As you’re more than aware, perimenopause, which is often described as the transition phase before menopause, brings about a whirlwind of changes in a woman’s body — and not just physically, but also emotionally and mentally. While most are us aware of the usual common symptoms, like hot flushes, night sweats and irregular heavy periods, there’s one critical area that often goes unaddressed. And that’s our mental health. Which means that for perimenopausal women, maintaining our mental wellbeing can be more of a challenge due to the hormonal shifts we’re experiencing, lifestyle factors such as juggling a career, family and perhaps caring for our ageing parents, and something that’s a particularly important, although less obvious, element — our gut health.

In recent years, science has shown us how crucial our gut health is, not only for our physical wellbeing (because up to 80% of our body’s immune system is influenced by the gut), but also for our mental and emotional balance. This is why the gut has become known as the ‘second brain’, seeing as it plays such a pivotal role in how impacts our moods, stress response and cognitive function. This is particularly significant for women going through perimenopause, because we can often experience heightened stress, anxiety and mood swings due to our constantly changing hormones.

Understanding The Gut-Brain Axis

To appreciate the connection between gut health and mental health, we first need to understand the concept of the gut-brain axis. The gut-brain axis is a two-way communication network between the gut and the brain, which is facilitated by various pathways that involve your nervous systems, your immune system and your endocrine (hormonal) systems. This connection is largely mediated by the vagus nerve, one of the largest nerves in the body, which runs along your spine and links the digestive tract directly to the brain.

The gut microbiome, which is a diverse community of bacteria and microorganisms in the digestive tract, also plays a crucial role in this communication system. That’s because microbes in the gut help to produce neurotransmitters and hormones like serotonin, dopamine and gamma-aminobutyric acid (GABA), which are critical for regulating your mood and anxiety levels. You may be surprised to find out that around 90% of our body’s serotonin, which is often called ‘the happiness hormone’, is produced in the gut, which just goes to show how integral your gut health is to your emotional wellbeing.

When our bodies enter perimenopause, most women experience a decrease in oestrogen and progesterone levels, the hormones that significantly influence our mood and emotional regulation. These hormonal fluctuations not only affect our brain chemistry, though. They also disrupt the balance of the gut microbiome. So, let’s look at how these factors interplay to impact mental health in perimenopausal women.

1. Hormones

Both oestrogen and progesterone influence the composition and diversity of our gut bacteria, which means that as levels of these hormones fluctuate during perimenopause, the balance of gut microbes can become disrupted. This imbalance, which is known as dysbiosis, can lead to inflammation — a known contributor to mental health issues. Chronic inflammation from poor gut health is not only linked to bloating and abdominal discomfort, but also to symptoms like anxiety, depression and the dreaded brain fog, which is one of the most common complaints that I hear from my lovely perimenopausal clients.

2. Neurotransmitters

When oestrogen levels drop, the production of serotonin, dopamine and other neurotransmitters in the gut can also be affected. And when we have lower serotonin levels, this can contribute to us experiencing wild mood swings, feeling irritable and even depression. Gut dysbiosis will worsen these symptoms by further inhibiting the production of mood-regulating neurotransmitters. So, for perimenopausal women who are already facing psychological challenges, a disruption in our gut health can exacerbate feelings of anxiety, stress and emotional instability.

3. Cortisol and The Stress Response

Perimenopause is often accompanied by increased stress, due to both the hormonal changes in our body, as well as lifestyle transitions. The gut microbiome plays a crucial role in modulating our cortisol levels, the body’s primary stress hormone. An imbalanced gut can lead to increased cortisol production, causing a heightened stress response and further aggravating mental health issues. In addition, if you are chronically stressed anyway, this negatively impacts your gut health, which will further exacerbate a vicious cycle where poor gut health leads to increased stress and vice versa.

Improve Your Gut For Better Mental Health

Given the profound impact of gut health on our mental wellbeing, perimenopausal women can benefit from nurturing a balanced and healthy gut microbiome. Here are some of my most effective strategies I use with my lovely clients to enhance their gut health:

• Eat Diverse: Eating foods that are rich in fibre, probiotics and prebiotics can help to cultivate a healthier gut microbiome. Prebiotics foods like dandelion greens, organic leeks, onions and garlic, asparagus, Jerusalem artichokes, organic apples and organic oats feed the good bacteria that live in our guts. Probiotic foods, such as organic yogurt and kefir, as well as organic sauerkraut and kimchi, introduce beneficial bacteria to the digestive system. Studies show that a diverse gut microbiome, nurtured by a varied diet, is linked to lower levels of anxiety and depression, making this approach essential for perimenopausal women facing mood changes.
• Cut The Crap: I know that I got on about this, but excessive sugar and processed foods disrupt your gut health by promoting the growth of harmful bacteria, which causes inflammation (and can lead to pain in your joints). Avoiding these foods WILL help to restore a healthier balance in your gut microbiome, which in turn will reduce inflammation AND improve neurotransmitter production. A low sugar intake will also aid in stabilising your moods and reducing the likelihood of irritability, which is so common among perimenopausal women. And yes, that means cutting down on the wine!!!
• Stress Test: Managing your stress is essential for maintaining a healthy gut. Chronic stress causes inflammation in the gut, which impacts more than your digestion — it also negatively affects your mental health. This is why incorporating mindfulness techniques, such as meditation, deep breathing exercises and yoga, is important to not only lower your stress levels, but also promote better gut health. Exercise is another beneficial practice, as it helps release endorphins, which elevate mood and reduce cortisol levels. Plus, prioritising good sleep hygiene, such as limiting your caffeine intake and reducing screen time before bed (so no social media interaction at least an hour before bed), can help improve your gut health.
• Supplement Help: Sometimes dietary changes alone aren’t enough to restore a gut balance and you may need some support using supplements like probiotics, prebiotics and omega-3 fatty acids. Probiotics can introduce beneficial bacteria into your gut, while prebiotic fibres feed the good bacteria that’s already present. Omega-3 fatty acids, which are found in fish oil, have anti-inflammatory properties that benefit both the gut and the brain. One of my favourite supplements to help with this is Nature’s Sunshine Pro B11, which is a high potency natural live bacteria supplement that provides almost 12 billion multi strain bacteria in each veg capsule to ensure your gut replenishs with beneficial flora. It also helps to protect the gut wall and prevents more harmful organisms from establishing themselves. Another favourite is Nature’s Sunshine Super Omega-3 EPA, which not only supports the gut-brain axis, but is also beneficial for the nervous, skeletal, cardiovascular, glandular and immune systems.

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Now Do I Have Your Attention?

The field into the link between gut health and mental health is a rapidly evolving area of research, but it holds real promise for perimenopausal women, especially when exploring how fluctuating oestrogen levels impact the gut microbiome. Perimenopause is already a complex phase in our lives and while many factors do contribute to our mental wellbeing during this transition, our gut health plays a pivotal role. As you’re now aware, the gut-brain axis serves as a powerful communication channel that influences our mood, stress levels and overall emotional health, so by nurturing a healthy gut through a balanced diet, stress management, quality sleep and, when necessary, supplements, perimenopausal women can support their mental health and navigate this transitional period with greater resilience.

I hope this gives you some understanding of how prioritising your gut health can empower your to take control of their mental wellbeing during perimenopause and help you embrace this phase with vitality and better peace of mind.

Love, Gaynor x