{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:12:27Z","timestamp":1792015947884,"version":"4.4.0"},"reference-count":65,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Nebraska NU Collaboration Initiative","award":["NU#55426"],"award-info":[{"award-number":["NU#55426"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Research on the human microbiome, particularly the gut microbiome, has expanded rapidly as its influence on health and behavior becomes increasingly evident. Once understood primarily in terms of digestion and immune function, the microbiome is now recognized as a key contributor to brain function, mood regulation, and social behavior. Emerging evidence links microbial dysbiosis to the onset and persistence of mood disorders, opening new pathways for mental health research and intervention. This paper challenges reductionist biomedical models by advancing a biopsychosocial framework for interpreting health outcomes related to microbiome dynamics. The gut\u2013brain axis illustrates the biological complexity of these interactions, with microbial communities shaping neurodevelopment and neurotransmitter production. Psychologically, alterations in microbial composition have been associated with depression, anxiety, and stress responsivity, while social determinants\u2014including early-life environments, socioeconomic conditions, and relationships\u2014structure microbial variation in ways that may reinforce existing health inequities. Focusing on women\u2019s health, this narrative review examines how microbial states both influence and are shaped by interconnected biological, psychological, and social factors. Interdisciplinary implications of microbiome research for understanding and achieving eubiosis and holistic models care in both research and clinical practice are discussed.<\/jats:p>","DOI":"10.3390\/bs16050627","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:29:03Z","timestamp":1776868143000},"page":"627","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Biopsychosocial Influences on the Gut Microbiome in Women\u2019s Health: Moving Towards Eubiosis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5645-7988","authenticated-orcid":false,"given":"Ashley J.","family":"Blount","sequence":"first","affiliation":[{"name":"Department of Counseling, University of Nebraska Omaha, Omaha, NE 68182, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8374-0423","authenticated-orcid":false,"given":"Kara","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Counseling, University of Nebraska Omaha, Omaha, NE 68182, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8149-1056","authenticated-orcid":false,"given":"Abby L.","family":"Bjornsen","sequence":"additional","affiliation":[{"name":"Department of Counseling, University of Nebraska Omaha, Omaha, NE 68182, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1384-6908","authenticated-orcid":false,"given":"Thang S.","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Counseling, University of Nebraska Omaha, Omaha, NE 68182, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7226-7367","authenticated-orcid":false,"given":"Gurudutt","family":"Pendyala","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3760-687X","authenticated-orcid":false,"given":"Tiffany A.","family":"Moore","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2524.e1","DOI":"10.1016\/j.cell.2021.03.022","article-title":"Snapshot: The microbiota\u2013gut\u2013brain axis","volume":"184","author":"Agirman","year":"2021","journal-title":"Cell"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e12309","DOI":"10.1111\/spc3.12309","article-title":"A psychology of the human brain\u2013gut\u2013microbiome axis","volume":"11","author":"Allen","year":"2017","journal-title":"Social and Personality Psychology Compass"},{"key":"ref_3","first-page":"576","article-title":"Evolutionary trends in host physiology outweigh dietary niche in structuring primate gut microbiomes","volume":"15","author":"Amato","year":"2021","journal-title":"ISME Journal"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13024-022-00522-2","article-title":"Microbiota in neuroinflammation and synaptic dysfunction: A focus on Alzheimer\u2019s disease","volume":"17","author":"Bairamian","year":"2022","journal-title":"Molecular Neurodegeneration"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.cell.2014.03.011","article-title":"Role of the microbiota in immunity and inflammation","volume":"157","author":"Belkaid","year":"2014","journal-title":"Cell"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1177\/10664807241231256","article-title":"Fertility by design: Integrating IVF, biopsychosocial tenets, and counseling","volume":"32","author":"Schneider","year":"2024","journal-title":"The