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The Menopause Gut: Balance Your Microbiome to Reclaim Your Health in Midlife and Beyond

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A gut-centric approach to women’s health through perimenopause and menopause from the author of Intermittent Fasting Transformation

The conversation around menopause has finally shifted toward helping women navigate this transition and easing their symptoms. But, as nurse practitioner and women’s wellness advocate Cynthia Thurlow illustrates in this paradigm-shifting book, medical advice for women at this stage of life has overlooked an essential The powerful connection between our gut and our health as we age.

As The Menopause Gut explains, the composition of the gut microbiome shifts over the course of a woman’s lifetime, peaking at age 40. Cutting-edge research suggests a bidirectional relationship between our estrogen and progesterone levels and our microbes. As our hormones shift, we become much more vulnerable to inflammation, which impacts our immune function, metabolism, mood, cognition, bone health and much more. But there are simple steps we can take to get our gut, and our health, back on track. Cynthia guides readers on how

• Combat bone loss through targeted exercise and nutrition
• Replace hidden gut disruptors with fiber-rich foods that balance our weight
• Practice cutting-edge stress management techniques that work
• Realign our circadian rhythm and prioritize rest
• Restore our immune systems by resolving leaky gut
• Understand the benefits of hormone replacement therapy

Actionable and life changing, The Menopause Gut will inspire and empower women to take charge of their health in midlife.

Audible Audio

Published April 28, 2026

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About the author

Cynthia Thurlow

4 books14 followers

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5 stars
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Displaying 1 - 15 of 15 reviews
Profile Image for Heather Adores Books (on vaca).
1,685 reviews2,015 followers
July 21, 2026
3⭐
Genre ~ women's health
Publication date ~ April 28, 2026
Est Page Count ~ 298 (13 titled chapters + FAQ)
Audio length ~ 8 hours 34 minutes
Narrator ~ the author

Since I’ve been in menopause since 2019 I’m always interested in learning more about what I can do to be healthier and hopefully live a long life.

The microbiome is the collective community of microorganisms—including bacteria, fungi, viruses, and parasites—that live in a particular environment, such as the human gut, skin, or soil. These microbes play crucial roles in daily bodily functions like digestion, immune system development, and protection against pathogens

Part 1: It's All Connected
This part is all about getting to know your microbiome; how it'll affect your immune system and how your ovaries and bones are affected, too.

Part 2: The Menopause Gut Plan
This part is all about tips on nutrition, staying active, sleeping well, and avoiding stress, and HRT and other prescribed medicine. There are some recipes that are on a bonus PDF, not read aloud in the audio, which is probably a good thing. Since I listened through Libby I am not sure how'd I'd be able to access them.

Overall, it read very textbooky and the chapters were super long. Almost wish I was read it instead of listening, so I could've captured the information better.

Interesting facts:
Approximately 80% of all autoimmune cases occur in women. The same mechanism that helps women fight off infections more effectively they turn against the bodies own tissues and lead to conditions like Lupus, Rheumatoid Arthritis and Multiple Sclerosis.

Research shows that if a woman goes into menopause before 40 it's considered to be premature menopause, or goes into menopause early, typically between the ages of 40-45, she is at a greater risk for dementia than a woman that goes into menopause in her 50's. This is me and my fear😭

Additionally, research shows the risk for Alzheimer's and cognitive decline is tied to our gut microbiome. We know that the risk for Alzheimer's disease increases during the menopause transition. Menopausal females make up to 60% of all Alzheimer's disease patients.

Obstructive sleep apnea ~ menopausal females have a greater likelihood of developing sleep apnea. It can affect our glymphatic system and in doing so it can increase build up of toxins that may increase Alzheimer’s disease, memory loss and brain fog. Also, there’s a greater risk of high blood pressure, heart disease, poor metabolic health, and overall worsening of hot flashes.

