Up to 50% of women will experience some form of digestive distress during their period, gastroenterologists report.
Oh, what fun menstruation is! It's our monthly reminder that we are capable of reproducing, which is a beautiful thing! But, unfortunately, to many of us, it brings with it some not-so-fun symptoms, including the gas/bloating, diarrhea, and constipation.
At this time of the month, you can notice gas, constipation, and constant gurgly noises coming from your gut. Up to 50% of women will experience some form of digestive distress during their period, gastroenterologists report.
Considering that a woman can expect to menstruate 450 times throughout her life, that's a lot of bathroom runs.
Diarrhea, as well as other gastrointestinal symptoms, such as bloating and nausea, may also occur during the week prior to your period. In this case, diarrhea may be part of a group of symptoms, usually including mild mood changes, called premenstrual syndrome (PMS).
You have enough to deal with during your period — diarrhea and changes in bowel habits are just more things you don't want to put up with. It's beyond rough when you suffer from digestive issues during your period. But why exactly do periods bring on gastro issues in the first place?
The most straightforward answer is that these symptoms are due to hormones and other natural chemicals in our bodies!
A woman’s menstrual cycle has a very direct and predictable effect on her digestive system, and if you understand what is happening you can take steps to mitigate any frustrating digestive problems that might crop up. So what is exactly going on there? Let’s have a closer look at the situation together.
A word from scientists
Many women describe having gastrointestinal (GI) symptoms around their menses, yet little research has been done to quantify the prevalence or nature of these symptoms, or to consider associated factors.
Scientists have found that it is very common for healthy women both before and during menses to experience a variety of symptoms. Not surprisingly, abdominal pain is quite frequent, but around one-quarter of the women also experience bowel habit disturbance in the form of diarrhea.
GI symptoms occur at a similar rate in both the premenstrual phase and during menses. Other prospective studies described abdominal pain, nausea, and bloating as the predominant GI symptoms, and found they tended to increase just before and during menstruation.
The depressed mood, anxiety and fatigue during menstruation are each significantly more likely to be associated with primary GI symptoms. Similarly, women who have a history of painful menses were also more likely to experience GI symptoms before the menstruation.
The clog up
First, a quick biology lesson. Your female sex hormones have an important role in regulating your periods; the rise and fall in these hormones at specific times in the month means you ovulate and have your period.
There are two main hormones associated with menstruation: estrogen and progesterone. These hormones do not just affect the sex organs. In fact, there are receptor cells for these hormones throughout your gastrointestinal tract. This is why many women experience digestive symptoms related to their menstrual cycle.
The hormone progesterone is the main player when it comes to the changes in our digestion each month. One of progesterone’s key jobs is to stimulate the growth of the uterine lining to prepare it for the implantation of a fertilized egg, so our progesterone levels are at their highest in the luteal phase of our cycles, directly after ovulation.
This hormone, progesterone, peaks right before ovulation. It’s during this phase that many women experience constipation: it tends to come around ovulation or a couple of days after, experts say.
So how is it all happening?
One of the properties of progesterone is that it’s a muscle relaxant. In fact, it’s commonly given to pregnant women to delay labor and preterm birth, because it’s relaxing effects are so effective that it can reduce uterine contractions. It’s this relaxing effect that can make us feel all clogged up.
So, why do some women sail through their period without a second thought whilst others feel they can hardly face the day ahead of them? Roughly the same patterns of hormones exist, right?
Well, usually this is the case, but in reality, hormones can easily fluctuate from “the norm”. Fluctuations are all part of the normal cycle (within reason), but if these hormones fluctuate too much, resulting in one becoming more dominant over the other when it shouldn’t, you can really feel the effects and symptoms can appear.
The bowel moves stool and waste (we wish there was a better word for that!) through the intestines using a process known as peristalsis. Through peristalsis, muscles lining the bowel contract and relax in a rippling, wave-like motion to move things through the intestines.
When there is more progesterone in our bodies, the relaxing effect this hormone has on our muscles makes it more difficult for the bowel to contract, thus making it harder to move things along.
This is completely natural, and as your progesterone levels drop in the run-up to your period, your constipation should subside.
Why you poop more
On the other hand, what if estrogen is too high? Estrogen dominance means your levels of estrogen are higher relative to progesterone, and this can translate into unwelcome symptoms.
Particularly heavy or painful periods are a common indication of this imbalance of hormones, as well as feeling angry, irritable, experiencing mood swings, and having sore breasts. The actions of progesterone (which generally has a slowing or quietening effect on the bowels) can be outweighed by estrogen, and guess what: you can experience diarrhea as a result.
The intricate balance of hormones and chemicals is what allows ovulation and menstruation to take place. Estrogen is the hormone that is important in preparing the egg for ovulation. The main symptoms that progesterone (and estrogen) cause are bloating, gas, and constipation. This is secondary to the slowing or quieting effect on the contractility of the smooth muscle of the digestive tract that progesterone causes.
In the days leading up to your period (and during the first few days), the lining of your uterus starts to disintegrate and prostaglandins are released. These chemicals can easily migrate to surrounding tissues and can easily stimulate contractions of your bowels. This explains why diarrhea in the run up to your period isn’t unheard of. Diarrhea can happen when prostaglandins begin to relax smooth muscle tissues as menstruation begins.
Prostaglandins can contribute to diarrhea during your period in exactly the same way as during the pre-menstrual phase, although, often to a greater extent. Prostaglandins are rife by the time your period decides to make an appearance – their release is in full flow. Prostaglandins actively stimulate contractions of the smooth muscle in the womb, shedding the lining, and the end result being your period.
However, the effects of prostaglandins don’t necessarily stop in the womb, and they can easily leak through into your nearby large intestine and give rise to sporadic gut contractions – this often means diarrhea isn’t far away. It’s common to be unsure whether your period cramps are originating from your uterus or your gut as both end up in equal turmoil!
It makes sense if you think of the cycle. Until ovulation, the uterus is preparing to accept the egg and, once it starts, the opposite happens — it’s cleansing to get ready for the next cycle.
What can you do about it?
As you can see, many women have mild, manageable digestive distress related to their menstrual cycle. For others, it’s more severe. Typically, most women experience constipation prior to their menstrual period and this resolves within the first few days of menstruation.
Also, according to experts , generally speaking, women who experience diarrhea during their menstrual cycle typically get it once menstruation has started, and it usually occurs in the first three days of your menstrual period.
However, all women are different in terms of the levels of hormones they have, and thus, different women can experience different symptoms at different times during their menstrual cycle. Regardless of your symptoms, there are steps you can take to manage them — or possibly avoid them altogether.
There are many things that can be done in the premenstrual and menstrual period to try and alleviate your symptoms. You can alter your diet to include lots of high-fiber foods, whole grains, and vegetables, and limit intake of extra salt, dairy, sugar, alcohol, spicy foods, and caffeine.
You can manage or decrease stress by using relaxation techniques such as yoga or meditation or by talking with someone. Regular exercise is also recommended during your premenstrual and menstrual period, which can help reduce stress and help your digestive system function more smoothly.
Keeping a diary of your GI symptoms prior to and during your period may help you identify patterns with symptoms and food/exercise/behaviors and then a plan can be developed to optimize or avoid certain things during these times to minimize symptoms.