Perimenopause and menopause are life stages that aren’t always clearly explained or widely talked about.
There’s stigma around this transitional life stage, and many women feel shame and embarrassment sharing their experiences. This period of life can be viewed as negative and associated with lack of desirability and ageing.
A 2023 study revealed that out of 214 perimenopausal and 108 postmenopausal women, over a third of the respondents feeling shame related to their menopause-related symptoms (37.4%), while the majority of respondents reported feeling stigma associated with symptoms (82.7%). In addition, most respondents endorsed talking about their symptoms with friends, family, partners, or doctors (80.8%), and felt that their peers might experience the same symptoms (93.9%) [1].
As awareness continues to grow, more women are beginning to better understand their body’s signals and seek support.
What is perimenopause and menopause?
Perimenopause
The period leading up to menopause, known as perimenopause, is typically marked by fluctuating hormone levels which contribute to symptoms of breast tenderness, irregular periods, moodiness, menstrual migraines, night sweats, vaginal dryness and hot flushes [2].
Menopause
Menopause marks the natural end of the reproductive stage of your life. You have reached menopause when you have gone 12 months without having your period. Most Australian females experience menopause between 45 and 60 years of age. The average age of menopause is 51 years [3].
How the microbiome evolves with hormonal changes via the gut-vagina axis
The Gut-Vagina Axis
The gastrointestinal (GI) tract and remote organs in the body share bidirectional communication via immune, neural, endocrine, or metabolic links called the “gut-organ axis”. Organs such as the brain, skin, bone, liver, heart, kidney and female reproductive tract have been known to communicate multidirectionally with the GI tract, and the microbiota appears to be the key player within these axes [4].
Menopause & The Gut-Vagina Axis
The vaginal microbiome is a dynamic, sensitive microenvironment that changes in response to pregnancy, the menstrual cycle, hormonal shifts, contraceptive use, antibiotic use, stress, pollutants, as well as diet & lifestyle [5].
The hallmark of a ‘healthy’ vaginal microbiome is currently believed to be one dominated by Lactobacillus spp., which acidifies the vaginal environment and help to protect against invading pathogens [5, 6, 7].
When the gut microbiome is affected by a decline in the diversity of bacteria present, the vaginal microbiome is affected by a loss of beneficial Lactobacilli [5, 6, 7].
In the ovulatory cycle, estrogen and progesterone have substantial effects on the composition of the vaginal microbiome. Alterations in the microbiota due to menopausal hormone changes include increased vaginal pH, caused by reduced estrogen, resulting in reduced levels of Lactobacillus. Such changes influence the vaginal structure and functions, contributing to the onset of genitourinary symptoms in menopause [5, 6, 7].
Hormonal shifts occur alongside many physical and emotional symptoms. Maintaining a healthy vaginal microbiome plays an important role in supporting women’s bodies during menopause. Targeted probiotics can support a healthy vaginal microbiome and symptoms of menopause [8,9,10].
Life-Space Probiotic + Menopause Relief to support your body during menopause:
Probiotic+ Menopause Relief is a targeted formulation designed to support women through menopause. It contains a combination of probiotic strains and traditional herbal medicines to provide a dual-action and complementary support.
* Always read the label and follow the directions for use.
The product contains the following probiotic strains:
- Lactobacillus rhamnosus GR1 + Lactobaccilus reuteri RC14 (Urex Blend) – clinically demonstrated to restore normal vaginal flora in postmenopausal women [8].
- Lactobacillus plantarum (UALp-05™) - clinically shown to reduce vaginal pH in women [11].
Sage has long been used as a remedy to support women during menopause, especially night sweats and hot flushes. Sage is generally well tolerated. The mechanism is thought to involve thermoregulation and mild anti-inflammatory/antioxidant effects [12, 13, 14, 15].
Conclusion: holistic view of wellbeing through this life stage
Menopause is a nuanced and unique phase of life, where each woman will have a different experience. It is important to listen to the body’s needs and seek medical advice when necessary. Supplementation can be supportive but is not intended for use as a sole treatment. We recommend a holistic approach which may involve healthcare practitioners, adjustments to diet & lifestyle, as well as supplementation to support symptoms of menopause.
