Microbiota and perimenopausal syndrome: mechanisms and therapeutic strategies (narrative review)
No reproducible gut dysbiosis pattern specific to perimenopausal syndrome has been established.
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Context
Over 70% of perimenopausal women report symptoms such as hot flashes and anxiety. The gut microbiota is a mechanistically plausible candidate, but causal involvement remains unproven.
What the study showed
The review synthesized clinical and preclinical evidence and found that findings on microbial diversity and changes in specific taxa are inconsistent across studies. No specific dysbiosis profile for perimenopausal syndrome has been replicated. Ovarian aging and hormonal fluctuations may reshape the gut microbial ecosystem, and microbial enzymes and metabolites may interact bidirectionally with the host.
How it was done
Narrative review with targeted searches of PubMed and Web of Science covering publications through July 15, 2026. Human studies were prioritized; high-quality animal and mechanistic studies were included when clinical evidence was limited.
Risk of bias
This is a narrative, not a systematic review with meta-analysis, and is subject to selection bias and methodological heterogeneity of included studies. This analysis is based solely on the available abstract without access to the full text.
What this study does NOT prove
This study does not demonstrate causality between microbiota alterations and perimenopausal symptoms, nor efficacy of any microbial intervention in this population.
In clinical practice
There is insufficient evidence to recommend microbiota-targeted interventions as treatment for perimenopausal syndrome. Clinical use of probiotics or fecal microbiota transplantation for this indication lacks robust evidentiary support.
Limitations
This is a narrative, not a systematic review with meta-analysis, and is subject to selection bias and methodological heterogeneity of included studies. This analysis is based solely on the available abstract without access to the full text.
Technical appendix
Version history
- 1.0 · 2026-10-29 — Auto-generated under Evidence Standard v1.0