Women, Gut Health, and Hormones: The Connection You Didn't Know About

Real talk: your gut isn’t just where food goes to get dealt with. It’s a busy biochemical control center that chats with your hormones, mood, metabolism, and even skin. If you’ve been wondering why your mood, cycle, skin, or sleep feel off — your gut might be part of the story. 

Your gut is home to trillions of microbes. Some of those microbes produce enzymes and metabolites that help process hormones—especially estrogens—and influence things like insulin, androgens (hello, PCOS), and neurotransmitters (mood, sleep, appetite). Changes in the makeup of your gut bacteria (aka “dysbiosis”) can shift how hormones are processed and circulated in your body, which can affect everything from your period to your mood. (1, 2)

There’s a special subset of gut bacteria called the estrobolome.These microbes make enzymes (notably β-glucuronidase) that can reactivate estrogens in the gut so they’re reabsorbed back into circulation. If this system is out of whack (too much or too little activity), your estrogen levels and balance can shift, which may show up as heavier periods, PMS, acne, or changes in skin and mood. Researchers are actively studying how estrobolome dysfunction relates to conditions like endometriosis, breast cancer risk, and menopausal symptoms. (1)

Why it matters: If your gut bacteria are sending the wrong biochemical signals, your body might be holding on to or losing estrogen in ways that change how you feel month to month.

Polycystic ovary syndrome (PCOS) is a complex hormonal condition that often includes higher androgens, irregular cycles, and insulin resistance. Growing evidence links altered gut microbiota to PCOS symptoms: certain bacterial patterns are associated with inflammation, insulin problems, and higher androgen activity. Some preliminary studies suggest modulating the gut (diet, probiotics) can help metabolic and hormonal markers in PCOS, though this research is still evolving. (3)

Bottom line: Gut health isn’t the only factor in PCOS, but it’s an important piece of the puzzle and a promising target for supportive strategies.

Your gut makes or influences big players like serotonin (which affects mood and sleep) and short-chain fatty acids (which influence inflammation and insulin sensitivity). The gut and brain communicate constantly via the gut-brain axis, so when your gut microbes shift, you can see changes in anxiety, postpartum mood, or stress resilience. That’s why increasing fiber and supporting healthy microbes often shows up as better mood and sleep for many people. (4, 5)

Quick practical idea: A fiber-first approach (whole foods, not fads) feeds the microbes that produce helpful metabolites for mood and metabolic health.

Short answer: maybe—but with nuance.

• Probiotics: Some clinical trials and meta-analyses show probiotics can help urogenital health, menopausal symptoms, and some metabolic/hormonal markers (especially in PCOS). Effects vary by strain, dose, and length of treatment. Probiotics aren’t magic, but certain strains may provide targeted benefit when combined with diet and lifestyle. (6,  7)
  
  

• Diet & fiber: High-fiber diets support microbial diversity and production of beneficial short-chain fatty acids, which help insulin sensitivity and inflammation—both tied to hormone balance. For pregnant and postpartum women, higher fiber intake has been associated with better mental-health outcomes in some studies. (8)
  
  

• Lifestyle: Sleep, stress management, exercise, and limiting excessive alcohol/sugar all support a healthier gut and more stable hormones.

What this looks like in practice: a daily plate with veggies, legumes, whole grains, fermented foods (if tolerated), consistent sleep, and a targeted probiotic if your doctor recommends one.

Watch for patterns, not single days of weirdness. Consider looking closer if you notice:

• New or worsening PMS, irregular cycles, or heavier bleeding.
  
  

• Persistent acne or skin changes that don’t respond to usual care.
  
  

• Bloating, chronic digestive upset, or frequent bloating tied to your cycle.
  
  

• Sudden mood swings, low mood, or sleep shifts that align with gut changes.
  
  

• Metabolic shifts like unexplained weight changes, sugar cravings, or insulin issues.

If several of these are true, your gut-hormone axis may be worth discussing with a clinician.

Some women find that balancing insulin and hormone signaling with nutrients like Myo & D-Chiro Inositol can help support a calmer cycle, which may also mean less dramatic bloating swings.

