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The Science

The gut–hormone connection, explained.

Fluctuating hormones disrupt the gut microbiome — the bacteria that help process oestrogen and shape how mood, sleep and weight feel through perimenopause. Here's the science behind that connection, and the targeted strains we've chosen to support it.

77%
of perimenopausal and menopausal women report bloating — the most common digestive symptom of the transition.Presented at The Menopause Society, 2025
01The science · step by step

How your gut shapes your hormones

The gut–hormone loop, in five steps. Open any one for how it works and the studies behind it.

See the full strain breakdown
01

The estrobolome

The community of gut bacteria that metabolise and recirculate oestrogen.

When the liver finishes processing oestrogen, it tags it for disposal and sends it to the gut. Certain gut bacteria — the estrobolome — can free that oestrogen to be reabsorbed instead of excreted. When the balance shifts, so does how much oestrogen stays in circulation. In a 2024 randomised trial, a probiotic with this β-glucuronidase activity helped maintain oestrogen levels in peri- and postmenopausal women — early clinical proof the estrobolome can be supported.

Plottel & Blaser, Cell Host & Microbe, 2011 · Baker et al., Maturitas, 2017 · Honda et al., J Med Food, 2024
02

The shift

Diversity drops and the gut barrier weakens through perimenopause.

The largest menopause–microbiome cohort to date found postmenopausal women have a measurably different, less diverse gut microbiome. Three things move at once: diversity falls, the oestrogen-metabolising species shift, and intestinal permeability and low-grade inflammation rise.

Peters et al., mSystems, 2022 (HCHS/SOL, n=1,322 women)
03

The cascade

How that one shift shows up across the body.

We trace the gut connection across four domains — gut comfort, gut–brain (mood, sleep & focus), vaginal & urogenital, and heart, metabolic & immune — and cite the connection for each rather than making one sweeping claim.

Explored in full in the next section, The cascade
04

The research

The papers that anchor the formulation — and the strains in it.

Plottel & Blaser (2011) named the estrobolome; Baker (2017) mapped how gut bacteria recycle oestrogen; Peters (2022) — the largest menopause cohort to date — showed the microbiome measurably shifts. On our own strains: Slykerman (2017) found HN001 lowered depression and anxiety in women, and Jones (2012) found L. reuteri NCIMB 30242 reduced LDL cholesterol by around 11%. We cite the nulls too — HN001 showed no effect in a student-stress trial (2022). Transparency is the point.

Curated by our science team · refreshed quarterly
05

The formulation

How the science becomes Better Gut.

The science above is the brief that produced Better Gut: six strains at 50 billion CFU, chosen as foundational support for the gut microbiome that shifts through the menopause transition.

Formulated by Joanna Lyall, Head of Nutrition & Co-founder, with a specialist gastroenterologist.
02One root, many symptoms

One shift in the gut, felt across the body

Hormones fluctuate through perimenopause, and the gut microbiome shifts with them — with knock-on effects almost everywhere: mood, sleep, digestion and more. Open each to see the connection and the science.

Gut comfort
Bloating & digestive comfort

Usually the first thing women notice. As oestrogen falls, the gut microbiome and its barrier shift — and digestive symptoms climb. This is where foundational gut support starts.

Denby et al., The Menopause Society, 2025 · Peters et al., mSystems, 2022
Gut–brain axis
Low mood

The gut makes and regulates much of the body's serotonin and signals the brain along the vagus nerve. As the microbiome shifts in menopause, that gut–brain signalling shifts with it.

Baker et al., Maturitas, 2017
Brain fog

Brain fog travels the same gut–brain axis as mood. A shifting microbiome alongside falling oestrogen is increasingly studied as one contributor to menopausal cognitive changes.

Baker et al., Maturitas, 2017
Sleep

Sleep runs partly on gut-made signals — serotonin, melatonin precursors and short-chain fatty acids produced overnight. A disrupted microbiome is one input into disrupted sleep.

Sejbuk et al., Nutrients, 2024
Vaginal & urogenital
Vaginal microbiome

The gut and vaginal microbiomes are linked, and both depend on oestrogen. As it falls, protective lactobacilli decline.

Baker et al., Maturitas, 2017
Urinary health

Falling oestrogen thins the urogenital lining and changes its microbiome — which is why urinary symptoms become more common in midlife.

Portman & Gass, Menopause, 2014
Heart, metabolic & immune
Heart & metabolic health

After menopause, cholesterol and cardiometabolic risk climb. The gut microbiome helps regulate how the body handles lipids and glucose — one reason gut and heart health are linked at this stage.

