The microbiome-hormone loop: why treating one without the other just doesn't work

It’s time to retire the idea that hormones and the vaginal microbiome live in separate worlds. They’re not neighbours, they’re housemates.

When one is out of sync, the other feels it.

This two-way relationship explains why some women can eat well, exercise, and still feel hormonally unstable or experience recurrent vaginal imbalances.

Hormones influence the microbiome

Oestrogen is such an important hormone, and really gets a bad wrap. We blame it for everything from mood changes to heavy periods (sometimes quite rightly!). The thing is, oestrogen is essential for good vaginal health.

When oestrogen levels are sitting in their optimal range this encourages glycogen production. Glycogen is food for lactobacillus - the good bacteria that lives in our vagina and keeps it protected at a lovely acidic level.

As oestrogen dips - think stress, oral contraceptive pill use, perimenopause - especially around ovulation and before our period, lactobacillus also declines which can allow other species to start to take hold. Often these other species are the ones that are driving irritation and odour. Now we want our oestrogen to dip at these points in our cycle, it’s actually really important. We don’t want it to dip too much or too quickly which is often happening in perimenopause.

The microbiome influences hormones

Yep, its a 2 way street! The gut microbiome (much more than the vaginal microbiome) helps regulate how oestrogen is metabolised and cleared from the body. An imbalanced gut can lead to all sorts of issues, from not being able to clear out the oestrogen properly in the first place, to reabsorption of “used” oestrogen (which is not really the type we want to help with our vaginal microbiome - that’s right, not all oestrogen is made equal).

When our body has too much oestrogen we can experience PMS, breast tenderness and heavier periods.

It’s a feedback loop and ignoring one part means the cycle of symptoms continues.

Time for an integrated approach

Often, my clients have seen different specialists - a gastroenterologist for their gut issues, an endocrinologist for their hormones, a GP or gynaecologist for their vaginal symptoms. There’s nothing connecting the issues together in conventional care. That’s what makes naturopathic care different - I connect the dots, or in this case, symptoms and body systems.

Testing both hormones and microbiomes (vaginal and gut as needed) gives us a much more complete picture. One that allows for precise, personalised treatment instead of trial and error.

Practical support tips and take aways

Balance isn’t built in isolation. We need our body to work in rhythm, hormones and microbes, they’re partners and both deserve attention, curiosity and care.

So lets start:

• Prioritise fibre and hydration for homone detoxification pathways through the gut
• Add fermented, pre and probiotic rich foods to gently nourish gut diversity
• Manage stress with consistent, predictable rest (not just catch up sleep)
• Reassess antibiotics, alcohol and sugar intake - they’re major microbiome disruptors
• Book a free, confidential Vag Hormone Assessment with Alison Patchett at https://bit.ly/BookWithAlison.

It’s time to see the whole picture.