Why do my IBS symptoms get worse around my period?

If your IBS symptoms seem to ramp up around your period, you’re not imagining it.

Many women with IBS notice that their digestive symptoms change throughout their menstrual cycle. Bloating, abdominal pain, diarrhoea, constipation and changes in bowel habits can all become more noticeable around menstruation.

And it makes sense that there is a connection. The gut contains receptors for female sex hormones, and the gut and reproductive system are closely interconnected.

So what's going on?

The exact relationship between hormones and IBS isn't completely understood, but we do know that changes in oestrogen and progesterone can influence gut function. Hormonal fluctuations may affect things such as gut motility (how quickly or slowly things move through your digestive system) as well as how sensitive the gut is to normal digestive activity.

This may help explain why some women find that their constipation, diarrhoea, bloating or abdominal pain changes at different points in their cycle.

And it's not just the gut.

The days around your period can also bring cramping, fatigue, changes in appetite, poor sleep and mood changes, all of which can influence how you experience your digestive symptoms.

So if your IBS seems to have its own monthly timetable, there may actually be some biology behind it!

But don't automatically blame everything on IBS

This is an important one. There is considerable overlap between IBS and conditions such as endometriosis, where pelvic and gastrointestinal symptoms can occur together and may worsen around menstruation.

If you have particularly painful or heavy periods, significant pelvic pain, pain during sex, or severe bowel symptoms that are strongly linked to your cycle, it's worth speaking to your GP or another appropriate healthcare professional rather than simply assuming it's IBS.

IBS should not become a catch-all explanation for every digestive or pelvic symptom.

What about menopause?

This is an interesting one, particularly as we get older. IBS symptoms can change during the menopause transition, and the relationship isn't quite as simple as saying “your hormones stop fluctuating, so your IBS will get better.”

Some women do find that their symptoms improve after menopause, while others notice new or different digestive symptoms during the transition.

And that's hardly surprising when you consider everything else that can change at this stage of life: hormones, sleep, stress, diet, activity levels and the microbiome can all be changing at once.

So rather than seeing menopause as something that inevitably makes your gut better or worse, I think it's more useful to look at the whole picture.

Can you do anything to help?

You can't stop your hormones fluctuating but you can support the things that help your gut cope with those changes.

That means looking at the basics:

Eat plenty of fibre and a wide variety of plant foods to support your gut microbes.

Keep your blood sugar reasonably steady by building meals around protein, fibre and healthy fats rather than constantly grazing on sugary foods.

Don't forget sleep. Poor sleep can affect both how we feel and how we experience gut symptoms.

Move your body. Regular movement can support bowel function and is particularly useful if constipation is part of your IBS picture.

And, as we've talked about in my other blogs, stress matters too. The gut and brain are constantly communicating, so a stressful week on top of hormonal changes can sometimes be enough to tip things over.

Your gut is part of the bigger picture.

I don't believe in trying to “fix” IBS by endlessly removing foods. Instead, I want to understand what might be contributing to your symptoms, support the gut with a diverse and nourishing diet, and look at the other factors that influence how you feel.

That might mean:

CONSIDER what's going on ADD IN dietary variety REPLENISH & NOURISH your gut and body BALANCE stress, sleep, movement and the other things that influence your health.

Because your gut doesn't operate in isolation and neither do your hormones.