Probiotics and prebiotics are important elements in everyone’s nutrition and health. But they are of particular interest during the menopause. In recent years, scientists in many countries have increased their efforts to learn more about how they work. This is to determine their contributions during this stage in a woman's life (1). Although they appear to be similar, they have a different role. 

Together, they help to maintain the health of the gut flora, which are a group of bacteria that live in the intestine. These bacteria are essential for overall health, so in this article we’ll explain everything you need to know about probiotics and prebiotics and how to include them in your diet to reap their benefits (2). 

What are probiotics and prebiotics?

Prebiotics are specialised plant fibres. They act in a similar way to a fertiliser, as they trigger the growth of healthy bacteria in the gut. And they can be found in the fibre and in resistant starch. These, although not digestible by humans, are digestible by bacteria and other microbes ⁽³⁾.

On the other hand, probiotics are live bacteria and yeasts that are known to have health benefits. When consumed, they restore the natural balance of gut bacteria, especially after illness or the use of antibiotics ⁽⁴⁾.

In this way, both help the body build and maintain a balanced intestinal flora, improving digestion. This is done by promoting beneficial bacteria in the body.

What foods can they be found in?

Prebiotics can be found in many natural foods, such as fibre from vegetables, fruits, and legumes. The most common foods are (2): 

• Pulses 
• Beans 
• Peas 
• Oats 
• Bananas 
• Berries 
• Artichokes 
• Asparagus 
• Garlic 
• Leeks 
• Onions 

On the other hand, probiotics can also be found naturally in some foods, especially fermented foods. The reason for this is that the bacteria in these foods thrive on the sugar and fibre they contain. Remember to moderate spicy foods such as kimchi if you are sensitive. The most common foods in which probiotics can be found are (2):  

• Yoghurt 
• Kimchi 
• Kombucha tea 
• Kefir 
• Some unpasteurised pickles 
• Unpasteurised pickled vegetables 

• They contain the right amount and types of bacteria. 
• Bacteria are still alive at the time of consumption. 

Benefits of their consumption during the menopausal period

During the menopause, oestrogen levels are thought to affect the gut flora. So, this may be associated with menopausal symptoms such as dry mouth, loss of appetite, vaginal dryness, weight gain and impaired bone health. In addition, it is worth mentioning that gut flora is closely related to moods, which, as is well known, can fluctuate into depression during this stage (5). 

Thus, probiotics and prebiotics can (1,6):  

• Increase calcium absorption in the intestine, thus helping to reduce loss of bone density and risk of osteoporosis. 
• Reduce inflammation of the gums and around the teeth. 
• Regulate weight by controlling to reduce obesity. 
• Prevent inflammation in general. 
• Improve blood glucose and fat metabolism.  
• Decrease intestinal symptoms such as gas, bloating, and stomach pain. 
• Help prevent depression and mood swings. 
• Improve symptoms of irritable bowel syndrome, colitis and types of haemorrhoids. 
• Relieve (in some cases) chronic constipation.

How to include probiotics and prebiotics in the diet?

Including them is easy: it's all about eating a varied and balanced diet. We remind you to consult your doctor or nutritionist before making any changes to your diet. No recommendation can replace their advice. Now, to include probiotics and prebiotics in your diet, you should make sure you consume (2,4):  

• Fermented foods. 
• Natural vegetables, legumes, greens, fruits and vegetables. In addition to containing probiotics, they contain phytoestrogens that help with hormone regulation and bone health. 

The benefits of probiotics and prebiotics are still being studied; however, what is certain is that they don’t cause harm to the body of a person with an adequate defence system. So, if in addition to being in the menopause you have a chronic illness or cancer, you should talk to your doctor about whether they are right for you (4). 

Remember that menopause is just another stage in life, so your main focus needs to be on acquiring healthy habits before, during and after the menopause. This will ensure a better quality of life

References

1. Szydłowska I, Marciniak A, Brodowska A, Loj B, Ciećwież S, Skonieczna-Żydecka K, Palma J, Łoniewski I, Stachowska E. Effects of probiotics supplementation on the hormone and body mass index in perimenopausal and postmenopausal women using the standardized diet. A 5-week double-blind, placebo-controlled, and randomized clinical study. Eur Rev. 2021;25:3859-67. Available from: https://www.europeanreview.org/wp/wp-content/uploads/3859-3867.pdf 
2. Lewis S. Probiotics and Prebiotics: What’s the Difference? [Internet]. Healthline; 2020 [cited 2023 Feb 12]. Available from: https://www.healthline.com/nutrition/probiotics-and-prebiotics 
3. Mayo Clinic. Prebiotics, probiotics and your health [Internet]. Mayo Clinic; 2021 [cited 2023 Feb 12]. Available from: https://www.mayoclinic.org/prebiotics-probiotics-and-your-health/art-20390058 
4. NHS. Probiotics [Internet]. 2023 [cited 2023 Feb 12]. Available from: https://www.nhs.uk/conditions/probiotics/ 
5. Foss C. Probiotics for Menopause [Internet]. Optibac Probiotics; 2020 [cited 2023 Feb 12]. Available from: https://www.optibacprobiotics.com/professionals/latest-research/female-health/which-probiotics-are-best-for-menopause 
6. Medical News Today. What is the difference between prebiotics and probiotics? [Internet]. 2018 [cited 2023 Feb 12]. Available from:  https://www.medicalnewstoday.com/articles/323490#takeaway