A natural phenomenon occurring around the age of 50, the menopause can have an impact on women’s quality of life. Many symptoms appear during this period and certain microbiota can be affected.
What is menopause?
Generally occurring between the ages of 45 and 55, the menopause corresponds to the cessation of ovulation and hormonal secretions (estrogen and progesterone), accompanied by the disappearance of menstruation. The menopause is truly established when menstruation has been absent for 12 consecutive months).
Today, 500 000 women enter the menopause every year. This affects a total of 14 million women in France.
The menopausal transition takes place in three phases:
- Perimenopause or pre-menopause: period during which the menstrual cycle becomes irregular and the first symptoms appear;
- Menopause: corresponds to the total absence of menstruation;
- Post-menopause: period beginning one year after the last period, during which the body adjusts to the new hormonal balance and problems diminish.
Some women reach menopause around the age of 40: this is known as early menopause. It can be spontaneous, i.e. of genetic origin, or the result of a particular health condition.
During this period, hormonal changes lead to significant psychological and physical symptoms:
- Hot flushes,
- Sleep disturbances,
- Night sweats,
- Fatigue,
- Irritability,
- Vaginal dryness,
- Loss of libido,
- Urinary and vaginal infections,
- …
They can also increase the risk of certain illnesses such as osteoporosis, metabolic and cardiovascular diseases, oral and dental problems.
Does the menopause affect intimate comfort?
Before the menopause, over 90% of the vaginal microbiota is dominated by Lactobacilli. These protective bacteria maintain an acid vaginal pH through the production of lactic acid and form a biofilm on the vaginal mucosa, preventing the growth and proliferation of germs that can cause vaginal infections.
During the menopause, the sudden drop in estrogen levels causes the mucosa to dry out and the vaginal microbiota to diversify. Lactobacilli become less abundant (10 to 100 times less than during childbearing). The vaginal pH is less acidic, allowing pathogenic micro-organisms to proliferate.
This dysbiosis can be the cause of vaginal infections such as:
- Bacterial vaginosis: caused by the proliferation of Gardnerella vaginalis, a pathogenic bacterium.
- Vulvovaginal candidiasis: caused by a fungus, Candida albicans.
After the menopause, women frequently develop urinary tract infections. Clinical evidence suggests that low estrogen levels lead to increase in residual urine volume and a dysbiosis of the vaginal microbiota. These are two risk factors for urinary tract infections.
To combat intimate discomfort, studies have shown that oral supplementation with probiotics can rebalance the vaginal flora by increasing the Lactobacilli population and reducing the incidence of vaginal and urinary tract infections.
Are other microbiota affected?
The vaginal microbiota is not the only one to be affected by the drop in hormones associated with the menopause. The reduction in estrogen also influences the intestinal microbiome:
- Impairment of the barrier function of the intestinal mucosa, allowing toxic substances and pathogenic bacteria to pass into the bloodstream and cause inflammation.
- Decreased production of short-chain fatty acids (SCFAs): these molecules have a protective anti-inflammatory action and regulate energy metabolism.
The oral microbiota is also affected by the menopause. Many women complain of dry mouth at this time of life. The drop in hormones causes reduction in saliva and could alter the oral microbiota. This dysbiosis is thought to be at the root of inflammatory conditions such as gingivitis and periodontitis.
During the menopause a woman’s physiological balance is upset. Numerous problems can arise, diminishing their quality of life. A balanced diet, regular exercise and the use of biotic-based food supplements (probiotics, prebiotics, postbiotics and symbiotics) can help maintain and rebalance their microbiota.
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References
Picture: Freepik
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