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You are probably already quite familiar with the commonly accepted symptoms of having your monthly period, like cramping, bloating, and low energy. But, the changes that might occur with your bowel movements are probably not the topic of every day discussion.  There are clear many reasons for bowel changes during your cycle, yet the exact symptoms that occur can depend on the person. Some women experience diarrhea while others struggle with constipation. A 2014 study found that 73% of women experienced some type of bowel changes during their cycle. Although this is normal to some extent, there are several reasons why this happens that can be helpful to understand.

Hormones, Hormones, Hormones

The hormonal shifts that happen during your period are likely to blame for the changes you are experiencing in your bowel habits. There is a surge in both estrogen and progesterone, which may have an impact on your digestive system.

At the beginning of your period, there is an increase of one particular hormone called progesterone. Levels of this hormone start to gradually go up after ovulation, until the time you get your period. A side effect of progesterone is to slow down digestion, which can lead to constipation.

There is also evidence that estrogen may play a role in constipation during your period. A 2013 animal study looked at the impact of hormones on constipation. Researchers found that estrogen was the hormone that slowed down digestion, not progesterone. But, this is an animal study and further research needs to be done on humans. For now, we can simply say that it is one of these two hormones that is causing the uncomfortable symptoms you are experiencing.

Diarrhea is the most commonly reported digestive symptom during the menstrual period. The 2014 study mentioned above found that 28% of women experienced diarrhea during their period. The diarrhea was worse in those that experienced emotional symptoms as well. Shocker, right?

The mechanism for diarrhea is not the same as for constipation. A different type of hormone-like substances called prostaglandins are to blame for that change. Prostaglandins are produced by the endometrial cells of the uterus during your period and get released as the lining begins to shed. Not only are these substances responsible for painful cramps, they can also travel to the bowel muscles causing them to relax and contract, leading to diarrhea. Prostaglandins also increase inflammation, so the diarrhea can be painful and make cramps worse.

Health Conditions

For women without any other health conditions, these bowel changes can be simply annoying. But, for those who struggle with bowel disease such as IBS, Crohn’s, or ulcerative colitis, you might find that your symptoms are much worse during your period.

Endometriosis, a painful condition where uterine tissue grows outside the uterus, can also cause pain during bowel movements when you have your period. The reason is that the uterine tissue can attach to your bowels, so it hurts to use the bathroom.

How to Manage Bowel Changes

Although there isn’t much you can do about your hormones during your period, you can help minimize symptoms and bowel changes during your cycle through some food and lifestyle changes. Here are a few things that can help:

  • Minimize foods that impact your bowel movements when you are not on your period. Foods like coffee, gluten, dairy, fried foods, and spicy foods can cause diarrhea or constipation at other times of the month. But, you may react to these foods more during your period. If you know a food is a trigger for you, avoid it a few days before your cycle.
  • Up your water intake. If you struggle with constipation during your period, drinking more water at least 10-15 cups a day, may help you get things moving.
  • Boost your fiber. Fiber can help both diarrhea and constipation. Eating more fiber a few days before your period, may help thicken the stool and eating fiber during your period can help relieve constipation. Fiber can also help normalize hormones, so maybe they won’t have such a huge impact. Aim to eat at least 25-30 grams of high fiber foods a day, particularly from fruits and vegetables.
  • Consider a probiotic. A probiotic supplement can help regulate bowel movements by helping increase the number of healthy bacteria in the gut.
  • Exercise. Although you probably don’t feel much like running a marathon during your period, gentle exercise can help move things along. Try workouts that require the body to work against gravity, like walking, which can relieve constipation.
  • Plan ahead. Although it is frustrating to have to change your life for your hormones, sometimes you need to plan ahead if you know the first few days of your period can be challenging. For example, this may mean not planning a long hike with limited bathroom access during that time, so you are not stuck with bowel issues and no recourse.
  • Manage your stress. Stress can make bowel symptoms worse at any time of the month, but particularly during your period. For the first few days make relaxation a priority. Take a gentle walk, warm bath, or do some yoga. Treat yourself nicely and you may find that your symptoms improve.
  • Consider anti-inflammatory medications. NSAIDs can help relieve the pain and inflammation caused by shifting hormones the first few days of your period. They also prevent the body from making excessive prostaglandins.
  • Treat the symptoms, if needed. If you must, consider taking medications to alleviate your symptoms or at least carry it with you if things get dicey. Imodium helps relieve diarrhea. Magnesium citrate may help with constipation. Although, it is best not to always rely on these types of medications to manage your symptoms, sometimes you just need something to make it better.
  • Speak to your doctor. If the symptoms are unmanageable, causing significant impact on your life, or are happening more often than just around your cycle, consider speaking to your doctor as there may be something else going on. You may have IBS or another bowel condition that needs to be addressed for your symptoms to improve.

Digestive symptoms caused by hormones can be annoying but might also be a sign of something more serious. Try a few of the mentioned lifestyle modifications to see if they help (you can also look here). If these symptoms are happening all the time, you may want to take a closer look at your diet or lifestyle habits to determine the underlying cause.