Struggling with weight gain, hot flashes, mood swings, or brain fog during perimenopause? The answer might be in your gut. In this episode of Functional Wellness with Dr. Alison, we explore the estrobolome—the collection of gut bacteria that directly regulate how your body processes estrogen.
Dr. Alison DiBarto Goggin, a functional medicine physician specializing in perimenopause and women’s hormones, breaks down the science behind beta-glucuronidase, the enzyme that determines whether estrogen leaves your body or gets recycled back into circulation. You’ll learn why you can experience symptoms of estrogen dominance even when blood tests show low estrogen, and what you can do about it.
In this 30-minute episode, you’ll discover:
• What the estrobolome is and how it controls hormone balance during perimenopause
• How beta-glucuronidase activity affects estrogen metabolism and drives common symptoms
• Why the GI Map stool test is essential for understanding your gut-hormone connection
• What disrupts the estrobolome (antibiotics, diet, stress, toxins, inflammation)
• Evidence-based strategies to support healthy estrogen metabolism through fiber and probiotics
• Specific probiotic strains that help (and which ones to avoid for hormone health)
• How doTERRA’s PB Restore probiotics and RevitaZen support perimenopause naturally
• Liver detox strategies and lifestyle changes that reduce estrogen dominance
• Why daily bowel movements matter for hormone balance
Whether you’re dealing with heavy periods, fibrocystic breasts, anxiety, weight gain, hot flashes, or night sweats, understanding the estrobolome can transform your perimenopause experience. Dr. Alison combines clinical research with practical solutions, offering functional medicine approaches that address root causes instead of just managing symptoms.
This episode is part of the Perimenopause Series on Functional Wellness with Dr. Alison, where we cover sleep, brain health, weight management, ADHD, libido, and more during the menopausal transition.
RESOURCES MENTIONED:
• GI Map stool testing for gut health and beta-glucuronidase levels
• doTERRA PB Restore probiotics
• doTERRA RevitaZen for stress and hormone support
• Research from PubMed.gov on estrogen metabolism and the microbiome
Ready to understand your hormones from a root cause perspective? Visit littleblackbagmedicine.com to work with Dr. Alison, order functional lab testing, and access personalized perimenopause protocols.
Subscribe to Functional Wellness with Dr. Alison for weekly episodes on functional medicine, women’s health, chronic illness, and holistic healing. New episodes every week.
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Transcript here:
Podcast Episode: The Estrobolome and Perimenopause
Why Your Gut Bacteria Control Your Hormones (And What to Do About It)
Welcome back to Functional Wellness with Dr. Alison, where we talk about medicine for the body, heart, and soul. I’m Dr. Alison DiBarto Goggin, and today we’re diving into something that honestly blew my mind when I first learned about it: the estrobolome.
Now, I know what you’re thinking. Estro-what? And before you click away thinking this is going to be some super technical biochemistry lecture, stick with me. Because understanding this connection between your gut bacteria and your hormones might be the missing piece in why you’re dealing with weight gain, brain fog, hot flashes, mood swings, or stubborn symptoms that just won’t budge no matter what you try.
Here’s the thing: your gut bacteria are literally controlling how your body processes estrogen. And if that system is out of balance, it doesn’t matter how perfect your diet is or how many supplements you’re taking. Your hormones are going to stay dysregulated.
So today, we’re going to talk about what the estrobolome is, how it works, what happens when it goes wrong, and most importantly, what you can actually do about it. I’ll walk you through testing that can give you real answers, and I’ll share some of my favorite tools to support this system, including specific probiotics and fiber strategies that actually work.
What Is the Estrobolome?
Alright, let’s start with the basics. The estrobolome is the collection of gut bacteria that are specifically involved in metabolizing estrogen. Think of it as a specialized team within your microbiome or gut bacteria whose entire job is to regulate how much active estrogen circulates in your body.
Here’s how it works. Your liver processes estrogen and packages it up to be eliminated through your bile and eventually your stool. But here’s where it gets interesting: certain gut bacteria produce an enzyme called beta-glucuronidase. This enzyme can actually reactivate estrogen that was supposed to leave your body. It essentially unpackages the estrogen, allowing it to be reabsorbed back into your bloodstream.
When this system is balanced, it’s brilliant. Your body maintains just the right amount of circulating estrogen. But when it’s out of balance, which happens more often than you’d think, you end up with either too much estrogen recirculating or not enough, depending on which direction things tip.
And this is where perimenopause gets really interesting. Because during this transition, your ovaries are already producing less estrogen. But if your gut bacteria are overproducing beta-glucuronidase and recycling too much estrogen, you can end up with symptoms of estrogen dominance even though your ovaries are winding down. On the flip side, if your estrobolome is depleted or dysbiotic, meaning there is an imbalance between good bacteria and bad bacteria, you might not be reactivating enough estrogen, making your symptoms even worse.
