Menopause and “leaky gut”: implications for midlife women’s health
Brandilyn A. Peters
Brandilyn A. Peters
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Commentary

Menopause and “leaky gut”: implications for midlife women’s health

Abstract

Menopause may have important consequences for gut barrier health. The roles of estradiol and progesterone in immune and mucosal barrier homeostasis have been well studied in the female reproductive tract. However, few human studies have described these hormones’ corresponding regulation in the gastrointestinal tract or how the menopausal transition affects gut barrier integrity. In this issue of the JCI, Shieh et al. report that markers of gut epithelial barrier dysfunction and microbial translocation–related immune activation increased across the menopause transition in a longitudinal study of healthy women. These findings suggest that ovarian aging may contribute to gut barrier dysfunction in midlife women and highlight new questions about clinical consequences and potential interventions.

Authors

Brandilyn A. Peters

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Figure 1

Proposed model linking menopause-related ovarian hormone decline with gut barrier dysfunction and microbial translocation.

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Proposed model linking menopause-related ovarian hormone decline with gu...
During the menopause transition, circulating ovarian hormones (estradiol and progesterone) decline. Experimental studies suggest that these hormones support intestinal epithelial barrier integrity, while longitudinal data from Shieh et al. (14) showed increases in markers of gut epithelial barrier compromise and microbial translocation–related immune activation across the menopause transition. An arrow marks the proposed time point when the final menstrual period (FMP) occurs relative to these hormonal and gut barrier changes.