How the gut-brain axis affects menopause symptoms — and how to track your microbiome at home
By Grayson Leverenz
10-minute read
I met Dr. Sonia Grego at one of my favorite annual events, Raleigh Durham Startup Week, and I’m thrilled to introduce her to you – our Unstuck Collection readers – today.
Dr. Grego has spent more than 20 years as an applied researcher, studying and building diagnostic devices for life sciences. A few years ago, she turned that expertise toward a system with untold insights we flush away without a second thought: the gut.
Her company, Coprata, is built on a simple, underexplored idea — your stool contains real, measurable health data, and almost none of us are using it. Dr. Grego has spent the last several years building the tools to change that, starting with an at-home test and eventually, a smart toilet.
When we sat down to talk, we centered our conversation not only on gut health, but also on how it connects to brain fog, mood, and cognitive health — menopause symptoms very important to our Unstuck community. Here’s our conversation, lightly edited for length and clarity.
What Drove a 20-Year Researcher to Build an At-Home Gut Health Test
Grayson: Hi Sonia. I’m so excited to speak with you today. Let’s start at the beginning. Please tell our readers about yourself and what you’re building at Coprata.
Sonia: Hi Grayson. Thanks for having me. I’m a scientist, an engineer, and an innovator. I’ve spent my career in technology development, mostly building devices for life sciences. A few years ago, with a long-time collaborator, we founded Coprata to make gut health measurement accessible for everyday use.
Grayson: You’d mentioned that you spent 20-plus years as an applied researcher before founding Coprata. What made gut health the problem that felt worth leaving the lab to solve?
Sonia: I love this question. Throughout my career, I was developing devices that could monitor things like infectious disease or other health conditions in everyday life — working toward continuous monitoring. I built several of these and realized almost all of them required something invasive: a drop of blood, or some other specimen you wouldn’t collect routinely if you were healthy and just wanted to stay that way.
Wearable sensors that measure your heart rate are fantastic — they already exist. But they don’t tell you anything about your chemistry. If you want real chemical information, you need a specimen. It turns out there’s one that people produce naturally, every day, in a reproducible way: what goes into the toilet.
Gut health information is sitting in stool, and it’s heavily underutilized because of the barrier to studying it — frankly, the disgust factor. I saw an unmet opportunity. There were no continuous, accessible ways to measure gut health from stool. I thought that needed to change.
Grayson: There’s an obvious discomfort barrier here, as there is with a lot of topics in women’s health. I’m a mom of humans and pets, so I spend a lot of time talking about poop — I’m perfectly comfortable with it. I’m curious – how do you talk about this product with someone who’s never considered what their bowel movements could be telling them?
Sonia: There’s a real stigma. Most people don’t use the words “stool” or “feces” in polite conversation — except on our team, where we talk about it constantly, over pizza, over lunch, wherever. That aversion is changing, though, the same way mental health was once taboo and is now discussed openly. As people realize how important gut health is, and how directly it’s reflected in their bowel movements, perception is shifting.
We try to be as delicate as possible with our customers. But I also think it’s about time this stigma gets over itself. It’s a bodily function — like breathing. You have to do it. For your readers, I’ll also mention I’ve worked on menstruation products in the past — another taboo. These are healthy, expected bodily functions. What’s so bad about that?
Grayson: That’s exactly the space I’m in now too — menopause has been deeply taboo, and I think that’s part of why you and I connected so easily. We’re both trying to share information about subjects that have been kept quiet, and trying to shift the culture around them. With that in mind — when we talk about your product, do you use “stool” or “feces”? Are they interchangeable?
Sonia: They’re interchangeable, but to be delicate, we call our product a “gut health test” rather than a stool test or feces test. We talk about what it does, not what it is. We’ve thought a lot about the importance of that language.
Grayson: That makes a lot of sense — I also work in marketing, and that’s exactly the idea of leading with the benefit, not the feature.
Sonia: It was a learning curve, though. In academic circles, I happily describe myself as an expert in stool analysis. Nobody else wants to be known for that — except me. I’m proud of it.
What Is the Gut-Brain Axis — And Why Does It Matter for Menopause?
Grayson: Let’s talk about the gut-brain connection. Most women in the Unstuck community are managing brain fog, memory lapses, and mood shifts that come with the menopause transition. Help me understand what the gut has to do with that.
Sonia: The gut and the brain are connected through what’s called the gut-brain axis. It’s complex, still being actively studied, and it operates on multiple levels.
There’s an anatomical connection — the nerves of the digestive system connect directly to the central nervous system. But the most significant connection is chemical: the gut microbiome produces, or is associated with the production of, neurotransmitters. When gut microbes are fed well, they produce metabolites called short-chain fatty acids, which are linked to major health benefits, including reduced inflammation — and inflammation affects brain health, cognition, and mood.
