Women’s Health Ingredients: Probiotics for Menopause – Recurrent UTI, Vaginal Atrophy

The changes women experience during menopause

Menopause marks the end of a woman’s reproductive years and a transition into a new stage of life¹. It’s driven by a steady decline in estrogen and progesterone, two important hormones produced by the ovaries. As these hormone levels drop, they trigger a wide range of changes throughout the body².

Hormonal changes and the vaginal microbiome

One of the less visible but important effects of menopause is its impact on the microbiome, the community of microorganisms that live in and on the body^3,4. Hormonal changes can influence the balance of bacteria in several areas, including the gut, vagina, skin and the mouth³.

In the vaginal environment, estrogen helps maintain a healthy balance of bacteria. During the reproductive years, vaginal tissues contain high levels of glycogen, which supports the growth of beneficial bacteria known as lactobacilli. These bacteria produce lactic acid, keeping vaginal pH in an acidic range of about 3.5 to 5.0. This acidic environment helps protect against infections in both the vaginal and urinary tracts⁵.

After menopause, lower estrogen levels reduce glycogen levels. This leads to a decrease in lactobacilli and a rise in vaginal pH⁵. The loss of protective bacteria allows for harmful microorganisms, such as Escherichia coli, Candida, Gardnerella and Enterobacter to grow more easily. As a result, postmenopausal women are more prone to infections such as bacterial vaginosis and vulvovaginal candidiasis⁶.

Moreover, estrogen is essential for maintaining the structure and function of the urogenital system. Its decrease causes the tissues in the vagina, labia, urethra and bladder to become thinner, drier and more fragile. These changes, combined with the shift in the microbiome, increase the risk of genitourinary syndrome of menopause (GSM). This condition is estimated to affect between 27% and 84% of postmenopausal women and can cause symptoms such as vaginal dryness, irritation and thinning of the vaginal and urinary tract tissues⁵.

The estrogen-gut microbiome axis

In addition to the vaginal microbiome, estrogen is also connected to the gut microbiome. This relationship appears to work both ways. Hormonal changes during menopause can alter the gut microbiome. Some studies suggest that menopause is associated with lower gut microbiome diversity and a shift toward patterns more commonly observed in men. However, larger-scale studies are needed to confirm these findings⁷.

On the other hand, the gut microbiome helps regulate estrogen levels in the body. Certain beneficial gut bacteria help “recycle” estrogen by converting it into a form that can be reabsorbed back into the bloodstream. This process, often referred to as the estrobolome, influences the amount of active estrogen that continues to circulate⁷.

Changes outside of the reproductive system

The effects of menopause aren’t limited to the reproductive tract. Falling estrogen levels affect other areas of health, such as decreased bone density, which increases the risk of osteoporosis⁸.

Menopause can also affect a woman’s cardiovascular health, as it’s associated with several risk factors. These include hypertension, insulin resistance, obesity and changes in body composition. Furthermore, it can lead to changes in how the heart and blood vessels function, such as reduced arterial flexibility and alterations in heart structure. This may increase the risk of heart disease⁹.

Interestingly, patterns during the menopause transition may offer clues about future cardiovascular health. In one long-term study of 428 women followed for up to 10 years, changes in menstrual cycle length were linked to later heart health. Women whose cycles lengthened later in the transition tended to have better artery health after menopause¹⁰.

Probiotics for vaginal health in menopausal woman

Probiotics are foods or supplements containing non-pathogenic microorganisms, including beneficial bacteria and yeast¹¹. Experts have recommended probiotics for gut health for many years, where they help restore balance to the microbiota, especially after disruption from antibiotic use, stress or illness¹². Outside of the gut, probiotics may also influence other microbial environments in the body. This has led to growing interest in probiotics for vaginal health, including menopause-related changes¹³.

How probiotics help restore balance

Probiotics may help restore a healthier vaginal environment by increasing Lactobacillus levels. This stabilizes the vaginal microbiota and lowers pH levels, thereby preventing and managing vulvovaginal candidiasis and bacterial vaginosis. They may reduce symptoms that often occur due to vaginal infections, such as vaginal discharge and odor¹³.

Moreover, Lactobacillus is important for protecting the vaginal lining, as it can attach to the vaginal epithelium and form a barrier that prevents pathogens from colonizing¹⁴. In addition, it produces natural substances that inhibit the growth of harmful bacteria and yeast, while helping to maintain a stable, acidic environment. This makes probiotics a promising approach to alleviate GSM symptoms, including recurrent UTIs, vaginal dryness and itching. The outcomes may be further optimized when combined with estrogen therapy¹³.

Other benefits of probiotics for menopause

Aside from vaginal health, probiotics for menopause are increasingly being studied for their broader impact on the body. Evidence suggests that they may improve symptoms such as hot flushes and mood changes. They may also benefit cardiovascular and bone health¹⁵.

Cardiovascular health

Studies show that probiotics may help address cardiovascular risk factors that tend to increase during menopause. Higher-dose probiotics containing Bifidobacterium and Lactobacillus have been linked to measurable improvements. These include healthier blood vessels, lower blood pressure and reduced inflammation in the body¹⁶.

Probiotics may support cardiovascular health through several other mechanisms. They reduce circulating inflammatory markers, which can help lower overall cardiovascular risk. Additionally, they may influence how the body processes fats. Certain probiotic strains can affect bile metabolism, leading the liver to use more cholesterol, which may help lower blood cholesterol levels. They may also improve insulin resistance by producing short-chain fatty acids. This further contributes to better metabolic health¹⁶.

Bone and metabolic health

There’s evidence that probiotics can enhance calcium absorption in the gut, which may help slow the decline in bone mineral density in women at risk of osteoporosis or osteopenia. This could potentially delay bone damage over time¹⁶.

Safety, tolerability and formulation considerations

Although research in postmenopausal women is still developing, current research demonstrates that probiotic supplementation is generally a feasible and safe strategy for managing menopause-related conditions¹⁶.

Both oral and vaginal probiotic formulations could offer a natural solution for restoring vaginal balance and reducing symptoms associated with GSM¹⁷. Oral probiotics, in particular, offer advantages compared to vaginal probiotics. They’re simple to take and incorporate into daily diets, and typically face fewer regulatory hurdles¹⁸.

Probiotic therapies are also being explored for their potential to improve the quality of life during menopause. Their ability to support microbial balance across different body systems makes them a promising addition to existing management strategies¹⁹.

An emerging support for menopause management

Probiotics are emerging as a supportive option for managing menopause-related changes, particularly those affecting vaginal and urinary health. Although more consistent evidence is still needed, their potential to restore microbial balance, reduce discomfort and support overall well-being makes them a promising addition to existing menopause management strategies.