Season 4 Bonus Episode: What’s the Deal With Period Poops?
If you’re menstruating and wondering why your poop is different during your period, this episode is for you! If you’re still learning about your cycle, that’s ok too! Consider this additional education.
In today’s episode, I’ll share how hormone shifts during your menstrual cycle cause changes in your poop throughout the month. We’ll even discuss how changes in our habits, based on how we feel, can affect our poop. As always, my goal is to educate and empower you to understand your body more so you can make the best decision for you!
In this episode, we cover:
What the menstrual cycle actually is
Explanation of menstrual cycle phases
The impact of heightened progesterone in luteal phase
Symptoms you may experience at the start of your period
How the estrogen drop at the beginning of ovulation can impact your gut
What may cause diarrhea and urgency during your period
Mood related changes and PMS
Some habit changes during your cycle that can contribute to symptoms
How symptoms of PCOS or endometriosis can overlap with IBS and other digestive issues
Don’t forget to connect to others in The GUT Community, a Facebook group for those with IBS and digestive disorders to support one another and dive deeper into each episode together.
Welcome back to our bonus episode all about period poops!
If you are menstruating individual, this episode is going to be extremely helpful in understanding why your poop shifts during your period, but also what shifts are happening throughout the rest of your menstrual cycle. If you're not a menstruating individual, this could still be valuable information for those menstruating individuals in the rest of your life, but this cycle will likely not be happening for you as it does follow the hormone shifts during your menstrual cycle.
So let's dive in by first explaining what the menstrual cycle actually is. As I'm talking through this, if you're getting a bit lost and trying to put it together, and you need a visual, I'm going to link a blog post that we have that correlates with this episode. You can pull that up and see some of the graphics and visuals even read through this to better understand it if you haven't been formally educated on your cycle, which you should not be ashamed of, because many of us have not. I personally was not educated on my cycle until I was an actual health professional adult. I didn't even get that through my training, it happened way later. So if that's you too, no shame! That's why the resources are available to make sure that this is fully sinking in, and that you can begin to apply this and understand it in your body.
So with your menstrual cycle, it starts with the first day of your full bleed during menstruation. And this is the start of your follicular phase. Now, this isn't when you're spotting, this is full bleed day. And if you are on hormonal birth control where your bleed is the pause of your pill that you're taking, that’s a different situation. So this is for like a normal menstrual cycle and it's going to start at day one.
Now, the menstrual cycle can last anywhere from three to five to seven days for some and the length of your cycle overall can also vary, it's around 28 days, but it can be a little bit shorter and a little bit longer. Now if it's very short, that's a sign something is wrong, and if it's very long, that's a sign something is wrong. So it is important to know, when you first have that full bleed day, whether you're tracking this in your calendar or through an app or somewhere else, you want to understand when that first day is and the length between that first day and the next first day of a full bleed. That is the length of your cycle.
So we start with menstruation, which is your follicular phase, and this leads you through the menstrual cycle and then through the period of time between your menstrual cycle and ovulation. The follicular phase ends in ovulation, which is typically around 14ish days after that first full bleed day, it's right in the middle of your cycle.
After ovulation you move into your luteal phase, which takes you from ovulation to your period. So when we talk about the luteal phase, that is leading up to your period and this cycles. So follicular phase starting with menstruation, continue the follicular phase to ovulation, and then you move into the luteal phase until you're back at menstruation. That is how your cycle works.
So when you are in the luteal phase, and you're leading up to menstruation, you have a hormone called progesterone that increases and hits its peak. So it's increasing throughout the luteal phase and it peaks really close to, like a few days before your menstruation. When this progesterone is increasing in peaks, this can actually lead to constipation, which might also lead to bloating, discomfort and gas. Those who are dealing with diarrhea, predominant symptoms may not really notice the shift, it may honestly feel really good. This is also when those PMS symptoms are typically starting, so you might notice that change in mood, but if you're having really good bowel movements, you may not notice this.
For those who deal with constipation predominant symptoms, this is something that could be pretty significant and it might be something that you're not aware of if you're not tracking and aware of your cycle in that much detail, because you're not bleeding yet, right? So it is important to know as you're getting close to menstruation, these shifts are going to start happening and you'll notice it with your mood, you're also going to notice it with your bowels as they might get a little bit slower and you may have more constipation.
Now right at the start of menstruation, usually with that first bleed day, like the day before, the day of, the day after, progesterone is at its peak and it drops, so it goes down really quickly. That shift can lead to pain, bloating, diarrhea and nausea. So that is one major explanation for what we call period poops, that drop in progesterone.
Now as you move through the rest of this follicular phase, after menstruation, you're going to start increasing estrogen levels, so another hormone that's involved. They're going to start increasing and they actually reach their peak at the start of ovulation, and then right after ovulation, which is kind of a moment in time, they drop, so they're reaching their peak and then they drop with ovulation. This peak reach and drop can cause more bloating and constipation, as well as pain. And so I do notice this with a lot of clients, especially those who have constipation predominant symptoms is that when they hit ovulation, their gut gets really crampy, painful, they are bloated, and it may only last a day or two, but it can lead to this kind of confusion because with ovulation, we don't have the clear sign of bleeding like we do with menstruation. And so again, watching your cycle, noticing other signs of ovulation, like discharge, and even the height of your cervix, like all those different details that you can learn about your body will help you understand why those symptoms may be coming up right in the middle of your cycle.
