#1 Menopause Gut Expert: Why Your Microbiome CONTROLS Hormones, Mood & Bone Loss | Cynthia Thurlow | #145

**Dr. Vonda Wright** (0:00)
When we talk about the gut in general, I think it's a vast unknown.

**Cynthia Thurlow** (0:05)
It is interrelated with every system, every organ in the body.

**Dr. Vonda Wright** (0:09)
Everybody must eat fermented foods and yogurt every day, no matter what, because it's going to hit us.

**Cynthia Thurlow** (0:14)
Aim for more high quality sleep. Try to manage your stress. Try to eat more nutrient dense food. Try to make sure you're exercising or moving your body. Those things don't change. One dose of appropriately dosed antibiotics will increase your likelihood of developing depression or anxiety by 25 percent. Just one dose. Bloating is probably one of the number one symptoms that women will report. And there's two reasons why I think this can happen.

**Dr. Vonda Wright** (0:38)
Number one, were there things as you were researching that you found surprising that would have effect on a gut that we don't commonly talk about in terms of long term health?

**Cynthia Thurlow** (0:49)
I would say probably the most surprising was.

**Dr. Vonda Wright** (0:54)
So, I'm really excited to talk to you today, Cynthia, because your new book, The Menopause of Gut is Covering a Subject, that I hear popping in once in a while, but there needs to be a thorough handling of this. And so, I'm glad you took up the challenge to do that. Because when we talk about the gut in general, I think it's a vast unknown. And the microbiome, right? So, I want to, even though my listeners are smart, savvy people, I want us to go back to the very beginning and have you help us understand what is the microbiome other than like all the stars in the sky, which is how it's commonly described. What is this that we need to be so interested in?

**Cynthia Thurlow** (1:47)
Yeah, it's so interesting because I'm sure when both of us train, there was little to no information. It really has been the last five to ten years. And if we understand that there is more viruses, protozoa, fungi, that are part of our bodies than there are human cells, to give you a sense, it's 40 trillion microorganisms that line every square inch of our bodies inside and outside. But specific to the gut microbiome, understanding that the gut microbiome, as intangible as it seems to be for many people, because we cannot see it like a bone or the heart or the brain, it is interrelated with every system, every organ in the body. And so this complex interrelationship is both fascinating to me and also so complex, because if you understand that your microbiome starts from the top of your head to the tip of your toes, it starts from your mouth all the way down to your anus. We have microbiomes in our mouth. We have microbiomes in the lung. We have microbiomes in the gut bone access. There is a microbiome in our vaginal area. And I think for a lot of people, because we cannot see these organisms, we assume they're not there. We assume they're not important. And over the last 10 years, I really have been privy, although at the beginning, I did not fully understand or appreciate how important supporting the microbiome is vis-a-vis the hormonal changes that are occurring in perimenopause and menopause, so much so that I humbly sit back and say, oh my gosh, if I had understood more, I could have been far more proactive, not just with patients, but with myself. And so when we talk about the microbiome, it's this complex interplay. It is 40 trillion, as I stated, bacteria, protozoa, fungi, et cetera, viruses that live for the most part happily and hospitably in our bodies and understanding the role of stress and sleep and nutrition and these hormonal changes that we now no longer called sex hormones, but progesterone, estrogen, testosterone. The complex interplay with our immune system when we go into menopause is largely dictated by the health of the microbiome. And so I think that when I decided to pitch this idea to my editor, I wasn't entirely sure she was going to be interested, but she said, really, no one is putting all these pieces together. And so I think this is a way for both clinicians and the lay public to really understand, like, what are the things we can be doing proactively to offset this hormonal flux, that it's going to come whether we realize it or not. The other thing that I think is important to mention, there's something called the micro-genderome, which is a fancy way of saying, our microbiomes as children are very similar with young girls, young boys. It's not until the influence of alterations in hormones, the estrogen, progesterone, testosterone, and puberty, that shifts the dynamics of the microbiome substantially. That also happens in pregnancy, if we go on to have pregnancies. And then fascinating enough, perimenopause is the next big P that shifts the microbiome again. And life comes full circle because in menopause, our diversity, the species of what we find in the microbiome starts to resemble men's again, because that is how dynamic these hormones are with this interplay and communication in the microbiome. But unlike men, their microbiomes have stayed fairly consistently. Ours do this 360-degree loop throughout the trajectory of our young lives into our middle-age lives and beyond.