Peters et al., mSystems, 2022
Bone strength

Oestrogen loss drives bone loss — and a "gut–bone axis" is now well described, where the microbiome, gut barrier and inflammation influence bone turnover.

Estrogen–gut–bone axis review, Cell Commun Signal, 2025
Immune resilience

Most of the immune system sits around the gut. As immune function shifts with age, a balanced microbiome is part of the foundation.

Peters et al., mSystems, 2022
03The research we follow

The papers this page is built on

The peer-reviewed studies behind the science here — open any to read the source.

04Why menopause needs a different probiotic

Most probiotics aren't formulated for menopause

A probiotic for menopause should clear a higher bar than "contains live cultures." Here's the standard we hold Better Gut to — and what to judge any probiotic against.

01

Targeted strains

Named, characterised strains — confirmed by signed manufacturer specification.

02

A meaningful CFU count

50 billion live cultures per serving — a high count, not the token few million many probiotics settle for.

03

Chosen for this stage of life

Selected for the perimenopausal microbiome and beyond, not generic gut health.

04

Honest about the evidence

We're upfront about what the science shows — and where it's still building.

05Inside Better Gut

Every strain, and the job it does

Six clinically studied strains. Open one to see what it does and the study behind it.

HOWARU® HN001™
6 billion CFU · dose-matched to cited RCTs
MoodMetabolicWellbeing

Our only trademarked strain — over twenty years in foods and supplements, 100+ publications, 47+ clinical trials.

Key research

Slykerman et al., EBioMedicine, 2017 · Wickens et al., Br J Nutr, 2017 · Chahwan et al., Nutrients, 2024

Lactobacillus rhamnosus
part of the 50 billion CFU blend
Gut barrierImmuneDigestive

One of the most-studied probiotics in the world, with a large evidence base for gut-barrier integrity and immune support — including reducing antibiotic-associated diarrhoea.

Key research

Sindhu et al., Clin Infect Dis, 2014 · Szajewska & Kołodziej, Aliment Pharmacol Ther, 2015

Lactobacillus reuteri
part of the 50 billion CFU blend
CholesterolCardiometabolicVaginal flora

Best evidenced for cardiometabolic health — a randomised controlled trial showed around an 11% reduction in LDL cholesterol versus placebo. As a Lactobacillus, it's also a natural part of the vaginal microbiome.

Key research

Jones et al., Eur J Clin Nutr, 2012 · Jones et al., Br J Nutr, 2012

Lactobacillus acidophilus
part of the 50 billion CFU blend
Vaginal microbiome

Studied for vaginal-microbiome support — taken orally, La-14 (with HN001) has been shown to reach and raise vaginal lactobacilli.

Key research

De Alberti et al., Arch Gynecol Obstet, 2015

Bifidobacterium lactis
part of the 50 billion CFU blend
RegularityTransitImmune

Part of our Bifidobacterium blend — the species is associated with bowel regularity and immune support in adults, both relevant through midlife.

Key research

Dimidi et al., Am J Clin Nutr, 2014 (meta-analysis)

Bifidobacterium bifidum
part of the 50 billion CFU blend
Gut barrierDiversity

The second species in our Bifidobacterium blend, included for gut-barrier and microbiome-diversity support.

Key research

Bifidobacterium & gut-barrier review, 2023

06From our customers

What women tell us after eight weeks

Real-world data
Better Gut lifestyle
84%

reported a noticeable improvement in bloating

79%

reported an improvement in overall menopause symptoms

76%

reported clearer thinking and less brain fog

Data collection: Method: self-reported survey of 200 Better Gut customers, after ≥8 weeks of daily use.

07The experts

Trusted by women's health professionals

Dr. Sabrina Ong

Dr. Sabrina Ong

Women's health specialist

"Better Gut is the one probiotic I recommend to all of my patients in perimenopause and beyond. Gut health is foundational in midlife."

Advisor-reviewed
Joanna Lyall

Joanna Lyall

Head of Nutrition · Co-founder

“I formulated Better Gut for perimenopausal women specifically — six strains chosen as foundational support for the gut microbiome at this crucial time."

Co-founder & formulator
Dr Shahzadi Harper

Dr Shahzadi Harper

Perimenopause Specialist

“The gut–hormone connection is one of the most under-explained parts of midlife health, supporting your gut health during this time can make a real difference."

Advisor-reviewed
Dr. Taniqua Miller

Dr. Taniqua Miller

women's health specialist

"Research shows that the specific bacterial strains in this blend directly address the digestive shifts many women face during midlife and menopause."

Advisor-reviewed

The science is the brief.
Better Gut is the foundation.

Six strains. 50 billion CFU. Foundational support for perimenopause and beyond.

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