Family Journal"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Blount, A. J., Adams, C. R., Anderson-Berry, A. L., Hanson, C., Schneider, K., and Pendyala, G. (2021). Biopsychosocial factors during the perinatal period. International Journal of Environmental Research and Public Health, 18.","DOI":"10.3390\/ijerph18158206"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bonaz, B., Bazin, T., and Pellissier, S. (2018). The vagus nerve at the interface of the microbiota-gut-brain axis. Frontiers in Neuroscience, 12.","DOI":"10.3389\/fnins.2018.00049"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jpsychires.2016.07.019","article-title":"Transferring the blues: Depression-associated gut microbiota induces neurobehavioural changes in rats","volume":"82","author":"Borre","year":"2016","journal-title":"Journal of Psychiatric Research"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qualitative Research in Psychology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","year":"2019","journal-title":"Qualitative Research in Sport, Exercise and Health"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Breit, S., Kupferberg, A., Rogler, G., and Hasler, G. (2018). Vagus nerve as modulator of the brain\u2013gut axis. Frontiers in Psychiatry, 9.","DOI":"10.3389\/fpsyt.2018.00044"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1017\/S0954579419000087","article-title":"Mind and gut: Associations between mood and gastrointestinal distress in children exposed to adversity","volume":"32","author":"Callaghan","year":"2020","journal-title":"Development and Psychopathology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/j.tem.2016.08.001","article-title":"Estrogen and microbiota crosstalk","volume":"27","author":"Chen","year":"2016","journal-title":"Trends in Endocrinology & Metabolism"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e12643","DOI":"10.1111\/jne.12643","article-title":"The role of the vagus nerve in appetite control","volume":"30","author":"Cork","year":"2018","journal-title":"Journal of Neuroendocrinology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1152\/physrev.00018.2018","article-title":"The microbiota-gut-brain axis","volume":"99","author":"Cryan","year":"2019","journal-title":"Physiological Reviews"},{"key":"ref_17","first-page":"111","article-title":"The microbiome-gut-brain axis in health and disease","volume":"249","author":"Dinan","year":"2017","journal-title":"Psychiatry Research"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1136\/gutjnl-2018-317503","article-title":"Role of the microbiome in human development","volume":"68","author":"Knight","year":"2019","journal-title":"Gut"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1038\/nrmicro3552","article-title":"Gut biogeography of the bacterial microbiota","volume":"14","author":"Donaldson","year":"2016","journal-title":"Nature Reviews Microbiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1126\/science.847460","article-title":"The need for a new medical model","volume":"196","author":"Engel","year":"1977","journal-title":"Science"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Foster, J. A., Baker, G. B., and Dursun, S. M. (2021). The relationship between the gut microbiome\u2013immune system\u2013brain axis. Frontiers in Neurology, 12.","DOI":"10.3389\/fneur.2021.721126"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.cell.2014.09.053","article-title":"Human genetics shape the gut microbiome","volume":"159","author":"Goodrich","year":"2014","journal-title":"Cell"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/S0899-3467(07)60142-6","article-title":"Writing narrative literature reviews for peer-reviewed journals: Secrets of the trade","volume":"5","author":"Green","year":"2006","journal-title":"Journal of Chiropractic Medicine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.molmet.2016.02.005","article-title":"A healthy gastrointestinal microbiome is dependent on dietary diversity","volume":"5","author":"Heiman","year":"2016","journal-title":"Molecular Metabolism"},{"key":"ref_25","first-page":"23","article-title":"The microbiome in posttraumatic stress disorder","volume":"91","author":"Hemmings","year":"2021","journal-title":"Brain, Behavior, and Immunity"},{"key":"ref_26","first-page":"81","article-title":"A novel role for maternal stress and microbial transmission in early life programming and neurodevelopment","volume":"3","author":"Rodgers","year":"2016","journal-title":"Neurobiology of Stress"},{"key":"ref_27","first-page":"117","article-title":"Gut microbiota and the social brain","volume":"28","author":"Johnson","year":"2018","journal-title":"Current Opinion in