Exploring How Diet can Impact Hormonal Health in Menstruating Females: The Power of the Microbiome and the Role Food Plays in Supporting it


Eating a diet that supports good gut microbiome health is important for all individuals. Biologically, female-bodied individuals have a very different set of hormones and reproductive anatomy than their male-bodied counterparts. This means there are unique dietary recommendations that support the microbiome and hormones of bleeding individuals that cycle through different phases month to month and throughout their lifetime.

This topic is very important to me as I see many women in practice with mood imbalances, painful and/or heavy periods, PMS, and other menstrual irregularities. Hormonal imbalances can also heighten the symptoms associated with the hormonal transition to menopause. There’s a cultural acceptance in our society that hormone-related cycles are inherently problematic and unpleasant, which is far from the truth. Despite the ability to achieve pain-free periods and more gentle hormonal transitions, I continue to hear from patients that their gynecologists told them to “just accept that periods are painful.” While it is common for periods to be painful, there is a lot you can do to support having pain-free periods. This is also true to big hormonal transitions female-bodied individuals experience throughout life. These transitions may be difficult, but we can certainly improve drastic hormonal swings and unpleasant side effects by supporting the microbiome, and therefore hormonal health.

Gut microbiome and hormones

The gut microbiome is responsible for producing and secreting hormones in addition to responding to any hormones that the body is making elsewhere. Because of its ability to regulate the expression of hormones throughout the body, it is now considered a “virtual” organ. Of course, we should be supporting an organ that has this much power and influence over the rest of our bodies! Take menstruation for example. Addressing gut health as a means to achieve pain-free periods can improve quality of life considering women bleed an average of 3,000 days in their lifetime! And that is just one benefit. The influence that the microbiome has over the entire body is so far-reaching that it affects energy levels, sleep, mood, appetite, weight, metabolism, chronic disease potential, and just about everything else one might pay a visit to the doctor for. There are several ways to support the microbiome including stress reduction, proper sleep, regular exercise, avoidance of environmental toxins, use of gut enhancing supplementation, and of course diet. Let’s deep dive into the diet category so you can begin to optimize your gut and hormones today.


Below are some of the most well-researched foods to support a healthy microbiome that can also help to support healthy hormones.


Phytoestrogens are a group of plant-derived compounds that mimic estrogen in the body. The most relevant phytoestrogens in regards to hormones are soy and flax seeds. Soy has been controversial through the years on whether or not it can contribute to or prevent cancer. A 2016 review of research concluded that soy foods can increase protective bacteria like lactobacilli and bifidobacteria and alter the ratio of the two largest phyla of bacteria in the gut microbiome. These changes are significant in reducing disease-causing bacterial populations. Flax seeds are a common phytoestrogen recommended when estrogen balancing is needed. They exhibit adaptogenic-like effects on the estrogen levels in that they can either bring them up or down, depending on what the individual needs.

Cruciferous vegetables

Cruciferous vegetables are foods like broccoli, kale, cauliflower, brussels sprouts, and cabbage. They contain protective compounds such as fiber and glucosinolates, which have been identified as protective against lung cancer and other digestive tract cancers. Fiber helps keep bowel movements happening regularly, which reduces the risk of gas, bloating and constipation, Fiber can also be fermented by bacteria in our gut to make short-chain fatty acids (SCFAs) which suppress the growth of tumor cells and support gut membrane integrity amongst many other things. Cruciferous vegetables are most notably high in a compound called indole-3-carbinol (I3C) which helps our bodies naturally detox estrogen. This is particularly helpful for individuals who experience period pain and other menstrual-related imbalances. The list of health benefits goes on with the bottom line being these veggies pack a serious hormone-supporting punch!


Fish oil has long been accepted as having a protective role in human health. The active ingredients in fish oil are a group of polyunsaturated fatty acids (PUFAs), better known as EPA and DHA. EPA, or eicosapentaenoic acid, has been studied for its ability to support a strong gut barrier. This is important to keep inflammation low as a permeable gut membrane is understood to be one of the biggest sources of systemic inflammation in the body. Higher EPA supplementation can be very supportive for period pain as it reduces an inflammatory chemical called prostaglandins that are responsible for increasing uterine contractions. DHA - or docosahexaenoic acid - on the other hand, is very helpful at supporting brain health and signaling. This nutrient is regarded as essential for pregnant and postpartum mothers as it is a critical building block of the brain, retina, and nervous system. Not only is it important for babies, but for mothers too as research shows EPA and DHA support healthy delivery and mood postpartum. Not only do omega-3’s provide the backbone required to make hormones, but we also cannot make omega-3’s on our own so it’s important that we consume them on a regular basis. The highest sources of omega-rich foods are cold-water fish like mackerel, sardines, salmon, and anchovies. Plant sources of omega-3’s include algae, walnuts, and chia seeds.


Prebiotics are non-digestible fibers that have been shown to increase important bacteria like bifidobacteria and lactobacilli, support gut lining integrity, improve immune response and keep pathogenic bacteria from growing at unhealthy numbers. Prebiotics are high in food such as garlic, onions, leek, asparagus, chicory root, bananas, oats, and Jerusalem artichokes. While there aren’t specific studies on prebiotics and women’s health, research shows they play a critical role in the prevention and treatment of obesity as well as regulating insulin sensitivity, which has a profound effect on female hormones. A common menstrual complaint called polycystic ovary syndrome (PCOS) is rooted in insulin resistance. The hallmark signs are male pattern hair growth, anovulation, and multiple cysts on the ovaries. PCOS is one of the biggest contributors to fertility issues amongst women. Eating prebiotic-rich foods is one great way to curb insulin resistance and diversify the microbiome - both of which are crucial to hormone and gut health.


At this point, you’ve probably heard the buzz about the benefits of probiotic-rich foods such as kimchi, sauerkraut, pickles, kefir, yogurt, and miso. The friendly bacteria in probiotic-rich foods are known to help colonize your gut with beneficial bacteria which keeps problematic bacteria from overpopulating. Like prebiotics, probiotics can enhance diversity within the microbiome and therefore significantly reduce the risk of gut membrane permeability (aka leaky gut). This keeps inflammation at bay and prevents many chronic inflammatory markers from rising that we know contribute to conditions like PCOS, endometriosis, hypothyroidism, and even breast cancer. Get your pickling jars out or hit up the fermented food aisle the next time you’re at the grocery store to ensure you’re adding these gut-friendly bacteria to your diet!

Liver Loving foods

The liver is the grand central station when it comes to detoxification in the body. Anytime we aim to reset our hormones, especially when someone may be dealing with estrogen excess, we must not forget to support the liver. Foods that congest the liver and contribute to hormonal imbalances are things like alcohol, processed foods, saturated fats, and sugar. Liver-loving foods include burdock, leafy greens, beets, artichoke, garlic, and cruciferous vegetables.

The gut microbiome and the trillions of microbes that inhabit it, work in a beautiful orchestration to support hormonal signaling through the body. We would not survive without them, but we can thrive when we help cultivate the right ecosystem for our body type. Tending your microbiome as if it were a garden and giving it the most nutritious and supportive foods will provide immense benefits to your overall health and hormones.

Dr. Elizabeth Wade, ND

Naturopathic Doctor

Dr. Elizabeth specializes in reproductive health, infertility, environmental medicine, and autoimmune disease. She is committed to staying up to date in the world of microbiome research and sees her doing so as fundamental in her ability to get to the root cause of her patients’ health concerns. Dr. Elizabeth offers one-on-one health consultations at her private practice in Portland, OR to ensure everyone has access to the information needed to reverse or prevent disease in the most effective and least invasive ways possible.

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