Are Probiotics Worth It For Women Over 35? An ObGyn’s Honest Take

Midlife and Hormones
Written By Jessica Nazzaro

I had a patient tell me that she was getting yeast infections so she started taking a pre-biotic and pro-biotic. If she stays consistent, the yeast infections don't happen.

I’ve had many women, whether patients or acquaintances, say they are taking a probiotic.

As humans and mammals, we are made up of many smaller organisms particularly within our gut. This collection of bacteria, which actually outnumbers our humans cells, is called the microbiome.

We acquire our microbiome before we're born, during birth, and breastfed babies acquire more prebiotics through breast milk.

A disordered microbiome can increase risk of several diseases, including:

  • Obesity

  • Irritable Bowel Syndrome (IBS)

  • Inflammatory Bowel Disease (IBD)

  • Type 2 Diabetes

  • Allergies

  • Cognitive changes

So, is this a necessary health regimen or over-hyped purchase?

What Are Pre and Probiotics?

Pre-biotics are substances that feed our gut bacteria.

Examples of pre-biotic foods include:

  • garlic

  • leeks

  • onion

  • asparagus

  • bananas

  • artichoke

  • barley

Pro-biotics are actual bacteria being introduced into the gut.

Strains studied in humans include:

  • Lactobacillus

  • Bifidobacterium

With many species within each class.

Why Did Probiotics Become So Popular?

With simultaneous increases in both chronic disease and health interest, the probiotic market is expected to reach $220 Billion (with a B!) by 2030.

The scientific and public interest in gut health is driving this market value. Research is showing that gut health underpins many aspects of health and longevity, while disrupting it leads to many chronic diseases that impact the world population.

What Are Evidence-Based Roles For Probiotics?

In postmenopausal women, probiotics have shown improved:

  • Bone Mineral Density (BMD)

  • Metabolic health

  • Oral health (upcoming article on the importance of this!)

  • Genitourinary Syndrome of Menopause (GSM) along with vaginal estrogen

Plus:

• Reduced risk of spine and hip fracture

While probiotic supplementation has not been trialed for breast cancer, there is observational evidence that probiotics could decrease the risk of breast cancer.

In PCOS patients when also taking vitamin D, one trial also found:

  • Improved mental health

  • Decreased testosterone

  • Decreased inflammatory markers

Other evidence-based benefits:

  • Improved treatment of Bacterial Vaginosis

  • Preventing recurrent vaginal yeast infections

These studies are highly variable as far as what types of probiotics were studied. That makes it weaker evidence despite the potential benefit.

When Are Probiotics A Waste of Money?

Any probiotic product with high amounts of added sugar is a waste of money.

Part of the gut disruption is due to the modern diet, part of which is high sugar content.

What I Tell Women Before Buying:

Food is always first. We can't supplement our way out of an unhealthy lifestyle, and the microbiome is no exception.

I support targeted supplementation but supplements are not regulated and there's no way of knowing if the cultures are live, dead, or effective.

Read the label. Look for the strains mentioned above and avoid unwanted ingredients: added sugar, dyes, and preservatives.

Big Picture of Gut Health in Midlife

The importance of gut health cannot be overstated, particularly for midlife women.

With menopausal changes to the gut microbiome, we're learning more every day about the impact this has on overall health.

Estrogen impacts the gut microbiome and the microbiome affects estrogen.

An overall healthy foundation of whole food, water, exercise, and avoidance of substances will set the stage. A targeted, high-quality supplement can help.

If this reflection resonated with you, I invite you to stay connected. I share thoughtful insights on women’s health, hormones, and faith—without rigid protocols or extremes.

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Resources:

Some of the information contained in this article is the result of my training, medical knowledge, and personal experience without a specific source to be cited.

The author can earn commissions through affiliate links.

Disclaimer: This is not medical advice. This is for educational purposes only. Discuss with your doctor.

Cesare Cremon, Maria Raffaella Barbaro, Marco Ventura, Giovanni Barbara, Pre- and probiotic overview, Current Opinion in Pharmacology, Volume 43,2018,Pages 87-92

Walker RW, Clemente JC, Peter I, Loos RJF. The prenatal gut microbiome: are we colonized with bacteria in utero? Pediatr Obes. 2017 Aug;12 Suppl 1(Suppl 1):3-17. doi: 10.1111/ijpo.12217. Epub 2017 Apr 26. PMID: 28447406; PMCID: PMC5583026.

Green M, Arora K, Prakash S. Microbial Medicine: Prebiotic and Probiotic Functional Foods to Target Obesity and Metabolic Syndrome. Int J Mol Sci. 2020 Apr 21;21(8):2890. doi: 10.3390/ijms21082890. PMID: 32326175; PMCID: PMC7215979.

https://www.grandviewresearch.com/industry-analysis/probiotics-market

The Unregulated Probiotic Market de Simone, Claudio Clinical Gastroenterology and Hepatology, Volume 17, Issue 5, 809 - 817

Wang F, Wei W, Liu PJ. Effects of probiotic supplementation on bone health in postmenopausal women: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2024 Nov 1;15:1487998. doi: 10.3389/fendo.2024.1487998. PMID: 39553313; PMCID: PMC11563942.

https://www.sciencedirect.com/science/article/pii/S1028455923003017?via=ihub

Jessica Nazzaro
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