My guest in this episode is Cynthia Thurlow, a nurse practitioner, host of the Everyday Wellness Podcast, bestselling author, international speaker, and author of the brand new book The Menopause Gut: Balance Your Microbiome to Reclaim Your Health in Midlife and Beyond.

Her TED Talk has over 15 million views, and I have to say, this book feels like her story — like she finally gets to share what she’s been living and learning over the past decade. We’re diving deep today into the gut-hormone connection, and I think this conversation is going to be eye-opening for so many of you.

How This Book Came to Be

Cynthia’s book is, in many ways, her personal story. What began as a romantic trip to Morocco turned into severe food poisoning, a 13-day hospitalization, six weeks of IV antibiotics, six weeks of antifungals, and nearly a year of chronic diarrhea afterward. She found herself at the intersection of a decimated microbiome and declining hormones — and realized how little awareness exists about this connection, even among clinicians.

When she dove into the research, she was shocked. There is a tremendous amount of science linking the gut microbiome to every organ system in the body. The microbiome is made up of approximately 40 trillion bacteria, viruses, and fungi housed in the colon, and they act as communication superhighways between all of our organs and cells. 

There are more of these microbes in our bodies than there are human cells. And yet this topic remains at the periphery of the menopause conversation, which tends to focus on heart health, brain health, and bone health — all important — while largely ignoring what’s happening in the gut.

What’s Really Behind Your Perimenopause Symptoms

Here’s what I want you to hear: Almost every symptom you might be experiencing in perimenopause can be a direct reflection of the health of your microbiome. Bloating, for example — so common, and so often dismissed. As estrogen declines, stomach acid changes, digestive enzymes shift, bile no longer emulsifies fats as well, and progesterone changes affect smooth muscle contractility. 

The intestinal lining, which is only one cell layer thick, becomes more vulnerable to damage from ultra-processed foods, chronic stress, alcohol, and antibiotics. When that lining is breached, food particles leak into the bloodstream and trigger immune responses — food sensitivities, hives, inflammation.

Women are frequently told they have IBS when the underlying issue is actually this hormonal-microbiome disruption. There’s also something called the estrobolome — the estrogen-processing center within the microbiome — that, when compromised, causes estrogen to recirculate rather than be properly cleared from the body. 

This can drive weight loss resistance, joint pain, brain fog, and breast tenderness. I, Dr. Doni, talk about this vicious cycle in my books as well — stress, hormone changes, toxin exposure, gut damage, bacterial imbalance — one thing leading to the next. And simply replacing hormones won’t unravel all of that. HRT is important, and every woman deserves that conversation with a knowledgeable provider, but it is not the whole answer.

The Stress and Trauma Connection

This is something I feel really passionate about as a stress expert, and I’m so glad Cynthia covers it in her book. Chronic stress and adverse childhood experiences have a measurable impact on gut and hormone health. Research shows that chronic cortisol exposure can actually age the ovaries faster. 

The ovaries are the most mitochondria-dense organ in the body — they’re like the canary in the coal mine, highly sensitive to stress, toxins, and disruption. Women who’ve experienced significant childhood trauma are at higher risk for autoimmune conditions, poor metabolic health, mental health challenges, and even early menopause.

Many women hold it together well for decades through adaptive coping strategies, and then perimenopause arrives and it becomes much harder to keep that mask on. That’s actually the opportunity — to finally address what’s been driving things all along. 

Women in high-stress fields are entering menopause in their 40s. And because we may spend half our lifetime in menopause, what we do now genuinely matters. Perimenopause is a litmus test for how well we’ve been caring for ourselves. The word “pause” really is an invitation to stop and think about how we’re living.

Testing and Finding the Right Support

Conventional stool testing checks for blood or parasites — that’s about it. Functional and integrative testing goes much deeper: Keystone bacteria, dysbiotic organisms, digestive capacity, hydrochloric acid, digestive enzymes, immune markers, short-chain fatty acid production. 

I’ve been using PCR-based stool analysis in my practice for about ten years (since the testing became available), and what I want people to know is that even severe microbiome imbalances can be turned around. It’s not too late, and it’s not too far gone. The microbiome is remarkably malleable.

What matters is working with someone who has real experience interpreting these tests and giving you a clear plan. An expensive test without meaningful guidance is just an expensive test. And please don’t expect this conversation to happen at a standard doctor’s appointment — you’ll need to seek out an integrative or functional provider.

