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Nutrients
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The Role of Diet and Microbiome in Peri/Menopause
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The Role of Diet and Microbiome in Peri/Menopause

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition in Women".

Deadline for manuscript submissions: 15 October 2026 | Viewed by 12621

Special Issue Editor

Prof. Dr. Siobhain M. O'Mahony

E-Mail Website
Guest Editor
1. Department of Anatomy and Neuroscience, University College Cork, T12 XF62 Cork, Ireland
2. APC Microbiome Ireland, University College Cork, T12 YT20 Cork, Ireland
Interests: women’s health; microbiome; brain–gut axis; diet; probiotic; prebiotic; fibre; synbiotic; stress; menopause; perimenopause; brain health; estrobolome; endometriosis; pregnancy; early life; pain

Special Issue Information

Dear Colleagues,

"The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease."—Thomas Edison.

Women’s health is entering a transformative era, especially during the pivotal stages of perimenopause and menopause, where the role of food as medicine is being redefined through both scientific innovation and lived experience. As hormonal changes intersect with shifts in metabolic health, mood, cognition, and inflammation, targeted dietary strategies are becoming essential tools for prevention, resilience, and empowerment.

Fibre, probiotics, and prebiotics—critical modulators of the gut–brain and gut–hormone axes—are emerging as powerful agents in supporting mental wellbeing, metabolic balance, and hormonal regulation during midlife transitions. From sleep disturbances to brain fog, diet-based interventions offer promising, evidence-based pathways for symptom relief and long-term health.

Yet, despite these advances, the nutritional needs of women in perimenopause and menopause remain underrepresented in both research and clinical practice. This Special Issue seeks to change this. We invite experts, researchers, and clinicians to contribute their insights, innovations, and critical perspectives on how diet, the microbiome, and integrative nutrition can shape the future of midlife and aging well for women.

Whether you work at the molecular, clinical, or community level, your voice matters. Join us in advancing the science and practice of dietary strategies that centre and support women through perimenopause, menopause, and beyond—across the lifespan and across the globe.

Prof. Dr. Siobhain M. O'Mahony
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • personalised nutrition
  • hormonal health
  • gut microbiome
  • lifespan approach
  • evidence-based interventions

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Published Papers (3 papers)

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Research

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18 pages, 615 KB  
Article
Time-Restricted Eating Combined with Exercise Reduces Menopausal Symptoms and Improves Quality of Life More than Exercise Alone in Menopausal Women: A Quasi-Randomized Controlled Trial
by Beata Jóźwiak, Adam Szulc and Ida Laudańska-Krzemińska
Nutrients 2025, 17(20), 3274; https://doi.org/10.3390/nu17203274 - 18 Oct 2025
Viewed by 7120
Abstract
Background: Menopause is often accompanied by menopausal symptoms and reduced quality of life. Studies on the combined effects of time-restricted eating and exercise in this population are lacking. This approach may provide additive preventive benefits by aligning nutritional timing with exercise to [...] Read more.
Background: Menopause is often accompanied by menopausal symptoms and reduced quality of life. Studies on the combined effects of time-restricted eating and exercise in this population are lacking. This approach may provide additive preventive benefits by aligning nutritional timing with exercise to improve health and well-being in menopausal women. We aimed to assess whether a combined intervention is more effective than exercise alone in reducing menopausal symptoms and improving quality of life. Methods: This study examined the effects of a time-restricted eating protocol (16:8) combined with a resistance and endurance circuit training program in menopausal women. Symptoms were assessed using the Menopause Rating Scale (MRS), and quality of life was evaluated with the Menopause-Specific Quality of Life Questionnaire (MENQOL). Participants (n = 54) were quasi-randomly assigned to a combination group (exercise + time-restricted eating; n = 24) or an exercise group (exercise only; n = 30), with allocation influenced by participant preference. Results: The reduction in the total MRS score, as well as in the psychological and somatic MRS subdomains, was significantly greater in the combination group than in the exercise group (p = 0.008, p = 0.009, p = 0.007, respectively). No significant difference was observed in the urogenital domain. For MENQOL, post-intervention scores in the physical and psychosocial subdomains were significantly lower in the combination group compared with the exercise group (p = 0.013, p = 0.002, respectively), while no significant differences were found in the vasomotor and sexual subdomains. Conclusions: These findings suggest that integrating time-restricted eating with exercise results in greater alleviation of menopausal symptoms and improvements in quality of life compared to exercise alone in menopausal women. Full article
(This article belongs to the Special Issue The Role of Diet and Microbiome in Peri/Menopause)
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Review

