD FOR YOUR GUT & A GREAT ADDITION TO YOUR MENOPAUSE PLATE

Sometimes the simplest meals are the best.

This Mushrooms on Toast takes around 15 minutes and packs plenty of plants onto your plate.

🍄 MUSHROOMS ON TOAST

Serves 2 | 15 minutes

INGREDIENTS

🫒 1 tsp extra virgin olive oil
🧄 2 cloves garlic, crushed
🍄 200g white button mushrooms, thinly sliced
🌿 ½ tsp dried thyme
🥄 1 tbsp reduced-salt tamari or soy sauce
🥛 A dash of unsweetened almond milk
🌱 10g parsley, finely chopped (optional)
🍅 100g cherry tomatoes
🥬 150g baby spinach
🍞 4 slices gluten-free bread, toasted
Black pepper, to taste

METHOD

1️⃣ Heat the olive oil in a frying pan and sauté the garlic for 1–2 minutes.

2️⃣ Add the mushrooms, thyme, tamari and black pepper. Cook until the mushrooms are tender and starting to brown.

3️⃣ Reduce the heat, add a dash of almond milk and stir for another minute. Remove the mushroom mixture and set aside.

4️⃣ Add the cherry tomatoes to the same pan and cook for around 2 minutes. Add the spinach and cook until just wilted.

5️⃣ Toast the bread and top with the mushrooms, tomatoes and spinach. Finish with parsley.

💪 WANT MORE PROTEIN?
Add a poached, fried or boiled egg on top—or another protein-rich food that suits you.

🍄 WHY MUSHROOMS?

Mushrooms provide fibre and contain unique carbohydrates, including beta-glucans.

And look at the plant variety in this one meal:

🍄 Mushrooms
🧄 Garlic
🍅 Tomatoes
🥬 Spinach
🌿 Thyme
🌱 Parsley

Eating a variety of plant foods provides different fibres and plant compounds as part of a dietary pattern that supports your gut microbiome.

And during menopause?

Rather than looking for foods that claim to “balance hormones,” I want you thinking about your whole dietary pattern:

🌿 Plenty of plants
🦠 Fibre
🫒 Healthy fats
💪 Enough protein

Protein becomes particularly important through midlife for helping maintain muscle mass—which is why adding an egg can turn this plant-rich toast into a more protein-focused meal.

Your gut health and menopause nutrition don't have to be separate conversations.

📌 SAVE this recipe for breakfast, brunch or lunch.

Lorraine English | Clinical Nutritionist
Specialising in Menopause & Gut Health
LEPT Nutrition

Menopause and Sleep: Why a Bad Night Can Affect Tomorrow’s Appetite

Did you sleep badly last night… and find yourself reaching for coffee, something sweet or extra snacks today?

That connection is worth understanding.

Sleep can become much more challenging during perimenopause and menopause.

Hot flushes and night sweats may wake you. Anxiety can make it difficult to switch off. Changing sleep patterns, stress, alcohol and lifestyle factors can all play a part.

But poor sleep doesn't necessarily stay in the bedroom.

It can influence how hungry you feel and the foods you want the following day.

After a disrupted night, appetite regulation, glucose metabolism and food choices can be affected. And when you're exhausted, highly palatable, quick-energy foods can become much more appealing.

Then a familiar cycle can begin:

😴 Poor night's sleep
☕ Extra coffee to function
🥐 Breakfast gets skipped
🍫 Afternoon cravings arrive
🍷 A glass of w**e to relax
🌙 Sleep is disrupted again

This is why I don't look at nutrition, sleep and menopause as completely separate issues.

What can you do?

Start with the basics:

🥚 Eat a proper breakfast if skipping it leaves you ravenous later.
Include protein rather than relying on coffee alone.

🥗 Eat regular, balanced meals.
Long gaps without food may make it harder for some women to manage hunger later in the day.

☕ Look at caffeine timing.
Caffeine can remain in your system for hours. If sleep is an issue, that afternoon coffee may deserve a closer look.

🍷 Don't use alcohol as a sleep strategy.
Alcohol may initially make you feel sleepy, but it can disrupt sleep quality later in the night.

🌿 Build meals around protein, fibre-rich plant foods and quality carbohydrates.

And remember: if hot flushes and night sweats are repeatedly destroying your sleep, nutrition isn't the only conversation to have.

MHT/HRT can be an effective treatment for menopausal vasomotor symptoms for appropriate women. Speak with your doctor about your individual options.

Nutrition doesn't replace appropriate menopause treatment.

And MHT doesn't replace good nutrition.

Both can have a place in supporting your health through menopause.

Lorraine English | Clinical Nutritionist
Specialising in Menopause & Gut Health
LEPT Nutrition

How Do Gut Bacteria Participate in Estrogen Metabolism?

We often think about estrogen as a hormone story.

But your gut bacteria are part of the conversation too.

Here's the simplified version. 👇

Estrogen is metabolised in the body, including in the liver. Some estrogen metabolites are conjugated and enter the intestine through bile.

This is where certain gut bacteria come in.