Psychology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.annepidem.2016.02.008","article-title":"Brain\u2013gut\u2013microbiota axis","volume":"26","author":"Kelly","year":"2016","journal-title":"Annals of Epidemiology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/nri.2016.90","article-title":"Sex differences in immune responses","volume":"16","author":"Klein","year":"2016","journal-title":"Nature Reviews Immunology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1016\/j.cell.2016.05.041","article-title":"From dietary fiber to host physiology","volume":"165","author":"Koh","year":"2016","journal-title":"Cell"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.cell.2012.07.008","article-title":"Host remodeling of the gut microbiome and metabolic changes during pregnancy","volume":"150","author":"Koren","year":"2012","journal-title":"Cell"},{"key":"ref_32","unstructured":"Lauer, L. (2025). The vagus nerve promotes memory via septo-hippocampal acetylcholine: Implications for obesity-induced cognitive dysfunction. bioRxiv."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Liu, Y., Hou, J., Qi, Z., Yang, L., Du, Z., Wu, Y., Song, Q., Li, X., Sun, J., Chen, P., and Guan, X. (2025). Prenatal psychological stress mediates vertical transmission. BMC Psychology, 13.","DOI":"10.1186\/s40359-025-03088-y"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1177\/1535370219891690","article-title":"The microbiota-gut-brain axis: An emerging role for the epigenome","volume":"245","author":"Louwies","year":"2019","journal-title":"Experimental Biology and Medicine"},{"key":"ref_35","first-page":"117","article-title":"The gut\u2013brain barrier in major depression","volume":"29","author":"Maes","year":"2019","journal-title":"Neuro Endocrinology Letters"},{"key":"ref_36","first-page":"13125","article-title":"Gut microbes and the brain: Paradigm shift in neuroscience","volume":"35","author":"Mayer","year":"2014","journal-title":"Journal of Neuroscience"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1146\/annurev-med-042320-014032","article-title":"The gut\u2013brain axis","volume":"73","author":"Mayer","year":"2022","journal-title":"Annual Review of Medicine"},{"key":"ref_38","first-page":"e34484","article-title":"Gut microbiota and mental health: A comprehensive review of gut-brain interactions in mood disorders","volume":"17","author":"Mehta","year":"2025","journal-title":"Cureus"},{"key":"ref_39","first-page":"1","article-title":"Psychological stress in childhood and susceptibility to chronic diseases of aging: Moving toward a model of behavioral and biological mechanisms","volume":"143","author":"Miller","year":"2017","journal-title":"Psychological Bulletin"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1002\/ccr3.647","article-title":"Diagnosis of Cushing\u2019s disease in a patient with consistently normal urinary free cortisol levels: A case report","volume":"4","author":"Moloney","year":"2016","journal-title":"Clinical Case Reports"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1038\/s41579-020-00460-0","article-title":"The gut microbiota\u2013brain axis","volume":"19","author":"Morais","year":"2021","journal-title":"Nature Reviews Microbiology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1096\/fj.201700333RR","article-title":"Characterization of soy-deprestatin, a novel orally active decapeptide that exerts antidepressant-like effects via gut\u2013brain communication","volume":"32","author":"Mori","year":"2018","journal-title":"The FASEB Journal"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Nuriel-Ohayon, M., Neuman, H., and Koren, O. (2016). Microbial changes during pregnancy. Frontiers in Microbiology, 7.","DOI":"10.3389\/fmicb.2016.01031"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Odamaki, T., Kato, K., Sugahara, H., Hashikura, N., Takahashi, S., Xiao, J. Z., Abe, F., and Osawa, R. (2016). Age-related changes in gut microbiota. BMC Microbiology, 16.","DOI":"10.1186\/s12866-016-0708-5"},{"key":"ref_45","first-page":"1042","article-title":"The enduring effects of early-life stress","volume":"51","author":"Waworuntu","year":"2019","journal-title":"European Journal of Neuroscience"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1038\/nrgastro.2009.35","article-title":"Principles and clinical implications of the brain\u2013gut\u2013enteric microbiota axis","volume":"6","author":"Rhee","year":"2009","journal-title":"Nature Reviews Gastroenterology & Hepatology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s11906-017-0721-6","article-title":"The gut microbiome, energy homeostasis, and implications for hypertension","volume":"19","author":"Riedl","year":"2017","journal-title":"Current Hypertension Reports"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1800870","DOI":"10.1002\/mnfr.201800870","article-title":"Sex