Intestinal health and menopause: uncovering an invisible axis
Recent surveys show that almost 60% of women report that menopausal symptoms negatively affect their daily lives, including family and sexual relationships. In Portugal, a national study led by the Gulbenkian Institute of Molecular Medicine (GIMM) aims to go deeper: to explore the so‑called invisible axis of women’s health by studying how the gut microbiota interacts with hormonal changes during perimenopause and menopause. The goal is to develop strategies that safeguard the health of women across the whole life span.
The study and its ambitions
Led by Ana Santos Almeida, a principal investigator at the Translational Microbiome Lab in Health and Disease, the project seeks to map the relationship between intestinal bacteria and estrogen levels. “We don’t yet know how these bacteria contribute to estrogen balance during menopause, a period when estrogen declines abruptly,” Almeida explains. Because estrogen plays a central role in many chronic conditions that accompany aging—such as depression and certain cancers like breast cancer—the research could offer new ways to prevent or mitigate these risks.
In menopause, the gut microbiota may metabolize estrogen, excreting or recycling it to influence the hormonal cycle. The study aims to clarify how this metabolic dance affects symptom burden and long‑term health, acknowledging that this is a relatively new field of inquiry.
How the study is being conducted
As part of the GIMM initiative “Semana da Mama” (Breast Health Week), researchers are collecting samples from 300 women aged 40 to 64—the period when perimenopause and menopause typically occur. Each participant provides a blood sample and a fecal sample, along with detailed information about dietary habits and other lifestyle factors. Almeida notes that the idea of stool collection is less about discomfort and more about unlocking vast microbial data: even a pea‑sized sample can reveal thousands of bacterial species and their functions.
The blood samples help researchers study hormone levels and inflammatory markers related to both aging and menopause. The ultimate aim is to integrate these biological signals with data on the microbiota and nutrition using advanced computational methods. By applying machine learning, the team hopes to build models that identify risk patterns, predict symptom severity, and flag potential disease risks tied to the menopausal transition.
From data to potential biomarkers and interventions
The long‑term ambition is to determine whether the gut microbiota can serve as a biomarker for menopausal symptoms or for risk of future illness. Unlike our genes, the microbiota is highly modifiable through diet and other lifestyle factors, which opens doors to targeted interventions. In practical terms, researchers hope to craft a framework where a woman’s microbiota profile, hormonal status, and nutrition history inform personalized recommendations to prevent chronic conditions or alleviate symptoms.
What comes next?
With funding currently provided by the Biocodex Foundation Portugal, the team plans to expand the study—enrolling more participants and following them through the menopausal window to refine the predictive models. The collaboration includes researchers from INESC‑ID and the Faculty of Medicine of Lisbon, underscoring a multidisciplinary effort to translate findings into real‑world strategies for women’s health care.
Why this research matters for women’s health
By shedding light on the connection between the hormonal system and the gut microbiome, the study holds the promise of moving from reactive treatment of menopausal symptoms to proactive, preventive care. If the microbiota proves useful as a biomarker or a modifiable factor, clinicians could tailor dietary and lifestyle interventions to reduce symptom burden and mitigate long‑term disease risk for women as they age.
Aiming for a healthier life course
Ultimately, this national investigation seeks to chart a path toward better health for women throughout life, starting with the menopausal transition. As scientists work to decode the “invisible axis” of intestinal health and hormones, the hope is for clearer risk assessment tools, more personalized care, and a future where gut health contributes meaningfully to healthier aging for all women.
