Bile, Oestrogen, and Midlife Metabolism
- Lauren Dyer
- Jul 15
- 2 min read
We often talk about declining oestrogen in perimenopause. But far less attention is paid to how oestrogen is cleared from the body and the role of bile in that process.
Oestrogen is metabolised in the liver, then conjugated for excretion. These conjugates are sent out via the bile and into the digestive tract. From there, they are either excreted or reabsorbed through the enterohepatic circulation.
This means that healthy oestrogen clearance depends not only on liver function, but on bile flow and microbiome balance. When bile is sluggish or absent following gallbladder removal, oestrogen metabolites may not be properly eliminated. Instead, they can be reabsorbed, contributing to oestrogen dominance symptoms.
In midlife women, this matters. Poor bile flow can impair fat digestion, reduce fat-soluble vitamin absorption, and alter microbial activity in the gut. When combined with hormonal fluctuations, stress, and insulin resistance, the result can be a perfect storm: bloating, weight gain, inflammation, and persistent fatigue despite HRT or a “healthy” diet.
In my clinical work, women with a history of gallbladder removal often report the following:
• Bloating and fatigue after meals
• Difficulty tolerating fatty foods
• Low vitamin D despite supplementation
• Ongoing weight gain, despite HRT
• Symptoms of oestrogen excess or poor detoxification
These are not isolated complaints. They are signs of impaired hormone clearance and digestive function.
Supporting bile flow can improve both digestive symptoms and hormonal balance. This includes targeted support for phase II liver detoxification (glucuronidation and methylation), ox bile or digestive bitters where appropriate, and microbiome interventions to reduce beta-glucuronidase activity.
In midlife health, the gallbladder often gets overlooked. But for women struggling with metabolic symptoms, unresolved inflammation, or poor HRT response, it may be the missing link.
If you are supporting women through perimenopause or postmenopause, bile flow and oestrogen metabolism are not optional considerations, they are central to restoring metabolic resilience.
Lauren Wallis Dyer
BSc, MSc, DipCLN, IFM Certified Health Coach, FNTP
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