There has been a surge of interest in hormones and gut health. More specifically, the human microbiome (the collection of bacteria in your gastrointestinal tract) and how these trillions of bacteria are crucial to our physiology and metabolism.

Every system in the body is connected and our gut is intrinsically linked to overall health and hormone balance.

What Is The Estrobolome?

The estrobolome is a collection of bacteria in the gut which is capable of metabolising and modulating the body’s circulating estrogen. It is the bacteria in the gut, and the estrobolome, that affects estrogen levels, which in turn can impact weight, libido and mood.

Hormones And Gut Health: Why Is Gut Health Important?

Optimising our gut health is key to keeping our hormones in balance. Gut health is so important because the microbiome has many functions. It:

• Aids the synthesis and regulation of hormones and neurotransmitters
• Facilitates absorption of macro and micronutrients
• Has an essential role in the immune system
• Contributes to regulation of estrogen levels in the body

Estrogens are primarily made in the ovaries and adrenal glands. There are three different types, all of which have vital roles in the body. In women, estrogens help regulate body fat, are essential to female reproductive function, cardiovascular health, bone health, and brain function (including memory). In men, estrogens aid in the maturation of sperm and maintenance of libido.

When the gut microbiome is healthy, the estrobolome is producing optimal levels of an enzyme called betaglucuronidase – too much and estrogen levels become imbalanced. Betaglucuronidase also has an important role in breaking down complex carbohydrates and the absorption of bilirubin and flavonoids. A healthy, diverse gut microbiome with a rich collection of different bacteria is critical for hormonal balance.

As the liver metabolises estrogen, this conjugated estrogen is delivered to the bile for excretion into the gut. A healthy estrobolome minimises reabsorption of estrogen from the gut allowing safe removal as waste in stool and urine again ensuring hormone balance.

Gut dysbiosis is an imbalance of the gut bacteria in the gastrointestinal tract. If there is an excess of bacteria that produce betaglucuronidase, this reverts estrogen back into its unconjugated active form and it is then absorbed back into the bloodstream resulting in estrogen dominance. Elevated betaglucuronidase levels are associated with conditions including:

• Pre-menstrual syndrome (PMS)
• Obesity
• Metabolic syndrome
• Estrogen-related cancers (breast and prostate)
• Endometriosis
• Infertility
• Mood disturbance
• Heart disease

Unfortunately, gut dysbiosis and gut microbiome imbalance are very common and the delicate balance of the microbiome and estrobolome can be affected by many different factors which include genetics, age, weight, diet, alcohol, antibiotics, environmental pollutants and more.

Signs Of An Unhealthy Gut

There are many signs of an unhealthy gut, which can often be misdiagnosed as something else.

• Digestive issues (bloating, gas, diarrhoea or constipation)
• Weight changes
• Food sensitivities
• Fatigue
• Skin irritation
• Autoimmune conditions
• Hormonal imbalance

4 Ways To Improve Gut Health And Hormone Balance

So how can we improve gut health and achieve hormone balance? We take a holistic approach in the clinic with our patients and combine lifestyle changes with bioidentical HRT to effectively correct hormone imbalance.

1. Look at what we put into our bodies

“The food we eat not only feeds our cells, but also determines what kind of inner garden we are growing in our guts.” – Dr. Mark Hyman.

Diet plays a vital role. A low GI (glycaemic index) diet which contains a diverse range of fruit, vegetables and fiber, high in phytonutrients – the so-called ‘rainbow plate’ – can encourage microbial diversity.

It is important to cut out what is referred to as ‘white carbs’ such as pasta, rice and potatoes which raise blood sugar very rapidly and eventually cause insulin resistance. Insulin resistance causes inflammation in the body which is the root of many disease processes.

Bear in mind that cruciferous vegetables, such as broccoli, contain compounds that ease detoxification of estrogen. The supplement DIM (diindolylmethane) contains concentrates of such compounds and can be effective in lowering more toxic estrogen byproducts.

Prebiotics and probiotics should also be considered. Prebiotic foods such as garlic, onion, asparagus and bananas provide the material that gut bacteria like to feed on. Probiotic foods such as kefir, kombucha, kimchi, and other fermented foods are really useful for introducing beneficial bacterial strains, like lactobacillus, to the gut.

The supplement calcium D glucarate is a betaglucuronidase inhibitor and allows estrogen to remain conjugated, and therefore safely eliminated by intestinal detoxification.

2. Consider our environment

Estrogens can also be obtained from the environment. Phytoestrogens from plants such as soya, tofu and tempeh are consumed as food while others are synthetically manufactured and called Xenoestrogens. These are found in common household products such as fragrances, pesticides and plastics. It is important to find ways of reducing these toxic substances that impact our health and find more environmentally friendly solutions. We should aim to eat organic food and reduce the use of plastic. Xenoestrogens are absorbed by the body and stored in liver and fat cells. They act synergistically with endogenously produced estrogens and influence cell proliferation and disrupt the delicate balance of hormones.

3. Antibiotics

The use of antibiotics disrupts the ecology of the gut microbiome, and can cause overgrowth or dysbiosis. A study by the University of Copenhagen found that six months after stopping antibiotics, most healthy people can recover the microbiome composition and function. However, the gut can still lack some of the beneficial bacteria and we then need to reintroduce the good guys!

4. Alcohol

We live in a society where alcohol is freely available and socially acceptable. But alcohol consumption can have a negative impact, not only on the gut microbiome but also on the liver and its ability to detoxify circulating estrogens and endocrine-disrupting chemicals. This contributes to estrogen dominance symptoms and an increased risk of estrogen related cancers. We encourage enjoyment of life but be mindful of safe drinking levels – 14 units a week for both men and women – as per the Chief Medical Officers’ guidelines. A single large glass of wine can contain up to 3 units of alcohol!

5. Physical activity

Exercise is an excellent way to support the detoxification that happens in the liver. Regular, moderate intensity exercise can lower levels of circulating estrogens. It can also reduce the stress hormone, cortisol, which can have a negative impact on our sex hormones. However, we do need to be mindful of what works for our own individual bodies. Activities that stimulate the parasympathetic nervous system or the body’s ‘rest and digest’ mode, such as yoga, are also very beneficial to hormonal health. Other mindfulness practices also have an impact on how our bodies deal with stress and subsequent hormone balance.

In summary, lifestyle, nutrition, physical activity and stress management can all help balance your estrobolome and ensure we keep our hormones balanced and optimal.

Got Questions?

If you think you may have a hormone imbalance, or feel that your gut health could be impacting your health, don’t hesitate to book a remote consultation with one of our specialist doctors.