Research published in the Journal of Clinical Endocrinology & Metabolism has shown that alterations in the gut microbiome can significantly impact estrogen metabolism and contribute to conditions like obesity, metabolic syndrome, and even breast cancer risk. That’s not meant to scare you. It’s meant to show you how powerful this connection is and why we need to pay attention to it.
The Beta-Glucuronidase Problem
Let’s zoom in on beta-glucuronidase for a minute because this enzyme is at the center of so many hormone issues I see in my practice.
Beta-glucuronidase is produced by certain strains of gut bacteria, and in a healthy gut, its activity is regulated. But when you have dysbiosis, meaning an imbalance in your gut bacteria, often due to things like chronic stress, antibiotic use, inflammatory diets, or even environmental toxins, certain bacterial species can overgrow and pump out way too much beta-glucuronidase.
When beta-glucuronidase levels are too high, estrogen that should be leaving your body through your stool gets reactivated and sent back into circulation. This creates a state of estrogen dominance, which can show up as heavy periods, breast tenderness, fibrocystic breasts, mood swings, anxiety, weight gain especially around the hips and thighs, and increased PMS symptoms.
And here’s what makes this so frustrating for women in perimenopause: you might be told your estrogen levels are low based on blood work, but you’re experiencing all these symptoms of high estrogen. That’s because the estrogen is being recycled through your gut, creating localized or tissue-specific estrogen excess even if your serum levels look normal or low.
Studies in Frontiers in Microbiology have demonstrated that elevated beta-glucuronidase activity is associated with increased risk of hormone-dependent conditions and metabolic dysfunction. This isn’t just about uncomfortable symptoms. This is about long-term health.
Now, on the other side, if beta-glucuronidase activity is too low or if your estrobolome is depleted, you’re eliminating too much estrogen too quickly. This can worsen perimenopausal symptoms like hot flashes, night sweats, brain fog, vaginal dryness, and mood changes. It’s all about balance.
How to Test: The GI Map Stool Test
So how do you know if this is happening in your body? That’s where functional lab testing comes in, and specifically, the GI Map stool test.
The GI Map is one of my go-to tools in practice because it gives us a comprehensive picture of what’s actually happening in your gut. It uses DNA analysis to identify the specific bacteria, yeast, parasites, and viruses living in your digestive system. But more importantly for our conversation today, it measures beta-glucuronidase activity directly.
When I run a GI Map on someone struggling with perimenopausal symptoms, I’m looking at several key markers. Obviously, beta-glucuronidase is one of them. If it’s elevated, that tells me we need to address bacterial overgrowth and support estrogen elimination. If it’s low, we might need to support overall microbial diversity and make sure the estrobolome has what it needs to function.
But I’m also looking at the overall diversity of your microbiome. Are you missing key beneficial bacteria that help regulate inflammation and support hormone metabolism? Do you have overgrowths of opportunistic bacteria or yeast like candida that can drive inflammation and worsen hormone imbalance?
The GI Map also shows us markers of intestinal permeability, or what people commonly call leaky gut, and inflammation markers like calprotectin and secretory IgA. All of these pieces matter because hormone balance doesn’t happen in isolation. If your gut lining is inflamed and permeable, if you have chronic low-grade infections, or if your immune system is constantly activated, your hormones are going to suffer.
I also look at digestive function markers. Are you producing enough digestive enzymes? Is your stomach acid adequate? Because if you’re not breaking down your food properly, you’re not going to absorb the nutrients you need to make hormones in the first place.
One thing I want to mention here is that this test isn’t always covered by insurance, and I get that cost can be a barrier. But in my experience, having this data saves you time, money, and frustration in the long run because you’re not guessing. You’re not throwing supplements at the wall hoping something sticks. You’re targeting the actual root causes.
What Disrupts the Estrobolome?
So what throws this system out of balance in the first place? Let’s talk about the common culprits that disrupt the estrobolome and drive up beta-glucuronidase activity or deplete beneficial bacteria.
First up, antibiotics. I’m not anti-antibiotic. There are absolutely times when they’re necessary and life-saving. But we have to acknowledge that they don’t discriminate. They wipe out beneficial bacteria along with the bad guys, and that includes the bacteria that regulate your estrobolome. Even a single round of antibiotics can alter your microbiome for months or even years if you don’t actively work to rebuild it.
Diet is huge. A diet high in processed foods, sugar, and refined carbohydrates feeds the wrong bacteria. It creates an environment where opportunistic species that produce high levels of beta-glucuronidase can thrive. On the flip side, a diet low in fiber starves the beneficial bacteria that help regulate estrogen metabolism. We’ll talk more about fiber in a minute because it’s one of the most powerful tools you have.