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26 pages, 1136 KB  
Review
Diet, the Gut Microbiome, and Estrogen Physiology: A Review in Menopausal Health and Interventions
by Michelle Jing Sin Lim, Elvina Parlindungan, E’ein See, Ching Hwee Gan, Rachel Yap and Germaine Jia Min Yong
Nutrients 2026, 18(7), 1052; https://doi.org/10.3390/nu18071052 - 26 Mar 2026
Cited by 1 | Viewed by 3272
Abstract
Menopause represents a key transitional phase in women’s health, characterized by declining estrogen levels and increased risk for cardiometabolic, musculoskeletal, and urogenital disorders. Beyond its endocrine roots, emerging evidence highlights the gut microbiome as a critical modulator of systemic hormonal balance. This review [...] Read more.
Menopause represents a key transitional phase in women’s health, characterized by declining estrogen levels and increased risk for cardiometabolic, musculoskeletal, and urogenital disorders. Beyond its endocrine roots, emerging evidence highlights the gut microbiome as a critical modulator of systemic hormonal balance. This review synthesizes current understanding of the bidirectional relationship between estrogen and the gut microbiome and its implications for women’s health during menopause. Evidence from current studies reveals distinct findings across populations, reflecting the complexity of estrogen regulation in part by the gut microbiome (i.e., estrobolome). While no ideal gut microbial composition has been identified for women across stages of perimenopause, likely due to geographically unique gut microbiome profiles among healthy women, greater microbial diversity has been positively associated with improved estrogen regulation. Conversely, reduced diversity and altered Firmicutes/Bacteroidetes ratios have been linked to biomarkers of inflammation during perimenopause, which is a key driver across many perimenopausal symptoms. Although hormone replacement therapy remains the primary clinical intervention during perimenopause, we highlight emerging evidence on the adjuvant potential of diet, synbiotics, phytoestrogens, and strain-specific probiotics in modulating the estrogen–gut microbiome axis for improved health span trajectories and better symptom management. Future longitudinal studies integrating diet, gut microbiome profiles and symptom trajectories are essential to clarify these mechanisms across ethnicity and geography. Ultimately, understanding localized diet–microbiome interactions will enable the development of accessible, personalized, and non-hormonal strategies to complement and increase agency in proactive management during the perimenopausal transition. Full article
(This article belongs to the Special Issue The Role of Diet and Microbiome in Peri/Menopause)
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Other

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17 pages, 604 KB  
Systematic Review
The Gut Microbiota in Perimenopausal Anxiety: A Novel Therapeutic Pathway Through Diet
by Giuseppe Marano, Claudia d’Abate, Ilaria Ianes, Giuseppe Sorrenti, Gianandrea Traversi, Rosanna Esposito, Francesco Pavese, Tatiana D’Angelo, Paola Fuso, Gianluca Franceschini, Ida Paris and Marianna Mazza
Nutrients 2026, 18(5), 743; https://doi.org/10.3390/nu18050743 - 26 Feb 2026
Cited by 1 | Viewed by 1573
Abstract
Background: Perimenopause is characterized by pronounced fluctuations in ovarian steroids, which are associated with an increase vulnerability to anxiety symptoms. Growing evidence indicates that declining estrogen levels influence gut microbiota composition and microbial metabolic activity, thereby modulating neuroimmune and neuroendocrine pathways involved in [...] Read more.
Background: Perimenopause is characterized by pronounced fluctuations in ovarian steroids, which are associated with an increase vulnerability to anxiety symptoms. Growing evidence indicates that declining estrogen levels influence gut microbiota composition and microbial metabolic activity, thereby modulating neuroimmune and neuroendocrine pathways involved in emotional regulation. This review explores gut microbiota alterations occurring during the menopausal transition and critically evaluates dietary strategies targeting microbiota–gut–brain mechanisms potentially relevant to perimenopausal anxiety. Methods: A structured literature search was conducted in PubMed, Scopus, and Web of Science to identify clinical, translational, and preclinical studies addressing: (i) gut microbiota changes across perimenopause and menopause; (ii) microbiota–gut–brain pathways implicated in anxiety; and (iii) dietary patterns, nutrients, probiotics, and prebiotics with documented microbiota-modulating effects. The available evidence was synthesized narratively, with particular attention to biological plausibility and clinical relevance. Results: The perimenopause transition is associated with reduced microbial diversity, depletion of Lactobacillus, Bifidobacterium, and short-chain fatty acid (SCFA)-producing taxa, and enrichment of pro-inflammatory microbial signatures. These alterations are linked to increased intestinal permeability, altered tryptophan-kynurenine metabolism, immune activation, and dysregulated hypothalamic–pituitary–adrenal axis activity. Dietary interventions, including Mediterranean-style diets, fiber- and polyphenol-rich foods, fermented products, and selected probiotic and prebiotic formulations, have been shown to modulate gut microbial composition, enhance SCFA production, and attenuate inflammatory and neuroendocrine stress pathways. Preliminary evidence suggests potential anxiolytic benefits; however, randomized controlled trials specifically targeting perimenopausal populations remain limited. Conclusions: Gut microbiota dysbiosis may contribute to anxiety vulnerability in perimenopausal women through interconnected immune, metabolic, and neuroendocrine mechanisms. Dietary modulation of the intestinal microbiota represents a biologically plausible and low-risk complementary approach to support emotional well-being during this transitional period. Well-designed, perimenopause-specific clinical trials are needed to confirm efficacy and inform microbiome-based nutritional strategies. Full article
(This article belongs to the Special Issue The Role of Diet and Microbiome in Peri/Menopause)
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