Oral and intestinal microbiota: towards a different management of menopause
Estrogen deficiency caused by menopause also increases the risk of several autoimmune and inflammatory diseases. More and more research studies have highlighted the role of the oral and intestinal microbiota in their development. Could prebiotics and probiotics be used as a supplement to hormone replacement therapy (HRT)?
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Many women complain about dry mouth during menopause. According to an international team of researchers12, this lack of saliva, associated to the drop in estrogen levels, could have harmful effects such as changes in composition of the oral microbiota, dysbiosis (imbalance of the microbial flora) and onset of inflammatory disorders (e.g. gingivitis or periodontitis) which create a loss of tooth support that potentially leads to tooth loss.
Drop in estrogen levels and diseases
Since female sexual hormones affect the composition of the different body floras, especially the intestine microbiota, a drop in estrogen levels impairs the microbial balance and promotes the onset of autoimmune diseases. This could explain why some autoimmune diseases affect women more than men (lupus, Sjögren syndrome,rheumatoid arthritis) or why they occur at specific moments of their hormonal lives, i.e. after their menstrual period or during their reproductive period (asthma). Moreover, microbiota alteration due to estrogen deficiency leads to metabolic changes. The one most feared by women is abdominal weight gain, which is a proven risk factor for type 2 diabetes. Finally, intestinal microbiota could affect breast cancer risk through its effects on estrogens produced by fatty tissue in menopausal women.
Composition of oral and/or intestinal microbiota and estrogen deficiency have been successfully linked to all these disorders that are likely to occur during menopause. That is why researchers are encouraged to continue investigating and study the effect of prebiotics and probiotics and their potential use as a monotherapy or in combination with HRT.
12. Vieira AT, Castelo PM, Ribeiro DA, Ferreira CM. Influence of Oral and Gut Microbiota in the Health of Menopausal Women. Front Microbiol. 2017; 8: 1884. Published online 2017 Sep 28.