Chronic stress is another massive factor. When you’re under constant stress, your body diverts resources away from digestion and immune function. This weakens your gut barrier, reduces stomach acid and enzyme production, and alters the composition of your microbiome. Studies have shown that chronic psychological stress can reduce microbial diversity and increase intestinal permeability.
Environmental toxins also play a role. Things like pesticides, heavy metals, and endocrine-disrupting chemicals found in plastics, personal care products, and household cleaners can damage your gut lining and disrupt your microbiome. They can also directly interfere with hormone metabolism in the liver.
And then there’s inflammation. Whether it’s from food sensitivities, chronic infections, autoimmune conditions, or just ongoing low-grade inflammation from any source, inflammation damages the gut lining and creates an environment where dysbiosis thrives.
For women in perimenopause, all of this is happening at a time when your hormones are already shifting. Your body is already under metabolic stress from changing estrogen and progesterone levels. Layer gut dysfunction on top of that, and it’s no wonder you’re struggling.
Supporting Your Estrobolome: Fiber and Probiotics
Okay, now for the good news. There are specific, evidence-based strategies you can use to support your estrobolome and regulate beta-glucuronidase activity. And they’re more straightforward than you might think.
Fiber: Your Estrogen’s Best Friend
Let’s start with fiber because this is foundational. Fiber, particularly soluble fiber, binds to estrogen in the gut and helps escort it out of your body through your stool. This prevents excessive reabsorption and helps regulate circulating estrogen levels.
Research published in the American Journal of Clinical Nutrition has shown that higher fiber intake is associated with lower circulating estrogen levels and reduced risk of breast cancer. Fiber also feeds your beneficial gut bacteria, promoting microbial diversity and supporting the production of short-chain fatty acids like butyrate, which reduce inflammation and support gut barrier integrity.
I recommend aiming for at least 25 to 35 grams of fiber per day from whole food sources like vegetables, fruits, legumes, nuts, seeds, and whole grains if you tolerate them. Focus on variety because different fibers feed different bacteria.
But here’s the reality: most people aren’t getting anywhere close to that amount from food alone, especially if you’re dealing with digestive issues or food sensitivities. That’s where supplemental fiber can help. And this is where I love using doTERRA’s products because they’re clean, well-sourced, and effective.
One of the tools I use with patients is increasing their intake of prebiotic fibers that specifically support beneficial bacteria. You can do this through food like garlic, onions, asparagus, and Jerusalem artichokes. But if you need additional support, look for supplements that contain inulin, fructooligosaccharides, or resistant starch.
Probiotics: PB Restore and the Right Strains
Now let’s talk probiotics. Not all probiotics are created equal, and this is where it really matters to choose the right strains.
doTERRA’s PB Restore is a probiotic I frequently recommend because it contains double-encapsulated probiotic strains that survive stomach acid and actually make it to your intestines where they need to work. It includes strains like Lactobacillus acidophilus and Bifidobacterium lactis, which have been shown to support gut barrier function, reduce inflammation, and promote microbial balance.
But here’s what’s important: when you’re dealing with elevated beta-glucuronidase or estrogen dominance, you want to focus on probiotic strains that don’t produce excess beta-glucuronidase themselves. Some strains of Lactobacillus and certain Bifidobacterium species can actually increase beta-glucuronidase activity, which is the opposite of what we want.
The strains you want to prioritize include Bifidobacterium longum, Lactobacillus rhamnosus, and Lactobacillus plantarum.
These strains have been shown in studies to support healthy estrogen metabolism without driving up beta-glucuronidase.
I also love combining probiotics with prebiotic fiber to create a synbiotic effect. This means you’re not just adding bacteria. You’re feeding them so they can colonize and thrive. Think of it like planting a garden. The probiotics are the seeds, but the fiber is the soil and water they need to grow.
You can also take:
Akkermensia and support with cranberry juice
doTERRA RevitaZen: Nervous System and Hormone Support
Now, I also want to talk about RevitaZen because managing perimenopause isn’t just about gut health. It’s about nervous system regulation, stress management, and supporting your body’s ability to adapt.
When your stress hormones are dysregulated, it affects everything. Elevated cortisol impairs gut function, increases intestinal permeability, disrupts sleep, and interferes with progesterone production. So supporting your nervous system is actually supporting your gut and your hormones at the same time.
I’ve seen women use RevitaZen alongside gut healing protocols and experience significant improvements in sleep, mood, and overall resilience during the perimenopausal transition. It’s one of those tools that addresses multiple systems at once.
Additional Strategies for Estrobolome Health
Beyond fiber and probiotics, there are a few other strategies that can really move the needle.
