Sunrise Functional Medicine

Dr. Tracy Tranchitella, ND | Sunrise Functional Medicine

When Dr. Tranchitella talks with patients about hormones, the conversation often goes beyond ovaries, adrenals, or lab numbers. Increasingly, it leads to the gut — because one of the most important influences on estrogen balance lives there. That influence is called the estrobolome. While it may sound technical, the idea is surprisingly simple: certain gut bacteria help decide how much estrogen stays active in your body and how much gets safely eliminated. When this system is working well, hormones stay balanced. When it’s not, symptoms often follow.

What exactly is the estrobolome?

The estrobolome is the collection of gut bacteria that plays a role in metabolizing estrogen. These microbes help regulate whether estrogen is cleared out of the body or recycled back into circulation. Estrogen doesn’t just float around indefinitely. After it has done its job, it’s processed by the liver, packaged for elimination, and sent into the digestive tract. Ideally, it leaves the body through stool or urine. But here’s where the gut comes in: certain bacteria can “unpack” estrogen that was meant to be discarded, allowing it to be reabsorbed into the bloodstream.

This recycling process isn’t inherently bad. In fact, it’s part of how the body maintains balance. The problem arises when recycling outweighs elimination.

The gut–hormone feedback loop

Hormones and gut bacteria have a two-way relationship.

Estrogen influences the diversity and health of gut microbes
Gut microbes influence how estrogen is metabolized and cleared

When estrogen levels are healthy, the gut microbiome tends to be more diverse. Diversity generally means fewer problems. But during times of hormonal transition — such as perimenopause, menopause, or periods of chronic stress — estrogen levels change, and microbial diversity often drops with them. Lower diversity can lead to higher activity of certain gut enzymes, particularly beta-glucuronidase, which plays a key role in estrogen reactivation.

Why estrogen clearance matters

The liver does most of the heavy lifting when it comes to hormone metabolism. It converts estrogen into forms that are easier to eliminate through a two-step detoxification process. Once that work is done, estrogen is sent into the gut for removal. If estrogen moves efficiently through the digestive tract, it exits the body as intended. But if digestion is sluggish, the gut is inflamed, or bacterial balance is off, estrogen has more time to be reactivated and reabsorbed.

This can contribute to a pattern often referred to as estrogen dominance, where estrogen levels are high relative to progesterone — even if estrogen itself isn’t technically “too high.” Common symptoms associated with estrogen dominance may include:

Heavy or irregular periods
PMS or PMDD
Fibrocystic breast changes
Mood swings, anxiety, or depression
Hormone-related headaches
Weight gain or fluid retention
Uterine fibroids or endometrial thickening

These symptoms don’t automatically mean estrogen is the problem — but they are often clues that estrogen metabolism deserves a closer look.

Diet, bacteria, and estrogen recycling

Two major groups of bacteria dominate the gut: Firmicutes and Bacteroidetes. Both are normal and necessary, but balance matters. Research suggests that diets high in saturated fats and low in fiber tend to favor bacteria that produce higher levels of beta-glucuronidase. Over time, this may increase estrogen reactivation. This same pattern is also associated with inflammation and metabolic issues. On the other hand, diets rich in plant fibers, resistant starches, and diverse whole foods support microbial diversity — which is linked to more efficient estrogen elimination.

Regular bowel movements matter here too. The longer estrogen sits in the gut, the more opportunity there is for it to be reabsorbed.

What about progesterone and testosterone?

Estrogen isn’t the only hormone influenced by gut bacteria. Testosterone is metabolized in a similar way and can also be reactivated by gut enzymes, potentially increasing circulating levels when bacterial balance is off. Progesterone metabolism is more complex, but gut activity can influence how much of its calming, balancing effect is available in the body. When progesterone is reduced or cleared too quickly — a common issue during perimenopause — estrogen’s effects may feel stronger and less buffered. This is one reason hormonal symptoms often feel more intense during life transitions, even when lab values don’t look extreme.

Dysbiosis: when balance is lost

The term dysbiosis simply means an imbalance in the gut microbiome. This can show up as:

Loss of beneficial bacteria
Overgrowth of less helpful microbes
Reduced overall diversity

Dysbiosis has been linked to inflammation, impaired gut barrier function, insulin resistance, and hormone disruption. Chronic stress, antibiotics, highly processed diets, infections, and environmental toxins can all contribute. When the gut lining becomes compromised, inflammatory compounds can enter circulation, further disrupting hormone signaling and metabolism.

