Gastroenterologist Dr Saurabh Sethi shares 5 things every woman should know about the gut-hormone link in menopause

Menopause not only affects the reproductive system, but also gut health. Dr Sethi explains how the link works and how one can better take care of themselves.

Menopause is a natural part of ageing in women, when her menstrual period stops permanently, and her fertility window closes. As one reaches the age of 45 to 55, there is a shift in hormone levels that affects not just the reproductive system but also the gut, according to Dr Saurabh Sethi, a California-based gastroenterologist trained at AIIMS, Harvard, and Stanford Universities.

Taking to Instagram on July 10, Dr Sethi explained that there is a gut-hormone link in menopause that every woman should know about. He shared how it works and what women can do to stay healthy.

1. Food is the new estrogen

During menopause, the production of estrogen decreases, and food comes in to take its place. “Fibre, fermented foods, and phytoestrogens are now load-bearing,” noted Dr Sethi.

If a woman is above the age of 50, they should target approximately 21 grams of fibre per day. For those below 50, the target is 25 grams. “Most women fall short everywhere this is studied, from Japan to the US to Europe,” noted the gastroenterologist.

2. Weakening of the gut lining

Estrogen protects the gut lining. When hormone levels fall during menopause, the gut loses its protection.

As Dr Sethi explained, “Declining estrogen weakens the tight junctions holding your gut together, raising permeability and inflammation. Postmenopausal women show measurably leakier guts than premenopausal women, tied to blood inflammation markers.”

3. Change in the gut microbiome

With menopause, there is a shift in the gut microbiome pattern. “Studies show bacterial diversity drops as estrogen falls, shifting toward a male-like pattern. Those bacteria regulate mood, weight, and inflammation,” stated Dr Sethi. It is not just a gut issue, but concerns the whole body.

4. Change in bowel movement

Constipation often follows menopause and is caused by the hormonal changes. As Dr Sethi explained, “Estrogen keeps things moving. When it drops, transit slows. In a 2025 survey of around 600 women, 94 percent reported digestive symptoms, 54 percent had constipation, and 82 percent said it started or worsened at menopause.”

5. Gut sets the mood

As per Dr Sethi, 90 to 95 percent of the serotonin is made in the gut, not the brain. “When hormones shift, that production shifts too - part of why anxiety and brain fog show up in menopause,” he explained.

How to support the gut during menopause

It is important to know that the gut did not become dysfunctional during menopause. It simply lost the protection it depended on for decades. As such, giving the right support can make it better again.

Three things that one can start right away to protect the gut include:

• Eating one fermented food daily - yoghurt, kefir, kimchi
• Getting 21 grams of fibre per day (25g if under 50) - lentils + berries gets you halfway
• Eating one phytoestrogen food - flaxseed, soy, chickpeas

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

This report is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.

Dr Saurabh Sethi is a California-based gastroenterologist with training from AIIMS, Harvard, and Stanford and more than two decades of clinical experience. He became a social media content creator sharing insight on his area of expertise during the Covid-19 pandemic.