Hormones and the Gut – How Are They Connected?

by | Aug 3, 2020

Diagram of estrogen metabolism in the gut

After your hormones are metabolized in the liver, some of the estrogen (known as conjugated estrogen) is excreted into the bile and dumped into the small intestine. The bacteria in your gut (the microbiome) play an important role in regulating circulating estrogens.

Watch this video to learn more: 

The “Estrobolome” 

These estrogen-metabolizing bacteria are referred to as the “estrobolome”, and they secrete an enzyme called β–glucuronidase which breaks down the conjugated estrogen, allowing estrogen to be reabsorbed by the gut and delivered into the bloodstream. 1 If there is an imbalance in the gut bacteria (referred to as dysbiosis), there can be an abundance of β-glucuronidase producing bacteria, which leads to elevated levels of circulating estrogens. 1

On the other hand, a lack of microbial diversity can result in lowered β -glucuronidase activity, leading to lower estrogen levels. This becomes of interest in post-menopausal women who already have naturally low estrogen. We know that low levels of estrogen have an impact on bone health, cognitive health, gut health and women’s health.

While further research is needed to clearly understand how modulation of the gut microbiome can influence estrogen driven disease, we know that the gut is important for hormone metabolism.

In clinical practice, I take gastrointestinal health into consideration when investigating hormonal imbalances.

Two dietary factors that impact the “estrobolome” and estrogen metabolism include:

Low Fibre Diet

Fibre is essential for gut health. It helps to normalize bowel movements and to support the gut microbiome. Increased fibre has been shown to reduce circulating estrogens, presumably by reducing β-glucuronidase activity and the reabsorption of estrogen. 2

The current recommendation is for individuals to consume between 21 – 30 grams of fibre per day dependent on their age 3, and yet a national consumption survey in the United States showed that only 5% of the American population were meeting these recommendations. 4 Consuming adequate fibre in your diet is perhaps one of the simplest ways to improve both gut health and to support hormone metabolism.

For perspective, 1 cup of broccoli contains 5 grams of fibre, 1 apple contains 4.5 grams of fibre, 1 cup of oatmeal (instant) contains 5 grams of fibre, and 1 cup of cooked black beans contains 15 grams of fibre.

One of my favourite high fibre breakfast snacks is the gluten-free seed loaf.


Alcohol consumption has been shown to increase estradiol levels. Alcohol decreases the microbiome diversity and reduces the metabolism of estrogen in the liver. 5,6  This may in part explain the negative impact alcohol can has on menstrual cycle health.  Long-term alcohol use is associated with decreased ovarian reserve and an increase in ovarian oxidative stress. 7

When assessing hormonal health, it’s important to acknowledge gastrointestinal health and diet. It is a piece of the hormone puzzle that we cannot ignore.

To read more about hormonal imbalances, read the following:


If you want to delve deeper into your hormone health, you can book a complimentary 15–minute meeting, to learn more about my approach, and how I may be able to help.

  1. Baker, J. M., Al-Nakkash, L., & Herbst-Kralovetz, M. M. (2017). Estrogen–gut microbiome axis: physiological and clinical implications. Maturitas, 103, 45-53.
    1. Aubertin-Leheudre M, Gorbach S, Woods M, Dwyer JT, Goldin B, Adlercreutz H. Fat/fiber intakes and sex hormones in healthy premenopausal women in the USA. J Steroid Biochem Mol Biol 2008;112: 32–9
    2. Recommended Daily Fibre Intake. (2019, April 08). Retrieved June 30, 2020, from https://cdhf.ca/health-lifestyle/recommended-daily-fibre-intake/
    3. Quagliani, D., & Felt-Gunderson, P. (2017). Closing America’s fiber intake gap: communication strategies from a food and fiber summit. American journal of lifestyle medicine, 11(1), 80-85.
    4. Lowe, P. P., Gyongyosi, B., Satishchandran, A., Iracheta-Vellve, A., Cho, Y., Ambade, A., & Szabo, G. (2018). Reduced gut microbiome protects from alcohol-induced neuroinflammation and alters intestinal and brain inflammasome expression. Journal of neuroinflammation, 15(1), 298.
    5. Eagon, P. K. (2010). Alcoholic liver injury: influence of gender and hormones. World journal of gastroenterology: WJG, 16(11), 1377
    6. Noth, R. H., & WaIter Jr, R. M. (1984). The effects of alcohol on the endocrine system. Medical Clinics of North America, 68(1), 133-146.