🦠 Some bacteria produce an enzyme called β-glucuronidase (beta-glucuronidase).

This enzyme can deconjugate some estrogen metabolites in the intestine.

Why does that matter?

Once deconjugated, some estrogen may potentially be reabsorbed through the intestinal wall and returned to circulation.

Other estrogen metabolites continue through the digestive tract towards elimination in the stool.

This microbial involvement in estrogen metabolism is part of what researchers refer to when discussing the estrobolome.

But here's the important part:

🚫 This does NOT mean “more beta-glucuronidase is bad” or that you need to “detox your estrogen.”

The relationship between our gut microbes, their enzymes and estrogen metabolism is complex—and research is still developing.

What we can focus on now is supporting overall gut health with:

🥦 Fibre-rich plant foods
🫘 Beans and legumes
🌾 Wholegrains
🥜 Nuts and seeds
🫐 A variety of colourful plants
🚶 Regular movement
💧 Adequate hydration

Your gut bacteria don't work in isolation.

Diet, lifestyle, medications, age, hormones and your individual health all contribute to the bigger picture.

🌿 Your gut is part of your menopause story.

Next in :
👉 What happens to the gut microbiome as estrogen declines during menopause?

Lorraine English | Clinical Nutritionist
Specialising in Menopause & Gut Health
LEPT Nutrition

MOKEY SHAKSHUKA — A MENOPAUSE-FRIENDLY MEAL YOUR GUT CAN GET BEHIND

When I talk about eating well through menopause, I'm not talking about a complicated “hormone diet.”

I'm talking about meals that bring together the nutritional foundations your body actually needs.

And this Smokey Shakshuka does exactly that. 👇

🍳 EGGS + TURKEY MINCE
Provide quality protein—particularly important through midlife when maintaining muscle mass becomes increasingly important.

🌿 TOMATO + CAPSICUM + SPINACH + ONION + GARLIC
That's five different plant foods before we've even counted the herbs and spices.

Plant variety matters because different plants provide different fibres and plant compounds—and that's good news for your gut microbiome.

🫓 WHOLEMEAL PITA
Adds a fibre-rich wholegrain carbohydrate to make this a more complete meal.

🫒 EXTRA VIRGIN OLIVE OIL
Provides predominantly unsaturated fats and beneficial plant compounds and fits beautifully into a Mediterranean-style way of eating.

🌶️ TURMERIC + CUMIN + PARSLEY + CHILLI + SMOKED PAPRIKA
Herbs and spices count towards plant variety too!

Why do I like this combination during menopause?

Because we're bringing together:

💪 Protein for muscle maintenance
🌿 Fibre + plant diversity for gut health
🫒 Healthy fats
🌾 Quality carbohydrates
🥗 Plenty of nutrient-rich whole foods

And THAT'S the connection I want women to understand.

Supporting your gut and supporting your health through menopause don't need to be two separate diets.

One well-built plate can do both. 💚

📌 SAVE this recipe for an easy lunch or dinner.

Lorraine English | Clinical Nutritionist
Specialising in Menopause & Gut Health
LEPT Nutrition

Caffeine, Sleep, Anxiety and Hot Flushes: Should You Cut Back?

“I can't function without my coffee.”

If you're navigating menopause and feeling exhausted, I understand why that morning coffee can feel non-negotiable.

But before you blame caffeine for every menopause symptom—or give it up completely—let's put it into perspective.

☕ Coffee isn't automatically the problem.

The questions are:

How much are you drinking?
When are you drinking it?
And what is it replacing?

Caffeine is a stimulant.

For some women, too much—or consuming it too late—may contribute to:

🌙 Difficulty sleeping
😰 Feeling jittery or more anxious
💓 Palpitations
🔥 More noticeable hot flushes
😴 A cycle of tiredness followed by more caffeine

But individual tolerance varies considerably.

The bigger issue I often see?

Coffee replacing food.

If breakfast is two coffees and nothing else, you're getting stimulation—but you're not getting the nutrition a meal provides.

No meaningful protein.

Little or no fibre.

No balanced source of energy.

Then 11am arrives and you're hungry.

Or perhaps you push through until lunch.

Then by 3pm?

The cravings hit.

This isn't necessarily a lack of willpower.

You may simply have under-fuelled earlier in the day.

Try changing the order:

🍳 Food first—or food WITH your coffee.

For example:

🥚 Eggs + wholegrain toast
🥣 Greek yoghurt + berries + nuts
🌾 Oats + chia + yoghurt
🍞 Wholegrain toast + cottage cheese + tomato

Then look at timing.

If sleep is poor, experiment with moving your last caffeinated drink earlier in the day and see whether YOUR sleep improves.

You don't necessarily need to give up the coffee you love.

But if you're drinking coffee all day because you're exhausted, the more important question is why you're so tired.

Poor sleep?

Night sweats?

Not eating enough?

Low iron?

Stress?

Something requiring medical investigation?

Don't use caffeine to continually mask a symptom that deserves attention.

Coffee can be part of your day. It just shouldn't have to carry your day.