References:
[1] Dahlgren MK, Kosereisoglu D, Smith RT, Sagar KA, Lambros AM, El-Abboud C, et al. Identifying Variables Associated with Menopause-Related Shame and Stigma: Results from a National Survey Study. Journal of Women’s Health (2002) [Internet]. 2023 Nov 1;32(11):1182–91. Available from:
[2] Stages of menopause [Internet]. Cancer Australia. 2020. Available from:
[3] Australia H. Menopause [Internet]. www.healthdirect.gov.au. 2019. Available from:
https://www.healthdirect.gov.au/menopause
[4] Takada K, Melnikov VG, Kobayashi R, Shihoko Komine-Aizawa, Tsuji NM, Hayakawa S. Female reproductive tract-organ axes. 2023 Jan 31;14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9927230/
[5] Holdcroft AM, Ireland DJ, Payne MS. The Vaginal Microbiome in Health and Disease—What Role Do Common Intimate Hygiene Practices Play? Microorganisms. 2023 Jan 23;11(2):298.
[6] Park MG, Cho S, Oh MM. Menopausal Changes in the Microbiome—A Review Focused on the Genitourinary Microbiome. Diagnostics. 2023 Mar 21;13(6):1193.
[7] Muhleisen AL, Herbst-Kralovetz MM. Menopause and the vaginal microbiome. Maturitas. 2016 Sep;91:42–50.
[8] Randomized, double-blind, placebo-controlled study of oral lactobacilli to improve the vaginal flora of postmenopausal women. European Journal of Obstetrics & Gynecology and Reproductive Biology [Internet]. 2008 Nov 1;141(1):54–7. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0301211508002388
[9] Andrews RAF, Lacey A, Roach H, Tomlinson R, Kidd EJ, Bache K. Investigating the effects of probiotics during the menopause transition: A systematic review & meta-analysis. Clinical Nutrition ESPEN [Internet]. 2025 Jul 8;69:241–56. Available from: https://www.sciencedirect.com/science/article/pii/S2405457725017632#
[10] Li Z, Li Y, Pan B, Wang X, Wu Y, Guo K, et al. The Effects of Oral Probiotic Supplementation in Postmenopausal Women with Overweight and Obesity: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Probiotics and Antimicrobial Proteins. 2022 Dec 28;15(6):1567–82.
[11] Martoni CJ, Frederiksen AKS, Damholt A, Leyer G. Effects of a 10-Strain Oral Probiotic on Parameters of Vaginal Health and Microbial Community: A Pilot Clinical Study. International Journal of Women’s Health. 2022 Jan;Volume 14:29–39.
[12] Bommer S, Klein P, Suter A. First time proof of sage’s tolerability and efficacy in menopausal women with hot flushes. Advances in Therapy [Internet]. 2011 Jun 1 [cited 2020 Mar 31];28(6):490–500. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21630133
[13] Tildesley NTJ, Kennedy DO, Perry EK, Ballard CG, Wesnes KA, Scholey AB. Positive modulation of mood and cognitive performance following administration of acute doses of Salvia lavandulaefolia essential oil to healthy young volunteers. Physiology & Behavior [Internet]. 2005 Jan 17;83(5):699–709. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15639154
[14] Rahte S, Evans R, Eugster P, Marcourt L, Wolfender J, Kortenkamp A, et al. Salvia officinalis for menopausal hot flushes: Towards determination of mechanism of activity and active principles. Planta Medica. 2013 Aug 21;79(13).
[15] Moradi M, Ghavami V, Niazi A, Seraj Shirvan F, Rasa S. The Effect of Salvia Officinalis on Hot Flashes in Postmenopausal Women: A Systematic Review and Meta-Analysis. International Journal of Community Based Nursing and Midwifery [Internet]. 2023 Jul 1;11(3):169–78. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10363264/