The importance of gut microbes for mood and anxiety has been known for decades. One of the earliest experiments gave mice a single type of gut bacteria orally, and it caused anxiety behavior in the mice. That was one of the first clear signals that this communication is real, strong, operates on many levels, and is bidirectional. Your brain affects how well you digest. Your gut, through its metabolic products, affects how well your brain works.
How Declining Estrogen Changes Your Gut Microbiome
Grayson: We know estrogen shapes the gut microbiome. So when it declines in perimenopause, what happens?
Sonia: First, some context: women are half the world’s population, and we spend roughly a third of our lives in menopause. And yet, out of tens of thousands of papers on the gut microbiome, research connecting it to menopause specifically is maybe one or two percent. The science here is pitiful, frankly.
What we do know: when your ovaries stop producing estrogen, there are consequences throughout the body. But you still have a small amount of estrogen, naturally produced by adipose tissue, and that appears to help attenuate symptoms. The gut may also be able to recycle some estrogen that would otherwise be eliminated — a portion of gut microbes help the body make a bit more usable estrogen during menopause. This is sometimes called the “estrobolome.”
So your gut microbes are absolutely affected by menopause, and many of those effects aren’t positive — they touch cardiovascular risk, diabetes risk, even gut permeability and integrity. But the open research question is whether the gut microbiome could be harnessed to better manage menopause. A few studies suggest that’s possible, and it’s a fascinating area.
Grayson: Is that something you hope to one day be able to measure?
Sonia: Our team is good at developing the tools to move a measurement from the lab into something people can use at home. We’re not in the business of biomarker discovery ourselves — we collaborate with research groups and scientists who are searching for those markers. We’re rooting for the research community to find markers that are relevant and actionable, and then we’ll build the tools to measure them.
What researchers are always looking for is something like A1C for diabetes — one simple, individual measurement that provides a highly informative outcome. There’s so much more needed in the microbiome-and-menopause space, and in many other areas, too.
Grayson: So could we say a woman’s gut health might be contributing to brain fog or mood changes, because of that bidirectional communication?
Sonia: Yes — and that’s true for everyone, not just women, because of how bidirectional this relationship is. A lot of research is ongoing here. The good news is that you can influence your gut microbiome through diet, stress management, exercise, and better sleep. That has a measurable effect on your gut microbes, which then has a measurable impact on your mood, your mental acuity, and your energy levels.
This is also a hot topic in research around preventing cognitive decline, dementia, and Alzheimer’s — since all of these are associated with the same inflammation and metabolic pathways. A healthier gut microbiome helps with brain fog, with mental alertness, and may even help prevent cognitive decline later in life.
How to Measure Your Gut Health at Home: The Coprata MAT
Grayson: Tell me about the Coprata MAT — the Microbiome Activity Tracker. What does it measure, and what would a woman do with that information?
Sonia: We realized there’s no easy way to measure your gut health. Some medical and consumer tests require collecting a specimen and shipping it to a lab for complex analysis — and you get results four weeks later, by which point you might have taken a trip that’s completely disrupted your microbiome. I remember an early customer saying, “What’s the point of getting results months later?”
So we built a test that measures a single indicator instead of your full microbiome composition: fecal pH. It’s a measure of acidity that correlates with the production of short-chain fatty acids — the molecules behind anti-inflammation and good immune function. Research on fecal pH goes back to the 1980s, but it’s traditionally required a lab. We built a kit that turns it into a rapid at-home test, similar to a COVID test. You get a score from 1 to 10, where 10 is the most desirable gut health activity.
Grayson: So a higher number means more acidic?
Sonia: There’s a broad normal range, and then a narrow optimal range within the acidic space — not too acidic, not alkaline, just right. Studies have shown that range is associated with reduced cancer risk and reduced bone-loss risk, so we assign the highest score there.
Grayson: The Goldilocks zone.
Sonia: Exactly, the Goldilocks zone. Early on, we gave people the raw pH values, and people were confused — understandably, since they hadn’t spent years studying the interpretation the way we have. Now we translate it into a score. And the interpretation depends not just on pH, but on gender — there’s a clear, documented difference in values between men and women. Our test is for everybody, but before we provide a score, we ask users to register their gender and a few other details, because that significantly affects interpretation.
Grayson: If someone gets a less-than-desirable score, how often should they retest? What happens after the first one?
Sonia: The value of this approach is in monitoring with some regularity. Unlike steps on a wearable, which you can measure daily, your gut microbiome doesn’t change overnight — even with a perfectly healthy diet. Shifting a bacterial population takes at least two weeks, sometimes up to four, of consistent change.
That’s why we sell the test as a pack of three: for people who want to know where they stand and then see if a change — a new exercise routine, a medication switch — moves the number. Medication has a huge effect on gut health, by the way. A week of antibiotics for a routine procedure can cause real disruption, and you’ll want to know where you land afterward, especially once you’re eating well again — lots of fiber, beans, whole grains, fruits, and vegetables.
This is especially useful for people who are proactive about their health and want to know if what they’re doing is actually working, or if nothing’s moving. We recommend retesting every two to four weeks, or monthly, for a while.
