• Menopause is a time of significant change
  • Like most life changes, menopause presents both challenges and rewards
  • Supporting key body systems can help improve your experience of menopause
  • The vaginal microbiome is a key component of female health and a balanced microbiome is key to maintaining vaginal health during menopause


Menopause is a natural part of life...

While this may seem an obvious statement, menopause is often viewed as a phase in life best skipped – not unlike how the menstrual cycle is viewed by many women.  But while menstruation and menopause present their challenges, they are also part of what makes you female.  Each representing a key milestone, highlighting the beginning and end of your fertility journey, one of the many wonders of the female body.

While menopause signifies the end of one chapter, it is also the beginning of another – one which provides the opportunity to focus on the important things in life, such as family, friends, and your health. 


Changing hormones and vaginal health

Fluctuating hormones associated with menopause are responsible for many of the better known menopausal symptoms, ranging from mood swings to hot flushes.  But what you may not be aware of is the impact of these hormone changes on vaginal health – in particular, the vaginal microbiome. [1][2]

Lactobacilli are the dominant bacterial species found in the vaginal tract, and these friendly microbes help to support vaginal health by modulating immune function, competing against harmful bugs, and promoting a healthy vaginal environment. Interestingly, the female reproductive hormone, oestrogen, has been shown to increase the production of a complex sugar source, known as glycogen in the vaginal tract, which helps to feed Lactobacilli. Therefore, as oestrogen levels decline during menopause, so too can vaginal Lactobacilli, which can alter the environment of the vaginal tract. [3][4]

The decrease in Lactobacilli in the vagina can lead to an imbalance between beneficial and harmful bacteria.[5] Symptoms of an imbalanced vaginal microbiome can include vaginal discharge, burning sensations during urination and local irritation.


How can you support the vaginal microbiome during menopause?

While the above list of symptoms can sound daunting, menopause is not a ‘one-sized-fits-all’ experience, and there is a lot you can do to improve your menopause journey.  For instance, research suggests that the intake of probiotics during menopause can help support a healthy vaginal microbiome in addition to improving overall gut health. In particular, probiotic strains belonging to the Lactobacilli species, have shown to help restore the balance of beneficial bacteria in the vaginal microbiome of post-menopausal women.[6][7][8][9] 

In addition to taking probiotic supplements, other helpful treatments can include:

  • Wearing breathable fabrics, such as cotton underwear, and sleepwear that can enhance comfort and reduce moisture that could promote the growth of harmful bugs.[10][11]
  • Increasing the intake of foods containing phytoestrogens, found in soy, red clover tea, and legumes. Phytoestrogen containing foods have been shown to mimic the hormone oestrogen, helping to provide relief from symptoms such as hot flushes and reducing vaginal dryness associated with menopause.[12][13]


In summary…

Menopause is a time of natural transition, which can present opportunity but also challenges.

Menopause is marked by fluctuating hormones which can contribute to various symptoms, including hot flushes.[2] Additionally, these fluctuations can contribute to a decline in healthy Lactobacilli in the vagina, resulting an imbalance between beneficial and harmful bacteria, contributing to vaginal symptoms.[5][6]

Clinical research has shown that supplementing with specific Lactobacilli probiotic strains can help increase the abundance of healthy vaginal Lactobacilli in menopausal women, in addition to supporting a healthy vaginal microbiome.[6]

Wearing breathable cotton underwear and sleepwear may help reduce symptoms associated with reduced oestrogen levels, while also supporting comfort levels. In addition, increasing the dietary intake of foods containing phytoestrogens have been shown to help provide relief from symptoms such as hot flushes and vaginal dryness associated with menopause.[3][14]


[1] Santoro N, Roeca C, Peters BA, Neal-Perry G. The menopause transition: signs, symptoms, and management options. The Journal of Clinical Endocrinology & Metabolism. 2021 Jan 1;106(1):1-5.

[2] Pinkerton JV. Menopause. University of Virginia Health System. 2021.

[3] Peters BA, Lin J, Qi Q, Usyk M, Isasi CR, Mossavar-Rahmani Y, et al. Menopause Is Associated with an Altered Gut Microbiome and Estrobolome, with Implications for Adverse Cardiometabolic Risk in the Hispanic Community Health Study/Study of Latinos. mSystems. 2022;7(3):e00273-22.

[4] Muhleisen AL, Herbst-Kralovetz MM. Menopause and the vaginal microbiome. Maturitas. 2016;91:42-50.

[5] Saraf VS, Sheikh SA, Ahmad A, Gillevet PM, Bokhari H, Javed S. Vaginal microbiome: normalcy vs dysbiosis. Archives of microbiology. 2021;203(7):3793-802.

[6] Reid G, Charbonneau D, Erb J, Kochanowski B, Beuerman D, Poehner R, et al. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS immunology and medical microbiology. 2003;35(2):131-4. DOH.

[7] Petricevic L, Unger FM, Viernstein H, Kiss H. 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. 2008;141(1):54-7.

[8] Marschalek J, Farr A, Marschalek ML, Domig KJ, Kneifel W, Singer CF, et al. Influence of Orally Administered Probiotic Lactobacillus Strains on Vaginal Microbiota in Women with Breast Cancer during Chemotherapy: A Randomized Placebo-Controlled Double-Blinded Pilot Study. Breast Care. 2017;12(5):335-9.

[9] Kaczmarczyk M, Szulińska M, Łoniewski I, Kręgielska-Narożna M, Skonieczna-Żydecka K, Kosciolek T, et al. Treatment With Multi-Species Probiotics Changes the Functions, Not the Composition of Gut Microbiota in Postmenopausal Women With Obesity: A Randomized, Double-Blind, Placebo-Controlled Study. Front Cell Infect Microbiol. 2022;12:815798.

[10] Macklaim JM, Clemente JC, Knight R, Gloor GB, Reid G. Changes in vaginal microbiota following antimicrobial and probiotic therapy. Microbial ecology in health and disease. 2015;26:27799-.

[11] Anukam K, Osazuwa E, Ahonkhai I, Ngwu M, Osemene G, Bruce AW, et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes and infection. 2006;8(6):1450-4.

[12] Chen MN, Lin CC, Liu CF. Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric : the journal of the International Menopause Society. 2015;18(2):260-9.

[13] Balk JL, Whiteside DA, Naus G, DeFerrari E, Roberts JM. A Pilot Study of the Effects of Phytoestrogen Supplementation on Postmenopausal Endometrium. Journal of the Society for Gynecologic Investigation. 2002;9(4):238-42.