Why IBS Symptoms May Be Worse During Your Period

Have you noticed that you’re IBS symptoms seem to ramp up in the days leading up to your period? You’re not alone! This is a concern I hear from many of my clients, and have actually experienced myself. There’s actually a clear reason why this happens. Let me start by saying that I am not a hormone expert, but I will share what I do know on the hormone level and how that correlates with IBS.

There are 2 major hormones involved in menstruation: estrogen and progesterone. These hormones are not only at work in our sex organs, but also have receptors in the gastrointestinal tract, so fluctuations in both hormones can influence gut function and IBS symptoms. Before ovulation, estrogen levels reach their peak, then rapidly drops at the end of ovulation. This can increase symptoms of bloating and constipation for those with IBS. During the luteal phase (before your period), progesterone levels reach their peak, then drop at the start of menstruation (your period). This can increase symptoms of abdominal pain, bloating, diarrhea, and nausea for those with IBS.

* Check out the chart below from the Monash University blog to see a visual of how this works. *

On the opposite side of the table, studies show that having IBS can also increase your risk or severity of period symptoms, including painful cramps, backache, fatigue, insomnia, food sensitivity, and water retention. Mood-related changes during menstruation (PMS) is not shown to increase for those with IBS. However, anxiety related to the increase in digestive symptoms during this time may increase.

Why in the world is all of this connected? We don’t fully understand the cause. There’s a lot of research to be done, so hopefully we have more answers in the coming years.

PCOS and Endometriosis

PCOS and endometriosis are two common gynecological disorders, that are both related to the balance of female sex hormones and the function of sex organs. Studies are also showing a connection between IBS and these disorders, but again there’s a lot we don’t fully understand. Symptoms can overlap between either of these and IBS, and many women will carry diagnoses for both. We aren’t sure which disorder causes or worsens the other, or if there’s an issue with misdiagnosing one for the other, but we do know that it’s important to develop a plan to address the common issues in both to manage symptoms fully.

So, what do I do?

If you’re dealing with an increase in IBS symptoms after ovulation or in the days leading up to your period, there are a few things you can do to support your body and improve your symptoms.

  1. Know your cycle. Tracking your cycle will allow you to know when you are ovulating, in the luteal phase, and approaching menstruation. Being proactive is key to preventing symptoms, so that starts with knowing your body. You can use apps, basal temperature thermometers, and more to do this. Chat with your gynecologist if you need guidance.

  2. Support your gut with gentle exercise, adequate hydration and fiber, reduction in trigger foods, and plenty of sleep leading up to the days when you experience symptoms the most. Avoid large amounts (doesn’t mean exclude completely!) of caffeine, sugar, or alcohol during these days as those can also worsen symptoms. Giving your body a little extra care will help prevent the symptoms from coming on in the first place.

  3. Easy symptoms you are not able to fully prevent with gentle movement (like yoga!), peppermint oil or capsules, ginger tea, heating pads, warm baths, and warm non-trigger foods!