The Vaginal and Oral Microbiome

As estrogen declines, the healthy lactobacilli of the vaginal microbiome are also compromised. This increases susceptibility to urinary tract infections, pelvic floor issues, and more. Vaginal estrogen alone can reduce UTIs by up to 70%. 

I talk about the importance of vaginal estrogen for helping women to prevent HPV from causing abnormal cells, and help women in my programs to use it effectively.

The oral microbiome is equally connected — periodontal disease, certain mouthwashes, even chewing gum can alter oral pH and affect the broader microbiome. The body is not a collection of isolated systems. What happens in the mouth, gut, and vagina are all in constant communication, and dysfunction in one place makes everything else work harder.

What Actually Helps

Cynthia emphasizes that sleep, stress management, nutrition, and exercise are the foundation — not optional extras. The biggest nutritional lever you can pull is becoming aware of how much protein and fiber you’re actually eating. Most women are not getting enough of either. 

Fiber is fermented in the colon, supports the mucus lining, is anti-inflammatory, and produces butyrate — a short-chain fatty acid that can actually cross the blood-brain barrier. Start by tracking your intake and increasing slowly. If you’re at 10 grams of fiber a day, go to 12. 

Freshly ground flax and chia seeds in a smoothie are a gentle way to begin. Healing the gut has far-reaching effects: better sleep, improved mood, less anxiety — and long-term protection against dementia, heart disease, and cancer. When we heal the gut, we really do see women’s whole health transform. That’s what I love about this work.

If you want to learn more about Cynthia you can find her on Instagram @cynthia_thurlow_ and Facebook @Cynthia Thurlow. You can also find a copy of her book The Menopause Gut: Balance Your Microbiome to Reclaim Your Health in Midlife and Beyond here.

If you would like to learn more about how you can navigate through menopause you can check out my Mastering Menopause Masterclass here for free.

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With proper support, testing, and treatment, women can maintain their health and vitality throughout menopause and beyond. Remember, investing in your health is not selfish – it’s necessary. Just as we’re told on airplanes to put on our own oxygen mask before helping others, we must prioritize our own health to be able to care for those who depend on us. 

The time has come for women to take charge of their health and well-being, understanding that preventive care now leads to better outcomes in the future.

It is also important to know that it is possible to recover from stress and trauma and truly heal, because you’re not likely to hear that from your standard doctor’s office. Keep in mind, they are not educated about diet, exercise, supplements, or stress recovery. 

I am living proof that it is possible to heal holistically and naturally. It’s possible to balance your hormones or to use hormone replacement safely and effectively, as well as to clear HPV and get a normal pap result, and to eliminate the effects of stress, trauma, anxiety and depression. I help patients with to do this in my practice every day – by phone and zoom, anywhere in the world. You can set up a one-on-one appointment here.

Once I meet with you one on one, we will create a strategic plan based on your health needs during menopause, including sessions with the health coach on my team to help guide you to implement my proprietary C.A.R.E. and Stress Mastery programs. 

If you’re dealing with persistent HPV I welcome you to join my next FREE How to Get Rid of HPV online workshop where I help you to create a plan to get HPV out of your life for good. From there, you might choose to join the Heal HPV Kickstart Program, for the initial steps of my protocol, including diet changes and supplements, over the next 30 days.

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Or you can begin with the comprehensive Say Goodbye to HPV Program, which is 3 months and includes everything you need to implement my full protocol and address all eight susceptibilities with live, group support, and access to testing and vaginal suppositories.

You can also go to clearhpvnow.com. There, you’ll find lots of resources and stories from women who’ve followed my protocol and cleared HPV to negative. 

Thank you for joining me today Cynthia, and congratulations on your new book! Thank you all for joining us for this episode of How Humans Heal. Make sure to follow and subscribe so you don’t miss the next one! You can access it on YouTube, Apple Podcasts, or wherever you prefer. You can also watch at doctordoni.com.

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Disclaimer: This specific article and all other Content, Products, and Services of this Website are NOT intended as, and must not be understood or construed as, medical care or advice, naturopathic medical care or advice, the practice of medicine, or the practice of counseling care, nor can it be understood or construed as providing any form of medical diagnosis, treatment,  natural HPV cure, or prevention of any disease.