First, support your liver. Your liver is where estrogen is initially processed and packaged for elimination. If your liver is sluggish or overburdened by toxins, alcohol, medications, or poor diet, that first step of estrogen metabolism doesn’t happen efficiently. Simple things like eating cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts, reducing alcohol intake, staying hydrated, and supporting liver detox pathways with nutrients like B vitamins, magnesium, and antioxidants can make a huge difference.
Second, reduce your exposure to endocrine disruptors. This means choosing organic produce when possible, avoiding plastics especially for food storage and heating, using clean personal care and household products, and filtering your drinking water. Every little bit of toxin reduction helps lighten the load on your liver and your gut.
Third, prioritize daily bowel movements. If you’re not eliminating regularly, estrogen that’s been packaged for removal just sits in your colon, giving bacteria more time to reactivate it with beta-glucuronidase. This is where fiber, hydration, and sometimes magnesium or gentle herbal support can help.
Fourth, manage stress. I know I sound like a broken record, but chronic stress is one of the biggest drivers of gut dysfunction and hormone imbalance. Whether it’s yoga, meditation, breathwork, time in nature, therapy, or whatever works for you, making stress management a non-negotiable part of your routine is essential.
And finally, consider working with a practitioner who understands functional medicine and can help you interpret testing like the GI Map and create a personalized protocol. Because while the general strategies I’m sharing today are helpful for most people, everyone’s gut is unique. What you need might be different from what your friend or sister needs.
Closing Thoughts
Alright, let’s bring this all together.
Your gut bacteria are not passive bystanders in your hormone health. They’re active players, regulating how much estrogen circulates in your body through the estrobolome and enzymes like beta-glucuronidase. When this system is balanced, your body can navigate perimenopause with more ease. When it’s out of balance, you can end up with symptoms of estrogen dominance or deficiency that make this transition so much harder than it needs to be.
The good news is that you have so much power to influence this. Through food, fiber, the right probiotics, stress management, and reducing toxic exposures, you can support your estrobolome and help your body process hormones more effectively.
And if you’re someone who’s been struggling with perimenopausal symptoms that just won’t budge no matter what you try, I really encourage you to look at your gut. Get tested. The GI Map can give you so much information about what’s actually happening in your microbiome and guide you toward targeted interventions instead of just guessing.
I mentioned a few tools today that I use in my practice. PB Restore for probiotic support, fiber for binding and eliminating estrogen, and RevitaZen for nervous system and stress hormone regulation. You can find these through doTERRA. If you want to learn more about how to access those or work with me directly, head over to my website at littleblackbagmedicine.com. We offer one-on-one consultations, lab testing, and personalized protocols to support you through perimenopause and beyond.
Before we wrap up, I want to say this: perimenopause doesn’t have to be something you just endure. You deserve to feel good in your body. You deserve to have energy, mental clarity, stable moods, and a sense of vitality. And with the right support, that’s absolutely possible.
Thank you so much for being here today. If this episode resonated with you, please share it with a friend who might need to hear it. And if you haven’t already, subscribe to the podcast so you don’t miss future episodes in the perimenopause series. We’re going to be covering sleep, brain health, weight, libido, and so much more.
Until next time, take care of yourselves. You’re doing better than you think.
Research References
For further reading and validation of the concepts discussed in this episode, explore these research sources from PubMed.gov:
1. Flores R, et al. Fecal microbial determinants of fecal and systemic estrogens and estrogen metabolite concentrations in postmenopausal women. J Clin Endocrinol Metab. 2012;97(8):2888-2896.
2. Baker JM, et al. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas. 2017;103:45-53.
3. Plottel CS, Blaser MJ. Microbiome and malignancy. Cell Host Microbe. 2011;10(4):324-335.
4. Kwa M, et al. The intestinal microbiome and estrogen receptor-positive female breast cancer. J Natl Cancer Inst. 2016;108(8):djw029.
5. Fuhrman BJ, et al. Association of the fecal microbiome with urinary estrogens and estrogen metabolites in postmenopausal women. J Clin Endocrinol Metab. 2014;99(12):4632-4640.
6. Adlercreutz H, et al. Studies on the role of intestinal bacteria in metabolism of synthetic and natural steroid hormones. J Steroid Biochem. 1984;20(1):217-229.
7. Chen KL, Madak-Erdogan Z. Estrogen and microbiota crosstalk: Should we pay attention? Trends Endocrinol Metab. 2016;27(11):752-755.
8. Goedert JJ, et al. Postmenopausal breast cancer and oestrogen associations with the IgA-coated and IgA-noncoated faecal microbiota. Br J Cancer. 2018;118(4):471-479.
Search terms for additional research: estrobolome, beta-glucuronidase, gut microbiome estrogen metabolism, perimenopause microbiome, fiber estrogen excretion