By Christine Bowen, ND
Author, Speaker, and Naturopathic Physician

I have been specializing in holistic digestive care since 2005 and have only recently come to have a better understanding of how hormones affect our guts and how our gut health can impact our hormones. Don’t get me wrong—I still have a lot of learning to do and the science is still young on this topic but I am excited to share a slice of what I have learned with you today! 

The Gut & Hormone Connection Overview

I definitely suspected that there was a gut ↔ hormone connection when I had patients that experienced healing or flares in their health conditions that involved both gut issues and hormone imbalance in women at the same time. One of my patients had an irregular menstrual cycle and then took a probiotic and their cycle normalized. Another one of my patients was having menopausal weight gain. Her weight gain was arrested and controlled after we restored her gut health. Now, we are gaining a deeper understanding of the intricate connections between the gut and our hormones but I am certain that we are still barely comprehending the full level of interconnectedness. 

Testing the Connection

I have been ordering stool tests more often in recent years to help understand more about hidden gut infections, inflammation, and other measurements that I might not have fully known about without this type of testing. 

The 3-day stool test measures many things:

  1. Levels of and presence of infectious or unhelpful organisms
  2. gut inflammation
  3. normal bugs and their types and amounts
  4. the breakdown products of those bugs
  5. how we break down our food. 
  6. It also gives us a snapshot of the balance (or imbalance) of the organisms in our gut microbiomes. 

Gut Imbalance

Have you heard the term dysbiosis? Dysbiosis is basically an imbalance of the bugs in our intestines and their environment, also known as our microbiome. When we overgrow certain types of organisms, it can create problems in other body systems instead of just creating problems that stay in the gut. 

One example of how the gut bugs can influence other body systems is how they break down Estrogen using beta-glucuronidase. Beta-Glucuronidase is an enzyme that is produced by an excess of certain types of gut bugs. Beta-glucuronidase breaks down (metabolizes) Estrogen and increases free circulating Estrogen in our bodies. This Estrogen effect coming from our imbalanced gut bugs is also referred to as the Estrobolome. When the Estrobolome is active and beta-glucuronidase is high, there are negative impacts on our bodies as a whole. Beta-glucuronidase levels are tested through stool tests, like the 3-day collection that I mentioned above.  

Female Estrogen Hormone Balance

When it is in balance, Estrogen is a useful hormone that helps with:

  1. the development of our sex organs 
  2. controls our menstrual cycle
  3. influences our moods
  4. helps with connective tissue
  5. supports the building of bone
  6. much, much more. 

Female Estrogen Hormone Imbalance

When Estrogen becomes deficient, we enter Menopause and any of these systems that are supported by Estrogen could be negatively impacted. If Estrogen is higher than it should be, as it is with elevated beta-glucuronidase, it could increase our risk of Estrogen sensitive breast cancer or make conditions exacerbated by excess Estrogen much worse. 

Studies have shown a link between elevated beta-glucuronidase and increased risk of postmenopausal Estrogen receptor-positive breast cancer. In order to help the body deal with high beta-glucuronidase and elevated Estrogen, there are many approaches to help to reduce this scenario. First and foremost, we must work on addressing gut dysbiosis (imbalance) through diet, lifestyle, and other herbal or nutrient therapies as appropriate, and secondarily, when high beta-glucuronidase is detected, a supplement called Calcium-D-Glucarate can be used to reduce the estrogen and beta-glucuronidase levels. 

When the health of our intestines is balanced and dysbiosis is addressed, the risk of negative female hormonal impacts is then reduced significantly.

estrogen hormone gut connection

Gut Hormone Connection: Take-Home Summary

Gut Dysbiosis => Elevated beta-glucuronidase => The Estrobolome => high estrogen, negative impacts

The Estrobolome and high beta-glucuronidase can increase Estrogen activity in the body and create major problems. To correct this excess Estrogen, the gut must be assessed and treated in addition to other supportive female hormone treatments. 

Doing adequate saliva testing for hormone imbalance is how we get this information and your treatments should always be individualized to your specific health needs!

Resources Used:

  1. Hiller-Sturmhofel S, Bartke A. The endocrine system: an overview. Alcohol Health Res World. 1998;22:153-164.
  2. Kwa M, Plottel CS, Blaser MJ, Adams S. The Intestinal Microbiome and Estrogen Receptor-Positive Female Breast Cancer. J Natl Cancer Inst. 2016;108.
  3. Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas. 2017;103:45-53.
  4. Mauvais-Jarvis F. Is Estradiol a Biomarker of Type 2 Diabetes Risk in Postmenopausal Women? Diabetes. 2017;66:568-570.
  5. Cani PD, Knauf C. How gut microbes talk to organs: The role of endocrine and nervous routes. Mol Metab. 2016;5:743-752.
  6. Parasar P, Ozcan P, Terry KL. Endometriosis: Epidemiology, Diagnosis and Clinical Management. Curr Obstet Gynecol Rep. 2017;6:34-41.
  7. https://academic.oup.com/jnci/article/108/8/djw029/2457487
  8. https://pubmed.ncbi.nlm.nih.gov/28778332/
  9. https://www.viome.com/blog/gut-imbalance-blame-your-hormonal-changes#:~:text=Estrogen%20and%20Gut%20Health&text=Now%20scientists%20have%20discovered%20the,estrogen%20in%20circulating%20blood3
  10. https://maxliving.com/healthy-articles/gut-health-and-hormonal-imbalances#:~:text=Leaky%20gut%20and%20other%20gut,of%20developing%20postmenopausal%20breast%20cancer
  11. https://www.vibrant-wellness.com/the-gut-microbiome-and-the-estrobolome-how-gut-microbes-affect-estrogen-metabolism/