May 27, 2020

The Menstrual Cycle and I.B.S

"Why do my IBS symptoms get worse when I have my period?"

No, you’re not imagining it. IBS symptoms can and often do get worse around the time of your period. This is due to the fact that the same hormones that fluctuate throughout your menstrual cycle have receptors in the gut and IBS symptoms tend to get worse when the levels of these hormones fall.

The exact mechanism of how this all works is not fully understood but there are studies that show that women with IBS have a more sensitive gut around the time of their period than those without IBS (I won’t go into this, but one study involved rectal balloons...).

Other observations have been that transit time (the time it takes for your food to pass through the gut) is slower during the second half of the menstrual cycle and women with constipation tend to find that their symptoms are significantly better just before and during her period when progesterone levels fall. More evidence for the link between female sex hormones and IBS comes from a study that sadly showed a possible link between those who have had a hysterectomy who went on to develop IBS soon after the operation.

Women who have IBS tend to have more frequent and severe symptoms around their periods such as insomnia, fatigue, backache, cramping, bloating and food sensitivity as well as painful menstruation and chronic pelvic pain. It is important to note at this point that endometriosis symptoms often overlap with features of IBS (including worsening of gut related symptoms around menstruation) so if your periods are particularly painful or heavy please go to the doctor to get this checked out.

The one light at the end of the tunnel is that during and after menopause the levels of sex hormones stop fluctuating so many women tend to see an improvement in their IBS symptoms after they are through this time.

One way of ensuring balanced hormones to avoid extreme fluctuations, is to balance your blood sugar but to also eat a fibre rich and colourful diet to feed the healthy microbes in your gut as they too have an influence on your sex hormones.  Check out my ‘How to balance your blood sugar’ and 'which fibre is best for me' blogs for further information on this.

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