Christine Garvin explains how the microbiome drives perimenopause and menopause symptoms. When Lactobacillus declines in the vagina, you get dryness, UTIs, and yeast infections. In the gut, the estrobolome loses its ability to recycle estrogen, triggering hot flashes, mood changes, and metabolic dysfunction.
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Hi there. My name is Christine Garvin and I'm an account manager here at Tiny Health. I'm also a functional nutritionist and I'm focused on perimenopause in my practice for many years now. So let's actually discuss symptoms that are common in perimenopause and menopause, so you know what to look out for. So vaginally, dryness, atrophy, painful intercourse, UTIs and bacterial vaginosis of, as I've already mentioned, are very common. Chronic inflammation that's linked to endometrial hyperplasia and vulvovaginal candidiasis are also something that can occur in those perimenopause and menopausal years more often in the gut looking at bloating, IBS exacerbation, you know, when that gets worse over the years, metabolic dysfunction like insulin resistance and weight gain and of course systemic inflammation. And this is a really big important part to think about for your long term health. Right. It is connected to things like osteoporosis, to cardiovascular risks and depression. Right. And also thinking beyond mental health to also brain health overall. And then systemically, we're going to see those things that so many women do experience in there, especially late perimenopausal years, early menopausal years. And that's hot flashes, that bone density loss that can continue well into, you know, our 70s and 80s and mood disturbances that are exacerbated by disrupted estrogen recycling, which we're going to talk a little bit more about that estrogen recycling here in just a moment. So how can you use Tiny health testing to really support and leverage your gut microbiome and your vaginal microbiome during these changing years? Well, let's dive into it. Let's talk about Emma's story. She is approaching her late 40s and hormonal fluctuations are starting because her estrogen is starting to decline. We're actually going to see a decrease in those vaginal Lactobacillus species that we were talking about a few minutes minutes ago and a rise in ph, which allows these other pathogens to really set up shop and increase her susceptibility to UTIs, dryness and discomfort. She's also maybe shifting into that non lactobacillus CST type 4 state. Remember, that's the one where we just don't really have Lactobacillus. And that is going to increase those infection risks, reduce estrogen recycling, which is going back to that estrobolone that I keep referencing. And I promise I'm going to tell you more about here soon. That increased her risk for metabolic and cardiovascular issues. And then of course, unfortunately, reduced gut barrier integrity does increase that microbial translocation. And that means that inflammation markers, you know, are going to increase. You know, if you do any other testing outside of Tiny Health that points to inflammation, you may see those increase at that point. So what we are really looking at once Emma is actually hitting her postmenopausal years, is that her gut microbiome has permanently shifted. You're going to see a lot less diversity and you're going to see in the vaginal microbiome, unfortunately, more diversity, which we don't want. She's experiencing symptoms like dryness, increased infection risk and metabolic changes. As these hormones really start to decrease and flatline, the female microbiome actually becomes much closer to the male gut microbiome at that point of life. But the good news is we can use both our gut health tests as well as our vaginal health test to assess these areas that are specific to her symptoms and bring some symptom relief. Okay, so what do we want to look for on Tiny Health gut testing? Of course, we want to look at beta glucuronidase. I've been referencing the astrobial lome here for a few slides, so I'm going to tell you a little bit more about it right now. So beta glucuronidase is an enzyme that that is produced in the estrobolome, which is a subset of our microbiome in our colon. So if you look here on the right hand side, you're going to see when you produce estrogen in your pre menopausal years, it's produced from your ovaries, from your adrenal glands and from your adipose tissue. And then it's going to go into circulation. But the thing about estrogen is it can become toxic if it's hanging out for too long. Right. We kind of want to use it and move it along so it goes through the liver in order to take it from a toxic substance to a non toxic substance. Once the liver has done its job, it's actually going to take that nicely packaged up estrogen that's no longer toxic down into the colon via the bile. And then as it makes its way through the colon to start to make its way out via the stool. We actually have that estrobolum in there. And that's where you're going to have some of what we call deconjugation of some of that estrogen by beta glucuronidase. So this enzyme is, you know, interesting and you really want it in kind of that really nice healthy reference range that we have on tiny health testing, because you do want a little bit of that estrogen deconjugated and released back into the system because that can help manage your estrogen levels. But as a pre menopausal woman and into perimenopause, when we start to have lower progesterone levels but kind of maintain those higher estrogen levels, we want to make sure enough of that estrogen is moving out of the body via the stool. So having that, you know, sort of high end of the normal place while we're in our premenopausal years is good. But then when we get into our menopausal years, often beta glucuronidase production really bottoms out because we're not having as much estrogen production right at that point, our ovaries are not, not producing any more estrogen. We're getting a little bit from our adrenals and for some women we still have in the adipose tissue. So we actually want our beta gluconidase up a little bit. Right? We want it in that healthy range still. But often we're trying to bring it up from being low in order to make sure that we are establishing that can kind of continuous estrogen release back and, and stabilizing those levels. So what else to look for on tiny health gut tests? We want to look at the GABA producers and breakdown section. We want to look at Shannon diversity and species richness, short chain fatty acids. And then because a lot of women out there are really focusing on protein and increasing protein in their diet, especially in their perimenopausal and menopausal years. We want to look at the protein breakdown capacity because you want to make sure you're breaking down that protein well and absorbing it well so that you're not feeding the microbes in your colon that actually will produce toxins from that protein. In terms of the vaginal test, we really want to look at your Lactobacillus levels. It's nice and simple, right? Do you have the Lactobacillus species in there that we want, like Crispatus or are they really dropping down? Are you starting to see other microbes like Streptococcus and Prevotella increase? We also really want to look to E. Coli for Utis, Gardnerella for BV and Candida for yeast. So you can get really specific on what types of species are correlated with certain conditions. It.