Lorraine English | Clinical Nutritionist
Specialising in Menopause & Gut Health
LEPT Nutrition

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What Does the Estrobolome Actually Do? 🧬🦠

Last time I introduced you to the estrobolome—the collection of gut microbial genes involved in estrogen metabolism.

But what does it actually DO?

Here's the simplified version. 👇

Estrogen is metabolised in the body, including in the liver. Some estrogen metabolites are conjugated and can enter the intestine through bile.

Now your gut microbes enter the conversation.

Certain bacteria produce enzymes, including beta-glucuronidase (β-glucuronidase).

These enzymes can deconjugate some estrogen metabolites.

Once deconjugated, some estrogen may potentially be reabsorbed through the intestine and returned to circulation, rather than being eliminated.

This is one of the ways our gut microbiome and estrogen metabolism are connected.

So can we “fix” the estrobolome?

This is where we need to be careful.

The estrobolome is a fascinating and emerging area of research, but we don't currently have a simple diet, probiotic or supplement that allows us to precisely “balance” it—or guarantee that doing so will balance your hormones.

What we CAN do is support the foundations of good gut health:

Eat plenty of fibre-rich foods
Include beans and legumes
Choose wholegrains where tolerated
Include nuts and seeds
Eat a variety of colourful plants
Include herbs and spices

And this matters whether you use MHT/HRT or not.

MHT has a different role in menopause care. It doesn't replace fibre, plant diversity or the nutrients your gut and body need from food.

Your gut and your hormones don't exist in separate worlds—they're part of the same incredibly complex body.

Next in The Menopause Gut Connection:

👉 What happens to the estrobolome as estrogen declines during menopause?

Lorraine English | Clinical Nutritionist
Specialising in Menopause & Gut Health
LEPT Nutrition

Iron and Perimenopause: Especially Important If Your Periods Are Heavy

We spend a lot of time talking about estrogen during perimenopause.

But there's another conversation I want more women to have:

IRON.

During perimenopause, periods don't always simply become lighter and disappear.

For some women, changing ovulation and hormone patterns are accompanied by heavier, longer or less predictable bleeding.

And repeated heavy blood loss can increase your risk of iron deficiency and iron-deficiency anaemia.

Signs can include:

😴 Persistent fatigue
🧠 Difficulty concentrating
🥶 Feeling unusually cold
💓 Heart palpitations
😮‍💨 Shortness of breath
🤕 Headaches
🏃 Reduced exercise tolerance

The difficult part?

Some of these symptoms can easily be attributed to perimenopause.

That is why we shouldn't assume every symptom in a woman over 40 is “just hormones.”

🥩 Food matters here too.

Iron-rich foods include:

• Lean red meat
• Seafood
• Poultry
• Eggs
• Legumes and lentils
• Tofu
• Nuts and seeds
• Iron-fortified foods
• Dark leafy greens

Iron from plant foods is less readily absorbed than haem iron from animal foods, but pairing plant sources with vitamin C-rich foods can improve absorption.

For example:

🥗 Lentils + capsicum
🥦 Tofu + broccoli
🍓 Iron-fortified cereal + berries

And here's something many coffee and tea lovers don't realise:

☕ Tea and coffee consumed with an iron-rich meal can reduce non-haem iron absorption.

If iron status is a concern, timing them away from iron-rich meals may be useful.

⚠️ But please don't start taking high-dose iron “just in case.”

Too much iron can be harmful. If you're experiencing heavy bleeding, significant fatigue or symptoms that concern you, speak with your GP about the bleeding itself and whether appropriate testing—including iron studies—is needed.

Nutrition can help replenish what you're losing.

But we also need to understand why you're losing it.

That's the difference between simply treating a symptom and looking at the whole picture.

Lorraine English | Clinical Nutritionist

SMOOTHIE WITH A LITTLE MORE SUBSTANCE

Smoothies can be a quick breakfast—but I like to make sure they're doing more than simply giving you a hit of fruit.

This one combines protein + plants + healthy fats to make it a more balanced option for busy mornings.

🥕 ½ carrot, grated
🥒 ¼ cucumber
🌿 100g kale leaves
🥑 ¼ avocado
🍎 ½ apple, chopped
🍌 ½ banana
🥛 250ml unsweetened almond milk
💪 20g protein powder (or 1 scoop)

METHOD:
Add everything to a blender and blend until smooth. Add a little extra almond milk or water if you prefer a thinner consistency.

Why I like this combination

💪 Protein helps make the smoothie more substantial and supports the maintenance of muscle mass—particularly important through midlife and menopause.

🌿 Plant variety gives your gut microbes a wider range of plant compounds to work with.

🥕 Fruit + vegetables provide fibre along with a range of vitamins, minerals and phytonutrients.

🥑 Avocado adds healthy unsaturated fats as well as additional fibre.

And here's my favourite part:

You've already included SIX different plant foods before your day has really started. 🌱

No “detox.”
No complicated rules.
Just a simple way to get more plants + protein + fibre into your day.

📌 SAVE this recipe for your next busy morning.

Would you try this one? 👇

Lorraine English | Clinical Nutritionist
Specialising in Menopause & Gut Health
LEPT Nutrition