When we talk about menopause, the conversation turns to hormonal factors – estrogen, progesterone, extreme hot flashes. According to Dr. Levidia Strauss, founder of Revita Health, the gut may be the single most overlooked factor in how women experience the menopausal transition. Strauss told Gisele Wertheim Ames on a recent episode of Wellness Wednesday that,
“Menopause, or the decline in hormones, suddenly puts a spotlight on the gut,”
Explain that women can often get away with poor diet, poor sleep, and chronic stress for years with no results. That is, until estrogen begins to decline, at which point her body’s tolerance for these habits disappears overnight. That’s because our gut does extraordinary hormonal and neurological work behind the scenes.
Dr. Levidia Strauss
Anesthesiology to Integrative Medicine: An Unexpected Journey
Strauss studied medicine at the University of Stirling and originally intended to become an anaesthetist. Her plans changed when her husband’s rugby career took the couple to France. A trip that she had originally planned for two years turned into eight years. There she encountered integrative medicine. This discipline looks beyond prescriptions and examines the patient’s lifestyle around health, diet, sleep, stress and movement.
“I did not choose this path for myself. God chose it for me. I am so grateful because I get to meet so many new people and I find a way to fulfill my passion for a healthy lifestyle, cooking healthy food and helping women along the way.“
She now describes her work as lifestyle medicine—a holistic medical practice with an approach that treats the gut, inflammation, and metabolism as central, not incidental, to women’s health.
Gut Health: Your Second Endocrine System
To understand why gut health is so important during menopause, it helps to understand what the gut does throughout the day. Strauss explains this Intestines are home to millions of microorganisms that help regulate the immune system, produce key hormones, and communicate with the brain.
The gut contains about 70% of the body’s immune cells and about 90% serotonin in the bodyour emotional hormone. During menopause, when estrogen declines and the diversity of the gut changes along with it, the system begins to vibrate. This can manifest as mood swings, inflammation, low energy and disturbed sleep.
Meet the estrobolom
If there’s one concept to keep in mind from this discussion, it’s the estrobolum. The estrobolome is a set of gut bacterial genes and taxa in the gut microbiome that metabolize and regulate estrogen levels. It targets specific microbial enzymes that determine whether the body removes or recycles estrogen.
Healthy gut bacteria help remove stored estrogen from the body. Less beneficial bacteria produce an enzyme called beta-glucuronidase, which can open those bonds and put the estrogen back into circulation instead of leaving it. Strauss points out that research shows that the gut recycles up to 40% of estrogen through this process each day.
“The gut microbiome not only helps us digest food, but is also actively involved in hormone regulation.”
December phone calls: the secret to gut health
Strauss drew attention to a pattern she had observed over sixteen years of prescribing hormone therapy. Around November and December, his patients, who had been doing well all year, suddenly called him again. They believed their hormones had “stopped working” tender breasts, spots and swelling.
The first question she asks has nothing to do with size. Strauss asks if they have gotten pregnant lately. It turns out that the answer is often yes. During the social festivities of the holiday season, his patients drink more, feel more stressed, and consume less. fiber. In these cases, hormones do not fail. The stomach has lost the ability to remove estrogen, which allows it to recirculate and cause symptoms that are identical to a fetus. quantity problem.
“Before I adjust the hormone dosage, I first go back and fix the gut. Many of them go back to feeling weird without fixing anything.”
According to Dr. Strauss, gut health is sometimes more important than how a woman experiences her hormones than the dose of those hormones.
The gut, inflammation and the secret to belly change
The term “leaky gut” has become both a popular and controversial topic on the internet. Some experts once dismissed it, but Strauss says the medical community now recognizes it as increased intestinal permeability. It is interesting that the intestinal layer, which is only one cell wall thick, takes over the work of absorbing nutrients. A protein called zonulin regulates this barrier. Chronic stress, poor diet, and inflammation can cause those tight junctions to break down, allowing bacteria and undigested particles to move into places they shouldn’t—increasing diarrhea. food sensitivities in many people with age.