Supporting a healthy estrobolome

Supporting estrogen balance isn’t about forcing hormones in one direction — it’s about restoring healthy communication between systems. Helpful foundations often include:

A fiber-rich, plant-forward diet
Regular digestion and elimination
Support for liver detoxification pathways
Addressing gut infections or imbalances when present
Movement, time outdoors, and stress regulation

Even simple lifestyle shifts — walking, gardening, spending time with pets, or being in nature — have been shown to positively influence microbial diversity.

Symptoms matter just as much as numbers. Hormone testing, stool testing, and metabolic markers can help clarify whether estrogen issues stem from production, clearance, or gut recycling. Tracking symptoms alongside objective data allows patterns to emerge — and those patterns often guide more effective, personalized support over time.

A more connected approach to hormone health

The estrobolome reminds us that hormone balance isn’t isolated to one organ or gland. It’s the result of ongoing conversations between the gut, liver, endocrine system, and environment. By supporting gut health, we’re often supporting hormone balance at the same time — sometimes more effectively than by focusing on hormones alone. Dr. Tranchitella brings this whole-system perspective to her work helping patients understand not just what is happening in their bodies, but why — and how small, thoughtful changes can restore balance in meaningful ways.

What This Means for You: Your Gut, Your Hormones, Your Everyday Life

If you’ve ever been told your hormone labs look “normal” but your body doesn’t feel normal at all, you’re not imagining things. Hormone balance isn’t just about how much estrogen your body makes — it’s also about how well your body processes and clears it. That’s where the gut comes in. Your digestive system plays an active role in determining whether estrogen leaves your body as intended or quietly cycles back into circulation. When that balance tips, symptoms can show up even when nothing looks dramatically “wrong” on paper.

You don’t need extreme symptoms for this to matter

Gut-related estrogen imbalance doesn’t always announce itself loudly. For many people, it shows up as a slow build of symptoms that feel frustrating but hard to pin down. You might notice:

Periods becoming heavier or more irregular
PMS that feels stronger or lasts longer than it used to
Breast tenderness or lumpiness that fluctuates with your cycle
Mood changes, anxiety, or feeling more emotionally reactive
Weight gain that doesn’t respond to the usual strategies

These aren’t random changes. They’re often signs that estrogen is being recycled more than it should be — or that progesterone isn’t able to fully do its balancing job.

Life transitions matter more than you think

Times of hormonal change place extra demand on the gut–hormone relationship. Perimenopause, menopause, postpartum recovery, high stress periods, and even long-term digestive issues can all influence how efficiently hormones are cleared. As estrogen naturally shifts with age, the gut microbiome tends to become less diverse. That doesn’t mean something is “broken” — but it does mean the body may need more support to maintain balance.

Why digestion and regularity are part of hormone health

One of the most overlooked factors in hormone balance is something very basic: elimination. Estrogen that’s been processed by the liver still needs to leave the body. If digestion is sluggish or bowel movements are infrequent, estrogen has more time to be reactivated and reabsorbed. Supporting regular, comfortable digestion is one of the simplest — and most effective — ways to support hormone balance. This isn’t about detox cleanses or drastic resets. It’s about helping the body do what it already knows how to do.

Small, steady changes make a difference

Supporting your gut and hormones doesn’t require perfection. Consistency matters more. Helpful starting points often include:

Eating a wider variety of plant foods over time
Including fiber that supports healthy bacteria
Staying hydrated and moving your body regularly
Reducing ultra-processed foods and excess alcohol
Addressing chronic stress, which directly impacts gut health

Even these foundational shifts can influence how estrogen is metabolized and cleared.

Testing can clarify the picture — but symptoms still lead

Functional testing can offer valuable insight into gut balance and hormone metabolism, but numbers alone don’t tell the full story. Symptoms provide context. Together, they help reveal whether estrogen issues are rooted in production, clearance, or recycling. This integrated view allows support to be targeted — not generalized — and adjusted as your body responds.

Hormone balance isn’t about controlling estrogen. It’s about supporting the systems that help estrogen move through the body smoothly and appropriately. When the gut is supported, hormones often follow.

Dr. Tranchitella takes this whole-person approach — looking at how digestion, stress, lifestyle, and hormones interact, rather than treating each piece in isolation. Because when your body’s systems are communicating well, balance tends to feel more natural — and a lot more sustainable. Learn more and request a consultation >>

The Estrobolome: How Your Gut and Hormones Talk to Each Other