IBS and Periods: What You Need to Know

It’s no secret that your period can come with uncomfortable and annoying symptoms like bloating, frequent trips to the bathroom, a constant tummy ache, and painful cramps. But for people with irritable bowel syndrome (IBS), the symptoms can be even worse, from the start of your monthly period and throughout the cycle.

The reason could be the link between the gut and the way the reproductive system functions during a menstrual cycle. Read on to find out how your IBS symptoms can affect your period.

It all comes down to hormones. During your period, hormones affect more than just your mood and energy levels — they can influence your digestive system.

Sex hormones fluctuate during different phases of the menstrual cycle, explains Olubunmi Oladunjoye, MD, MPH, a general internist and an assistant professor at Baylor College of Medicine in Houston. ”Estrogen is usually at its peak just before ovulation, while progesterone is at its peak during the luteal phase — the phase between ovulation and the onset of menstruation,” she says. “But these hormones drop to the lowest levels just before the period begins.”

She also says that when progesterone is at its peak during the luteal phase, it usually can cause constipation.

Hormones appear to play a role in aggravating IBS symptoms. “Estrogen and progesterone inhibit the smooth muscle contractions in the intestines, which adversely affects gut motility and may be the cause of heightened IBS symptoms during periods,” Oladunjoye says.

When it’s that time of the month, Oladunjoye recommends treating your IBS symptoms the same way you would treat them at any other time. She suggests you:

• Avoid trigger foods, such as fried foods, that could set off your symptoms, especially during your period.
• Eat more foods containing soluble fiber.
• Steer clear of gas-inducing foods like beans, broccoli, Brussels sprouts, and cabbage, as they increase bloating, particularly during your period.
• Drink plenty of water.
• Exercise regularly.
• Get quality sleep.
• Keep up with your IBS medications as prescribed by your physician.
• Seek medical care to ensure a proper diagnosis and adequate treatment if your symptoms prevent you from performing your daily activities.

The link between the gut and reproductive health is essentially a control or balance of estrogens and progesterones, says Rudolph Bedford, MD, the director of gastroenterology at Providence Saint John’s Health Center in Santa Monica, California. He adds that estrogens, in particular, can “control and cause a variety of situations within the gastrointestinal tract.”

Using estrogen as an example, Dr. Bedford explains how female sex hormones interact with the gut microbiome: The liver deactivates active estrogen that has been transported from the ovaries. This deactivated estrogen then exits the liver through the bile and moves to the small intestine, which is home to the microbiome. The gut bacteria produce an enzyme that interacts with the estrogen before it gets excreted. But if the microbiome gets interrupted, the estrogen may not metabolize properly. Instead, it may return to the bloodstream, eventually causing digestive issues such as constipation and bloating.

Bedford believes that the excess circulating estrogen and progesterone caused by dysbiosis may also result in a variety of conditions and worsening symptoms related to menstrual cycles and fibroids alongside altered bowel habits.

Maintaining the interplay between the sex hormones and the gut microbiome will promote gut-reproductive health, Bedford says. He notes that a healthy microbiome is important for a healthy reproductive system; it encourages the proper metabolism of sex hormones, which prevents the onset of digestive disturbances.

To keep your gut and reproductive health in tip-top shape, try these tips.

• Stay physically active. From walking to lifting weights, the key is to keep moving. If you’re too busy and can’t get to the gym, Oladunjoye says at-home workouts can be just as effective.
• Eat a healthy, balanced diet. Oladunjoye maintains that what we feed our gut can affect our reproductive health (and health overall). Include lots of fruits and vegetables in your diet, which are high in fiber and promote quality bowel movements. But keep in mind that certain fruits and vegetables can be hard to digest for some people. If that happens, it’s a good idea to see your doctor or a nutritionist to work out a food plan. And if getting enough fiber from food alone is challenging, Oladunjoye says taking a supplement could be helpful.
• Cut back on alcohol. Alcohol is known to disrupt the microbiome, which can lead to an unhealthy gut lining.

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• Try to manage and reduce stress with strategies like meditation, deep breathing techniques, and yoga. Stress can affect the gut-brain connection and may trigger GI symptoms, like bloating and abdominal pain more easily.

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• If your IBS symptoms worsen during your period, it may be due to fluctuating hormones like estrogen and progesterone that affect gut motility.
• To manage IBS symptoms, avoid trigger foods such as fried items and foods that cause gas, especially around your menstrual period.
• Gut health maintenance is vital; a balanced diet rich in fruits and vegetables, physical activity, and adequate sleep can support overall gut and reproductive health.
• If IBS symptoms become severe enough to interfere with daily life, seek medical advice to ensure proper diagnosis and treatment.