Impact of long-term medication on estrobolome-associated β-glucuronidase and sulfatase activities: Implications for estrogen homeostasis in postmenopausal women.
Level 5 - mechanism / opinion, no new human data
Narrative review with no systematic search methodology or new experimental data
PubMed 41534157 · doi:10.1016/j.maturitas.2026.108830
What was done
This narrative review performed a targeted literature search to evaluate how long-term medications commonly prescribed to postmenopausal women (for hypertension, diabetes, dyslipidemia, osteoporosis, and depression) affect gut microbial taxa that exhibit β-glucuronidase (GUS) and sulfatase activities.
What was found
The abstract reports no quantitative figures. Antidiabetic agents (specifically metformin) and antidepressants were the most frequently studied drug classes altering relevant bacterial genera (including Bifidobacterium, Roseburia, Faecalibacterium, and Clostridium). However, the authors found that no clinical studies have directly measured or evaluated the actual impact of these chronic medications on estrobolome GUS or sulfatase enzyme activity in postmenopausal women.
Why it matters
It maps out a potential mechanistic pathway connecting long-term drug use, gut microbiome shifts, and estrogen recycling, while clarifying that direct functional evidence in postmenopausal populations is currently missing.
Limits
The review relies on targeted rather than systematic search methods. Evidence is indirect and mechanistic; no study directly measured gut enzymatic activity (GUS/sulfatase) or circulating estrogen changes following pharmacotherapy in this population.
Cited by
- supports Gut bacterial beta-glucuronidase deconjugates estrogen metabolites, and gut dysbiosis can cause estrogen recirculation and elevated estradiol levels.