Narration notes:
She sounded fine. I have no complaints.
Profile Image for Stefani.
255 reviews20 followers
May 10, 2026
Another menopause book... but with a slight gut angle to it. I wish it had MORE of a gut angle, though. If you've read other menopause books, this might not have much that's new (I've read Next Level and Unbreakable), but she did have a good section on supplements, so that's nice.
Profile Image for Janice.
171 reviews
July 11, 2026
I listened to this book and I highly recommend every female to read it starting at age 30 so you can be informed before perimenopause and after menopause! I also believe every general practitioner read it as well and offer the tests mentioned in this book.
Profile Image for Lynnette.
77 reviews1 follower
July 8, 2026
Nurse practitioner Cynthia Thurlow explores the growing body of research linking hormonal changes during perimenopause and menopause to alterations in the gut microbiome. The book explains how declining estrogen levels may affect gut health, inflammation, metabolism, immune function, cognition, bone health, and weight regulation. Thurlow emphasizes that lifestyle strategies, including nutrition, physical activity, sleep, stress management, and, when appropriate, hormone therapy, can support healthy aging.

Key takeaways include prioritizing a high-fiber diet to support microbial diversity, minimizing foods and lifestyle factors that disrupt gut health, incorporating regular strength training and exercise, managing stress, optimizing sleep, and understanding the role of hormone replacement therapy.

Readers should note that research on the gut microbiome and menopause is evolving. It is important to consult your doctor before making any significant changes.

This book is recommended for women seeking a deeper understanding of how gut health shapes menopausal outcomes. It may also be valuable for health practitioners who want to incorporate microbiome focused strategies into midlife metabolic care.

Chapter summaries provide a succinct wrap-up of each chapter. Many personal stories are woven throughout the book, illustrating how to implement her recommendations and the successes achieved. The FAQ and recipes chapters are valuable resources.

If you want to look up the studies supporting her advice, you need to visit her website. The functional perspective may not resonate with all readers.
Profile Image for Adelle.
66 reviews
June 3, 2026
Easy to read and full of information; however not a ton of information about the gut. Since I have read many menopause books, I didn't really glean new information, however it was a helpful reminder that what I am dealing with is real and I need to be proactive about my health. Always grateful to medical professionals who advocate and educate perimenopausal and menopausal women.
Profile Image for Erin Kerry.
247 reviews12 followers
July 22, 2026
This isn’t just a book about gut health, though that’s the initial focus. There are so many great resources for supplements, lab tests, exercise, nutrition, etc for the perimenopausal/menopausal phase of life. Highly recommend. I regret getting on audio because I’d love to have it on hand to reference and the narration was a little robotic. But the info was great!
Profile Image for LauraBeach123.
146 reviews2 followers
July 6, 2026
Worth the time just for the word “Jerusalem FARTachoke”. I thought I was the only person who couldn’t handle them but I guess not since they have a nickname. Very comprehensive with lots of doable information,
Profile Image for Tracy Allen.
68 reviews2 followers
Review of advance copy received from Goodreads Giveaways
February 13, 2026
Interesting read and as a mid-forties female in the midst of perimenopause, very informative, easy to read. Read whole book in two sittings.
Profile Image for Roxanne.
1,047 reviews89 followers
May 18, 2026
Great information, but I was expecting more about the "gut"
Profile Image for Madeleine Booth-Smits.
889 reviews15 followers
May 24, 2026
An interesting take on the menopause books that are out there. I really enjoyed the gut angle and all the extra information on the science behind menopause. Absolutely worth a read.
100 reviews1 follower
May 31, 2026
4 if you have no knowledge of the microbiome; 3 if you do.
Profile Image for Molly.
670 reviews
June 18, 2026
I found this book to be very informative and helpful as I’m just starting to navigate all this dumb stuff!
Profile Image for Laura.
28 reviews
June 18, 2026
Copious amount of errors, including basic physiology, and not highly concentrated on gut health and gut microbiome in menopause.
Profile Image for Pamela.
232 reviews1 follower
May 22, 2026
A wealth of information

This book has a wealth of information and includes recipes and supplement recommendations (test don’t guess). Different tests are mentioned as options for functional testing.
Profile Image for Angela.
86 reviews1 follower
May 26, 2026
Very informative and easy to understand. I finished in 2 days. 2nd book I have read about menopause and I found myself highlighting and taking notes. Great resource to have while beginning this journey.
Displaying 1 - 15 of 15 reviews