differences in the gut microbiota as potential determinants of gender predisposition to disease","volume":"63","author":"Haro","year":"2019","journal-title":"Molecular Nutrition & Food Research"},{"key":"ref_49","first-page":"1","article-title":"The role of diet and intestinal microbiota in the development of metabolic syndrome","volume":"56","author":"Camargo","year":"2018","journal-title":"The Journal of Nutritional Biochemistry"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"3654","DOI":"10.1038\/ncomms4654","article-title":"Gut microbiome of the Hadza hunter-gatherers","volume":"5","author":"Schnorr","year":"2014","journal-title":"Nature Communications"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"101943","DOI":"10.1016\/j.cpr.2020.101943","article-title":"The gut microbiota in anxiety and depression","volume":"83","author":"Simpson","year":"2021","journal-title":"Clinical Psychology Review"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s12967-017-1175-y","article-title":"Influence of diet on the gut microbiome and implications for human health","volume":"15","author":"Singh","year":"2017","journal-title":"Journal of Translational Medicine"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1146\/annurev-clinpsy-032816-045159","article-title":"Social safety theory","volume":"16","author":"Slavich","year":"2020","journal-title":"Annual Review of Clinical Psychology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1002\/nau.25356","article-title":"The brain, gut, and bladder health nexus","volume":"43","author":"Smith","year":"2023","journal-title":"Neurourology and Urodynamics"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1055\/s-0035-1564579","article-title":"Brain\u2013gut axis and gut microbiota","volume":"5","author":"Sudo","year":"2015","journal-title":"Journal of Pediatric Biochemistry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1113\/jphysiol.2004.063388","article-title":"Postnatal microbial colonization programs the hypothalamic\u2013pituitary\u2013adrenal system for stress response in mice","volume":"558","author":"Sudo","year":"2004","journal-title":"The Journal of Physiology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.cell.2016.11.003","article-title":"Transkingdom control of microbiota diurnal oscillations promotes metabolic homeostasis","volume":"167","author":"Thaiss","year":"2016","journal-title":"Cell"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"k2179","DOI":"10.1136\/bmj.k2179","article-title":"Role of the gut microbiota","volume":"361","author":"Valdes","year":"2018","journal-title":"BMJ"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1038\/s41564-018-0337-x","article-title":"Neuroactive potential of the human gut microbiota","volume":"4","author":"Falony","year":"2019","journal-title":"Nature Microbiology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1016\/j.cell.2018.10.029","article-title":"US immigration westernizes the gut microbiome","volume":"175","author":"Vangay","year":"2018","journal-title":"Cell"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1207\/s15324796abm2702_5","article-title":"Gender differences in food choice: The contribution of health beliefs and dieting","volume":"27","author":"Wardle","year":"2004","journal-title":"Annals of Behavioral Medicine"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1159\/000083753","article-title":"Age and gender dependent profile of food choice","volume":"57","author":"Westenhoefer","year":"2005","journal-title":"Forum of Nutrition"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/imo2.35","article-title":"Global meta-analysis of gut microbiome variation","volume":"1","author":"Xie","year":"2024","journal-title":"iMetaOmics"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1038\/s41398-020-00878-3","article-title":"A key role of the subdiaphragmatic vagus nerve in the depression-like phenotype and abnormal composition of gut microbiota in mice after lipopolysaccharide administration","volume":"10","author":"Zhang","year":"2020","journal-title":"Translational Psychiatry"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/s41575-018-0061-2","article-title":"You are what you eat","volume":"16","author":"Zmora","year":"2018","journal-title":"Nature Reviews Gastroenterology & Hepatology"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/5\/627\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:06:13Z","timestamp":1777982773000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/5\/627"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":65,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["bs16050627"],"URL":"https:\/\/doi.org\/10.3390\/bs16050627","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]}}}