1. Eat more fiber: Aim to add fruits, veggies, legumes, and whole grains gradually—this feeds beneficial microbes.

2. Include fermented foods (yogurt, kefir, miso) if you tolerate them; these can support diversity.

3. Consider a targeted probiotic after chatting with your doctor—strain matters, and so does context (PCOS, menopause, postpartum needs differ). (7,  9)

4. Try digestive support when meals feel heavy: Digestive enzymes can help break down things like protein and fat so they don’t linger and cause bloat.

5. Prioritize sleep and stress management:The HPA axis (stress hormones) talks to your gut, so calmer = better communication. (4) Supporting stress resilience with adaptogens and botanicals can help tame both your nervous system and your digestive drama.

6. Track patterns:Use a short symptom diary for 1–2 cycles to see if digestive and hormonal changes align. Data helps your provider give better advice.

If you’re seeing significant menstrual irregularities, strong metabolic shifts (rapid weight gain, blood sugar symptoms), severe mood changes, or symptoms that interfere with daily life, consult your healthcare provider. Some conditions need targeted medical treatment (e.g., hormonal therapy, insulin-sensitizing meds), and gut-focused approaches are often best used alongside medical care. (10,11)

Your body is complex, and hormones are messy—and that’s okay. The gut doesn’t have to be a mysterious enemy; it can be an ally. Small, consistent changes to diet, sleep, and stress—and smart, evidence-based support like targeted probiotics when appropriate—can move the needle. You're not broken for asking questions. You're smart for doing something about it. We’ve got your back. 

1. Pai AH, et al. Gut Microbiome-Estrobolome Profile in Reproductive-Age Women with Endometriosis. Int J Mol Sci. 2023 Nov 14;24(22):16301.  https://pmc.ncbi.nlm.nih.gov/articles/PMC10671785/

2. Baker JM, et al. Estrogen–gut microbiome axis: Physiological and clinical implications. Maturitas. 2017 Sept (103): 45-53. https://www.sciencedirect.com/science/article/abs/pii/S0378512217306503

3. Sun Y, et al. Gut microbiota dysbiosis in polycystic ovary syndrome: Mechanisms of progression and clinical applications. Front Cell Infect Microbiol. 2023 Feb 24;13:1142041.  https://pmc.ncbi.nlm.nih.gov/articles/PMC9998696/

4. Appleton J. The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health. Integr Med (Encinitas). 2018 Aug;17(4):28-32.  https://pmc.ncbi.nlm.nih.gov/articles/PMC6469458/ 

5. Barandouzi, Z.A., et al. Associations of neurotransmitters and the gut microbiome with emotional distress in mixed type of irritable bowel syndrome. Sci Rep 12, 1648 (2022).  https://www.nature.com/articles/s41598-022-05756-0

6. Andrews RAF, et al. Investigating the effects of probiotics during the menopause transition: A systematic review & meta-analysis. Clin Nutr ESPEN. 2025 Jul 8;69:241-256.  https://pubmed.ncbi.nlm.nih.gov/40639456/

7. Arab A, et al. Effects of probiotic supplementation on hormonal and clinical outcomes of women diagnosed with polycystic ovary syndrome: A double-blind, randomized, placebo-controlled clinical trial. Journal of Functional Foods. 2022. Sept (96): 105203 https://www.sciencedirect.com/science/article/pii/S1756464622002730

8. Xie T, et al. Association between gut microbiota and its functional metabolites with prenatal depression in women. Neurobiology of Stress. 2024. Jan (28): 100592. https://www.sciencedirect.com/science/article/pii/S2352289523000802

9. Szydłowska I, et al. Effects of probiotics supplementation on the hormone and body mass index in perimenopausal and postmenopausal women using the standardized diet. A 5-week double-blind, placebo-controlled, and randomized clinical study. Eur Rev Med Pharmacol Sci. 2021 May;25(10):3859-3867.  https://pubmed.ncbi.nlm.nih.gov/34109594/

10. Yang, Yanan et al. Gut microbiota in women with polycystic ovary syndrome: an individual based analysis of publicly available data. eClinicalMedicine, Volume 77, 102884.  https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370%2824%2900463-2/fulltext

11. Rizk MG, Thackray VG. Intersection of Polycystic Ovary Syndrome and the Gut Microbiome. J Endocr Soc. 2020 Nov 16;5(2):bvaa177.  https://pmc.ncbi.nlm.nih.gov/articles/PMC7757431/