Probiotics and Prebiotics: Any Role in Menopause-Related Diseases?

Abstract

Purpose of Review The aim of this review is to provide an overview of the menopause-related changes in microbiota and their role in the pathogenesis of menopause-related diseases. In addition, evidence on probiotic supplementation as a therapeutic strategy is discussed. Recent Findings The human microbiota is a complex community that lives in a mutualism relationship with the host. Menopause is associated with dysbiosis, and these changes in the composition of microbiota in different sites (gut, vaginal, and oral microbiota) might play a role in the pathogenesis of menopause-related diseases (i.e., osteoporosis, breast cancer, endometrial hyperplasia, periodontitis, and cardiometabolic diseases). Summary The present review highlights the pivotal role of microbiota in postmenopausal women health, in particular it (a) may increase intestinal calcium absorption thus preventing osteoporosis, (b) is associated with reduced risk of breast cancer and type 1 endometrial hyperplasia, (c) reduces gingival inflammation and menopausal periodontitis, and (d) beneficially affects multiple cardiometabolic risk factors (i.e., obesity, inflammation, and blood glucose and lipid metabolism). However, whether oral probiotic supplementation might be used for the treatment of menopause-related dysbiosis requires further clarification.

Guest editorial from The BMS Annual Lecture 2023

“…These treatments aim to restore microbial balance, reduce inflammation, and improve estrogen metabolism, offering a complementary or alternative strategy to HRT. 13,14 The menopausal transition is not solely a physiological shift but a complex neuroendocrine reorganization, with diet and the gut microbiome playing vital roles in modulating the effects on the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis, a central stress response system, is intimately linked with common neurological symptoms in menopause, such as mood swings, anxiety, and cognitive changes.…”

“…These treatments aim to restore microbial balance, reduce inflammation, and improve estrogen metabolism, offering a complementary or alternative strategy to HRT. 13,14…”