Grayson: That’s a satisfying process — establish a baseline, make changes, check your progress. That’s the kind of experience a consumer wants.
Sonia: Right.
Grayson: We’ve established this isn’t a medical diagnostic. How do you think about the difference between clinical gut testing and what Coprata offers as a wellness tool?
Sonia: There are important clinical gut health tests for people with diagnosed conditions, like colitis — we’ve done research on making those more accessible, too. But that’s a far more complicated product to bring to market. A consumer wellness product, one that describes wellness without being diagnostic, is the easiest entry point for us. We hope to add more complex, diagnostic markers to our product suite as we make progress.
That said, if someone has symptoms or a medical condition, a physician needs to be involved, and a lab measurement is warranted. Even with a test well-studied and FDA cleared like Cologuard for colorectal cancer screening — if that at-home test comes back positive, you still need a follow-up medical examination, likely a colonoscopy.
Grayson: Help our readers understand what a thriving gut actually looks like in the data. Is there a number, a pattern, a threshold?
Sonia: We provide a number, but as we work with users, we’re realizing it’s really a personalized pattern — some people live in different ranges than others. Whether you’re moving in a positive direction matters more than the single baseline, though the baseline is still useful, since it tells you how common or uncommon your result is compared to everyone else we’ve measured — whether you’re in the top 5%, for example. Depending on the result, we may strongly encourage users to work with a registered dietitian or another healthcare provider. Watching the pattern change over time is the fascinating part.
Grayson: That reminds me of tracking HRV with an Oura ring — it’s more about the pattern than the absolute number.
Sonia: Very much so, although the Oura ring gives you a score every night. With this, the timeline is a bit longer — closer to weeks.
The Best Foods for Gut-Brain Health After 40
Grayson: Let’s get really actionable for our readers. What’s one thing women over 40 can start doing this week to support their gut-brain health?
Sonia: There are well-established foods that support brain health and gut-brain health — because you’re essentially eating your medicine. Polyphenols, the compounds found in berries, are great for this. Berries have a high fiber-to-sugar ratio — relatively low sugar, packed with fiber — and the pigments that give them their color are compounds that are good for your brain. It’s summer, so: berries, in all shapes and colors.
Grayson: I love it. [A short aside here: after reading a Coprata blog post on dietary diversity, I’d gone out and bought three new kinds of berries I’d never tried. Sonia laughed — she does the same thing with vegetables, often coming home with something she Googles before she buys. She’s a big proponent of beans for their fiber content, and when people ask her favorite type, her answer is “all of them” — white, red, black-eyed, brown, black. Eat the rainbow. She’d recently discovered lentils come in just as many colors. We swapped notes on keeping one good recipe and just rotating the ingredients — variety over repetition. Now, back to the questions] What’s the most common misconception about gut health you keep running into?
Sonia: That eating one healthy meal and repeating it every day is enough. The idea that variety helps the gut microbiome ecosystem isn’t widely known. People say, “I eat the same green salad every day” — that’s great, but you have to mix it up. That’s the misconception we run into most often.
The Future of Gut Health Testing: Smart Toilets and Beyond
Grayson: Where does gut diagnostics go from here? What’s the version of this you’re building toward?
Sonia: Our vision for the future is a smart toilet that automatically measures gut health biomarkers after you flush — no specimen handling, no waiting. We have patents, inventions, and working demonstrations of this. It’s a complex product, and it will come to market after the MAT, which is already commercially available. But if every toilet in every home had this feature, it would work like a regular toilet — until you wanted to check your gut health, and then you’d just push a button. You wouldn’t need to look at or handle anything.
One of the bigger commercialization challenges is demonstrating enough value that someone replaces a perfectly functional toilet they’ve had for ten years. That’s why it matters so much to show people actually changing their behavior — and improving their health — because they wanted to improve their MAT score.
How to Start Tracking Your Gut Health (Plus an Exclusive Discount)
Grayson: If a woman reading this thinks, “My gut is probably not thriving,” what’s step one?
Sonia: Step one is easy: go to our website, order a test, and subscribe to our newsletter. Once you’re a customer, you’re part of a community that gets gut-health tips and evidence-based information on what’s emerging in the space. From there, you measure your baseline and start implementing changes that work for your life.
Grayson: Anything else you’d like Unstuck readers to know?
Sonia: I believe your readership is so well aligned with our target audience that I’d be happy to offer a discount code. Use code UNSTUCK20 for 20% off the Coprata MAT’s introductory price of $89.99.
This interview has been edited for length and clarity.
Learn more about Sonia’s work and order the Coprata MAT at coprata.com
Unstuck readers get 20% off the $89.99 intro price with code UNSTUCK20.
You can also find Sonia on LinkedIn at linkedin.com/in/sonia-grego/
If this topic resonated with you, we hope you’ll join the Unstuck community at unstuckcollection.com for more conversations like this one.