Do probiotics help with menopause? What the research does and doesn't show

The evidence does not support probiotics as a way to relieve menopause symptoms such as hot flashes, bloating or poor sleep. We found no verified trial of an ordinary probiotic for hot flashes. The small trials that exist measured bone density, blood estrogen or mood, used specific products, and were mixed.

What the evidence doesn't support

• No symptom relief was reported: none of the studies below reported hot flashes as an outcome.
• Better sleep. In 66 postmenopausal women given probiotic yogurt for six weeks, sleep quality did not differ from ordinary yogurt.
• Menopause bloating. We found no verified trial of probiotics for bloating in perimenopause or menopause.
• "Hormone balance." The estrogen trial tested one named strain formula in a small group and did not measure symptoms.

What the trials found

Bone density

A meta-analysis of 12 randomized trials in 1,183 postmenopausal women found probiotics were associated with higher bone mineral density at the lumbar spine (SMD 0.60, 95% CI 0.14 to 1.05) and hip (SMD 0.74, 95% CI 0.15 to 1.33) and lower CTX and BALP bone-turnover markers versus control. Other markers did not differ. The effect was stronger in women with osteopenia than osteoporosis. Strains and doses varied by trial, and the review calls for further trials to confirm.

Mood and sleep

A triple-blind trial in 66 postmenopausal women aged 45 to 55 compared 100 g a day of probiotic yogurt with ordinary yogurt for six weeks. Anxiety (adjusted difference -0.56) and stress scores (-0.76) were slightly lower with probiotic yogurt (p = 0.044 and 0.046) and quality-of-life scores improved; depression and sleep quality did not differ. The strain is not stated in the abstract.

Blood estrogen

An exploratory, randomized, double-blind, placebo-controlled trial in healthy peri- and postmenopausal women tested a formula containing Levilactobacillus brevis KABP052, chosen for its beta-glucuronidase activity. After 12 weeks serum estradiol (31.62 vs 25.12 pg/mL) and estrone (21.38 vs 13.18 pg/mL) were higher than with placebo, where levels fell. The trial reports hormone levels, not symptoms, and the abstract does not state the dose.

Questions people ask

Are probiotics good for menopause?

We found no verified evidence that they relieve menopause symptoms. The measured differences were in bone density, a mood score and blood hormone levels, in specific small trials.

Which probiotic is used for menopause, or for perimenopause bloating?

No product is established. The estrogen trial used L. brevis KABP052; the mood trial used a probiotic yogurt with an unstated strain. Neither is a recommendation. For bloating, see probiotics: what the research does and doesn't show.

See also probiotics and sleep and how to choose a good probiotic.

When to talk to a doctor

A probiotic is not a treatment for menopause symptoms or bone loss. Heavy or irregular bleeding, bleeding after menopause, severe hot flashes, mood changes that interfere with daily life, or a bone density concern should be assessed by a doctor. Ask a doctor or pharmacist before starting any probiotic if you have a weakened immune system or take prescription medicine.