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Estrogen-gut microbiome axis: Physiological and clinical implications.

James M Baker1, Layla Al-Nakkash2, Melissa M Herbst-Kralovetz3

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The gut microbiome regulates estrogen levels, impacting women's health. Dysbiosis can reduce estrogen, contributing to various diseases, but microbiome modulation offers therapeutic potential.

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Area of Science:

  • Endocrinology
  • Microbiology
  • Women's Health

Background:

  • Post-menopausal estrogen decline affects cognition, gut health, and reproductive systems.
  • The gut microbiome is a key regulator of circulating estrogen levels.
  • Gut microbiota influences estrogen activity via β-glucuronidase secretion.

Purpose of the Study:

  • To review the gut microbiota's role in estrogen-modulated diseases.
  • To explore the bidirectional relationship between gut microbiota and metabolic profiles in estrogen-driven conditions.
  • To discuss therapeutic interventions targeting the gut microbiome for estrogen-modulated diseases.

Main Methods:

  • Literature review of the gut microbiota's influence on estrogen metabolism.
  • Analysis of the link between gut dysbiosis and reduced estrogen deconjugation.
  • Examination of therapeutic strategies including bariatric surgery and metformin.

Main Results:

  • Gut dysbiosis, marked by reduced microbial diversity, impairs estrogen deconjugation, lowering circulating estrogen.
  • Altered estrogen levels are linked to obesity, metabolic syndrome, cancer, endometriosis, PCOS, CVD, and cognitive dysfunction.
  • Microbiome modulation can positively impact metabolic profiles and alleviate estrogen-modulated diseases.

Conclusions:

  • The gut microbiome significantly influences estrogen levels and contributes to various diseases.
  • Therapeutic manipulation of the gut microbiome shows promise for treating estrogen-modulated conditions.
  • Further research into dietary therapeutics and unexplored areas is warranted.