This chronic, low-grade inflammation is closely related to a change in body composition that many women experience during menopause: the appearance of visceral fat. This fat is not only under the skin around the organs. Strauss explains that estrogen encourages fat storage around the hips and thighs; as it decreases changes in fat distribution instead of the stomach. Visceral fat is not inactive; it actively produces inflammatory molecules. Dealing with periods of inflammation, poor sleep, and stubborn weight gain can cause serious emotional frustration for many menopausal women, describing them as “doing everything right and still struggling.”
Mood, brain fog, and gut health
Strauss connects the two most tragic symptoms of menopause low mood and brain fog, directly back to the gut. Serotonin production is closely related to gut health, so a disrupted microbiome can certainly affect a person’s mood. The gut also communicates with the brain via the vagus nerve, meaning bacterial changes can manifest as anxiety, low mood or sleep problems, not just digestive symptoms.
“Often, when we fix a patient’s bowel, they tell me, “Wow, my anxiety is lifted.”“
The second driver of low mood, Strauss notes, is directly hormonal. Without ovulation, the body stops producing progesterone. Many describe progesterone as the body’s natural “Valium.” For many women, regardless of what’s going on in their bowels, the discharge is less consistent and more troubling than it used to be.
Bones, heat and the heart: access to gut health
Strauss links several others menopausal symptoms Back to Gut Health:
- Bone density: The gut absorbs calcium, magnesium, and vitamin D, all of which are important for bone strength, and the role of the microbiome in circulating estrogen further links gut health to bone health.
- Hot flashes and night sweats: these, she was clear, were directly related to the decline in estrogen, not the gut, and hormone therapy often resolved them in suitable candidates.
- Heart health: While the loss of estrogen has an anti-inflammatory effect, the blood vessel protector mainly contributes to the rapid growth of blood vessels. cardiovascular risk After menopause, gut inflammation is at risk by driving visceral fat, insulin resistance, and inflammation.
First the food
When people ask if the answer to gut health is simply taking a probiotic, Strauss is clear that nutrition comes first. He points to fiber as a key factor. Both insoluble fiber (which adds bulk) and soluble fiber (which forms a gel-like matrix that slows glucose absorption and regulates blood sugar) are important in one’s diet.
Strauss advocates resistant starch. You will find resistant starch in cooled baked potatoes, cooled cooked rice, green bananas, oats, beans, and lentils. These foods feed the butyrate-producing bacteria, the “hero” bacteria of the gut. One of his popular supplements is partially hydrolyzed guar gum, a tasteless fiber powder that feeds these bacteria without causing excessive swelling.
Strauss takes a delicate position on sugar. He’s not worried about the natural sugar found in whole fruit, which is packed with fiber and antioxidants that the body knows how to process. Her main concern is added sugar. He describes the daily tolerance of added sugar for women as 24 to 36 grams for men. In its processed and packaged form, sugar coats the liver in a way that greatly reduces whole foods.
About testing, supplements and the risk of overdose
Despite working at the cutting edge of gut science, Strauss is cautious about switching to microbiome testing for every patient. He notes that most commercially available tests compare results to populations in North America or Europe. These datasets do not reflect South African diets, environments or genetics. Strauss is currently part of a South African research team working on building a population-specific microbiome database. The biggest concern with direct-to-consumer testing is interpretation: isolated bacterial readings without understanding how they mean little different groups of bacteria mutual
“The gut works together in groups,”
He compares a a healthy microbiome to the rainforest – not just ferns, not just moss, but abundance and diversity working together. He reserves the test for patients who do not respond lifestyle changes, rather than using it as a first step.
Food is not the enemy
At the end of a personal note, Strauss reflected on what she called the “food prison,” which is why many women feel trapped from a young age. It involves a lifetime of eating less food and hearing that smaller is better. Her message, which she says she passed on to her teenage daughter, is that women should enjoy food, not fear it. Strauss recalled a recent two-week trip to France in which he ate freely and walked frequently, not gaining weight in the process. In her opinion, this was proof that pleasure and health are not opposites.
As a devoted rooibos tea drinker, Strauss considers his Carmienne tea blend to be a travel companion during his travels in France. She also uses Energize and Menopause brand blends daily. Strauss is carrying the same food philosophy this Women’s Month, joining a food jam event in Cape Town on August 1.