And then the cycle again starts all over. So things start to even out, your estrogen has dropped, it's kind of settling in, and then your progesterone is starting to increase again throughout the rest of your luteal phase, leading to menstruation and so on. Now, during your period, there's another kind of component that's involved, and these are called prostaglandins. These are fatty acids that are released to relax the smooth muscle tissue of your uterus during menstruation that's going to help with that uterine lining shedding, which is what's happening during menstruation. So it helps relax the uterus.
These can also make their way into the bowels and in the colon, and they can relax the bowel muscles, which might cause more diarrhea and urgency. So you would think relaxation would be like this calming effect, but when those muscles have been moving with peristalsis, and then they relax, that can cause things to be emptied really quickly and so that might lead to more of the urgency. So not only are you having this diarrhea that's happening because of that change in hormones, but now we have prostaglandins in the picture that may also be contributing to this diarrhea and urgency that you're experiencing. This is what we most commonly refer to as period poops. It's a hormone impact and the prostaglandin impact that is kind of coming to the head right with menstruation.
Now, mood related changes in PMS can also contribute to symptoms. And this can make this even almost more significant or worse to experience because you've got this shift in your mood, you may be more irritable already, maybe you haven't slept as well because of what's happening with hormones. Maybe you have cramps and other pain and this is now contributing to more anxiety or stress, which then is leading to even more diarrhea, more pain, more urgency. And so that can lead to a cycle for those who do notice that the shifts in their mood or stress can impact their gut as well.
Something to note is that this could be even more significant in those who are dealing with constipation at the end of their luteal phase leading up to menstruation. If you have been constipated and your colon is filled with stool and now we have this impact of clearing from the constipation, in addition to the shift in hormones that prostaglandins, then you may be dealing with more cramping, more pain, more discomfort and more subtle output. So that's why it is important to get on top of the constipation prior to menstruation if you can, by using different tools and supports that work for your body, and also being cautious to not keep those supports going too far into menstruation if you're having these other symptoms, so it's just knowing your body, knowing those communication signals, and then knowing your cycle really well.
Now something else that can happen is that there are not only new changes that happened throughout the cycle, but there can also be habits that are a result of the shifts and these changes that can contribute to symptoms. This isn't always something that we need to overly focus on, but it is something to be aware of if you are trying to put together all of the pieces of your gut symptoms and what's happening in your body in another way. And so it's good to know you know, how am I coping with stress? Am I moving less because maybe I am in more pain with cramps or things that are going on, I'm just feeling more fatigued. And so if I'm moving less, that could be impacting my gut, my digestion, maybe I'm reaching for more processed food, which is totally fine, those things can fit really well into the diet, but if your body is used to eating a lot of diversity and rich like fiber rich foods and plant foods, and then you switch to fiber less foods, that can also impact stool formation and the motility of your stool, which can lead to both constipation and diarrhea for different people.
It's important just to recognize what changes are happening with my habits that could be impacting my gut as well, and how can I build in maybe some supporters for myself or some strategies and just some things that I can implement throughout my cycle that will help not only reduce the severity of those symptoms that I'm seeing, but also help with overall control of symptoms to keep me out of this kind of flare, recover, flare, recover, flare, recover cycle that can happen many times simply related to the menstrual cycle.
Something else to note is that those who deal with PCOS, polycystic ovarian syndrome, or endometriosis, these are common conditions that can overlap with IBS and other digestive disorders, and symptoms throughout your cycle might be even worse, because there may be more significant shifts happening with hormones or even how like referred pain from the organs that are involved and all of those different pieces. So if you know that you have PCOS or endometriosis, or it is something that has been talked about with your doctors, that might be something to consider and something to bring as part of that strategy plan to make sure that you're taking care of those conditions as well as your digestion and your digestive symptoms.
For endometriosis, if you do suspect this or you know you have it, endometriosis can happen on your uterus, in your ovaries, but it can also happen on your bowels. And this can this isn't as common as you know, true endometriosis, but it can happen and I've seen this happen in practice where it has made its way to the bowel tissues and the outer part of the bowels, which is not going to be seen through a colonoscopy. This can actually hinder motility cause more pain, and might be a reason why some people are experiencing symptoms that aren't really responding to different treatments and therapies that we're expecting them to respond to.
So that is something again, with this conversation around your period and your menstrual cycle, we have to take into account the full picture and think about you as a person. What are the different layers and factors that are involved here and how can we put together a plan that works for you holistically. I hope that was helpful and if you're curious about well, what would be considered diarrhea or constipation what's normal, what's not normal? Please go check out that episode on Is My Poop Normal? because that will be a really helpful place to start. I hope that this will empower you with some tools that you can use in your everyday and in your life to get more control and hopefully feel more confident in your plan and in your body!
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