Periods and IBS
I’m sure we’re all aware that IBS is a very complex condition. The severity and nature of symptoms can vary from person to person, with around twice as many women suffering as men. For some, IBS can flare up every once in a while but, for others, it can be an everyday struggle to cope with symptoms. Equally, some women find that they have very manageable periods with little to no disruptive symptoms; others struggle with difficult or painful periods each month.
Unfortunately, the link between IBS and the menstrual cycle is just as complicated as the condition itself. However, we do know that certain changes around the time of menstruation can make matters worse for many women.
In fact, one study reported that 73% of women (without IBS) experienced symptoms such as diarrhoea, nausea, abdominal pain and constipation either in the week leading up, to or during, their period.1 These results demonstrate just how disruptive your period can be to your digestive processes; and that’s without an irritable bowel!
This disruption can be due to a range of factors, such as surging hormone levels, as well as structural changes which occur during menstruation and can have an effect on the gastrointestinal (GI) tract.
First up, we have hormones, many of which will fluctuate significantly throughout the menstrual cycle. In the week leading up to your period, sex hormones oestrogen and progesterone are at their lowest. As we know, the gut can be sensitive to hormone changes as the gut wall contains a number of hormone receptors. This could be why so many women experience issues with the gastrointestinal tract around this time of the month.
In the days leading up to menstruation, including the first couple of days of your period, you could be more likely to experience symptoms such as abdominal pain, diarrhoea and nausea. These are common symptoms associated with IBS and, if you already experience these symptoms, they could be made even worse around the time of your period as levels of oestrogen and progesterone take a dive.
On the other hand, around two weeks before your period begins, you can be more prone to symptoms such as bloating and constipation as your sex hormones fluctuate and progesterone levels increase relative to oestrogen.
Prostaglandins (inflammatory chemicals) can also come into play when you are having your period and can cause unwanted or exacerbated IBS symptoms such as diarrhoea. Excess prostaglandins produced during your period can reach the muscles lining the small intestine and cause them to contract in the same way that your uterus contracts, causing period pains. Stimulating the small intestine this way can result in your faecal matter being pushed out quicker than usual, hence the looser stools.
A good way to keep track of your menstrual cycle and irritable bowel is to keep a symptom diary for a few months. This can help you to get a clearer idea of which symptoms become worse, and when they appear, in relation to your menstrual cycle.
To sum up:
So, fluctuating hormones can have quite a drastic effect on your digestive system and are thought to be responsible for increasing various IBS symptoms. Symptoms like constipation and bloating are common in the weeks leading up to your period, while diarrhoea, nausea and pain are more likely to occur during your period, especially in the first few days. Track your symptoms in relation to your monthly cycle so you can be prepared for what’s coming and experiment with remedies.
Before I explain the structural factors which can also make IBS symptoms worse, first, a little geography.
Your uterus and ovaries sit nestled within the intestines. In the second half of your cycle, your uterus is busy making things nice and cosy for the possible implantation of a fertilised egg. As the uterus swells and the endometrial lining grows thicker, it can put pressure on the intestines since there’s nowhere else for it to go!
As you can imagine, this can cause abdominal pain as the large intestine and bowel are constricted. What’s more, IBS symptoms can flare up too. As the bowel is pressurised, this can make it more difficult for stools to pass through and can cause discomfort in the form of bloating, pain and constipation.
Plus, just to make matters worse, the reallocation of blood to the uterus and reproductive organs at this time of the month means that the blood supply to other processes (like digestion!) can be reduced. This is another reason why your gut might move even more slowly around the time of your period. Gentle abdominal massage (ensuring that you work up the right hand side of your abdomen and down the left) can help.
Finally, another aspect of periods I’m sure we all know too well is cravings. You might find that your body is crying out for the wrong kinds of foods around this time of the month, and it can be it increasingly difficult to manage IBS symptoms if you’re indulging in foods that can worsen your symptoms.
Over at A.Vogel Talks Periods, our Women’s Health advisor Emma has some great advice on cravings; what they mean, how you can manage them, and how to pick healthy alternatives. These tips should help you to make smarter choices when it comes to sugary treats or fatty snacks, helping to keep IBS symptoms in check.