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Female health and the gut

Updated: Jan 5, 2023

By Emma Jamieson dipION mBANT CNHC

Are you one of the many women whose hormones drive a long-standing heath condition? Or perhaps each month brings anxiety, pain and mood swings thanks to PMS.

What is often not known is that the health of your gut (aka the digestive system) can play a major role in the intricate dance between our female sex hormones, particularly oestrogen.

Women have four main hormones that fluctuate throughout the month, resulting in the release of an egg. They also prepare the uterus in case fertilisation takes place, and initiate its breakdown if this doesn’t happen, causing menstruation. These four key players are oestrogen, progesterone, luteinising hormone and follicle stimulating hormone.

When levels are in balance and working optimally, the monthly cycle happens seamlessly. However, when there is an imbalance - particularly with regard to oestrogen - health problems can occur.

Signs and symptoms of oestrogen imbalance

Imbalanced oestrogen can either be a result of too little, or too much. Both are linked to health issues.

Low levels of oestrogen may be a result of not enough being produced by the body, or because it is being removed from the body too quickly. Possible causes include low body weight, over exercising, the contraceptive pill and/or the menopause. Some symptoms that low oestrogen can cause include:

• mood swings

• dry skin

• vaginal dryness

• breast tenderness

• headaches

• irregular periods or no periods

• hot flushes

• brittle bones

On the flip side, high levels of oestrogen can be due to overproduction or insufficient clearance. PCOS, breast cancer, endometriosis and fibroids have all been linked to high oestrogen, as well as the following symptoms, which may coincide with certain times of the menstrual cycle:

• heavy or painful periods

• swollen, tender breasts

• lumpy breasts

• mood swings

• headaches


You will notice that some symptoms can be a result of both too much, and too little oestrogen. This is where looking in detail at your overall health will help to understand what the root cause of your own symptoms might be.

How does the gut influence levels of oestrogen?

As I’ve mentioned above, both fast, and slow, clearance of oestrogen can impact on overall levels in the blood. Once oestrogen has been used it is detoxified by the liver, which neutralises it and packages it up for removal from the body through urine or in our stools.

When the gut is working optimally, just the right amount is removed from the body each day to ensure that levels remain balanced and are prevented from building up. We have our gut microbiome - the collection of trillions of beneficial bacteria living in our colon - to thank for this. They manage the balance by secreting the enzyme beta-glucuronidase when circulating levels of oestrogen in the body are low. This enzyme unpackages the oestrogen and allows it to be reabsorbed into circulation.

Unfortunately, when there are more pathogenic than beneficial bacteria present in the gut (known as dysbiosis), elevated levels of beta-glucuronidase may be secreted which can lead to too much oestrogen being reabsorbed back into circulation and causing high levels in the blood. In addition, when dysbiosis is present, the gut lining can also become more permeable, sometimes referred to as a ‘leaky gut’. This can make it easier for the unpackaged oestrogen to pass through the gut lining into the bloodstream.

Women suffering from constipation may also find their oestrogen levels rising. If the daily clearance of stools is compromised, beta-glucuronidase has a longer opportunity to unpackage the oestrogen and allow it to be reabsorbed. Daily bowel movements are key to ensure optimal oestrogen clearance from the body.

What can be done to encourage optimum levels of oestrogen?

The good news is that much can be done to improve the health of the gut microbiome such as increasing the variety of plant foods in the diet, adding fermented foods, or taking a daily probiotic. This will all help the beneficial bacteria to thrive, thereby controlling secretions of beta-glucuronidase and help reduce gut permeability at the same time.

Looking at liver support to ensure detoxification of oestrogen is working optimally in the first place, and working at reducing any constipation to allow it to leave the body in a timely manner, will also help balance hormones and reduce any unwanted symptoms.

My thanks to Emma for contributing this blog. You can read more from Emma on here website here: Emma Jamieson - Nutritional therapist and digestive health specialist

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