Can your Period Trigger IBS?

Can Menstrual Cycles Affect IBS? Yes. Here’s How to Feel Better

Dr. Jolene BrightenPublished: Last Reviewed: Digestion, IBS & IBD, Menstrual Cycle Leave a Comment

If you’ve noticed your irritable bowel syndrome (IBS) symptoms get worse around your period, you aren’t alone. Even women without IBS can experience gastrointestinal discomfort during their menstrual cycle. 

So if you suffer from IBS, things can get even worse during your period. Bloating, cramping, diarrhea (hello period poops) are all symptoms of IBS in women that can be exacerbated by fluctuations in hormones. No, period diarrhea isn’t an absolute sign of IBS, so don’t panic if that happens to you.

Why does this happen, and why do symptoms especially flare during your period? Can your period trigger IBS? I’ll explain below, plus give you some helpful tips to get things under control.

Understanding Female Hormones and IBS

Changes in hormones involved in your menstrual cycle are linked to worsening symptoms in your gastrointestinal (GI) tract. But why? 

One reason is that there are hormone receptors throughout your body, including your GI tract, which means hormones can stimulate your gut. There are several ways this can exacerbate IBS symptoms.

Menstrual Cycle Hormones

Let’s start with a quick overview of your menstrual cycle before we explore the various ways it can affect your IBS symptoms.

The primary sex hormones involved are estrogen and progesterone. Your cycle begins on the first day of your period. During the first half, the follicular phase, estrogen rises to help thicken your uterine lining in preparation for egg release and to help with the ovulation process. 

Towards the end of the follicular phase, estrogen peaks and activates the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This triggers ovulation, and estrogen levels drop soon after.

Estrogen persists during the second half of your cycle, the luteal phase, and then drops off towards the end, initiating your period. At the same time, progesterone (the predominant hormone of the luteal phase) begins to rise and peaks during your luteal phase in preparation for pregnancy. 

But if the egg is not fertilized, progesterone also drops off to trigger the beginning of your period. Both hormones are low right as you start your period.

If you’re looking for a more detailed breakdown of the menstrual cycle, I’ve got a full guide for you!

How Can Hormones Make IBS Symptoms Worse?

Understanding the patterns of these hormones can help explain why symptoms of IBS can get worse throughout the month. 

For example, progesterone can impact your gut motility, slowing the movement of food through your GI tract. So increased progesterone during your luteal phase can contribute to constipation and bloating for all women, not just those with IBS. 

But as both hormones (estrogen and progesterone) drop before your period, you’re more likely to notice opposite symptoms like diarrhea. One study on women with mixed-IBS (alternating constipation and diarrhea) found that one-third noticed constipation mainly during the luteal phase. But amazingly, as the women got closer to their period when progesterone and estrogen were low, not one person had constipation as a primary GI symptom. 

Estrogen also influences how you experience pain by regulating your nervous system. Inflammation chemical messengers, and HPA-axis (how your brain and adrenal glands communicate). It does this in various ways, including synthesizing proteins known as neurotrophins that regulate pain and boosting opioid receptors (also involved in pain regulation) in the brain. Estrogen also can influence the release of inflammatory signaling chemicals that lead to the body’s pain activation. 

As a result, when estrogen levels are higher, your GI-related pain may be more tolerable (yay!). But unfortunately, as it drops, as when you get your period, pain sensations can increase.

Studies also suggest that the drop in estrogen and progesterone at the end of your luteal phase can create signals in your GI tract that increase stool frequency, urgency, and abdominal discomfort.

Finally, hormonal shifts can also affect the diversity of bacteria in your gut and the health and function of your intestinal barrier—both red flags for IBS.

Essentially, there are quite a few ways that hormonal changes during your cycle can affect IBS symptoms, and they’ll vary depending on a lot of factors—everyone is different. And a lot of this research is very new, meaning that even scientists aren’t yet aware of all the ways that hormones may affect IBS.

While this can be challenging and frustrating, it’s definitely worth paying close attention to how your cycle affects your IBS symptoms. To do this requires that you learn to notice and name subtle shifts in your symptoms throughout the month, which I'll describe in the following section. 

@drjolenebrighten β-glucuronidase reactivates the inactive estrogen metabolites produced by the liver. #estrogen #hormoneimbalance #drjolenebrighten ♬ Drive Forever – Remix – Sergio Valentino

How to Distinguish Symptoms of IBS from Menstrual Cycle Symptoms

The connection between your menstrual cycle and IBS can be tricky to figure out because the symptoms look so similar. Symptoms can also change throughout your cycle, as noted above. 

Interestingly, IBS is also more common in women than men.

There are three primary types of IBS:

  • IBS-D or diarrhea-predominant
  • IBS-C or constipation-predominant
  • IBS-M or mixed having both constipation and diarrhea 

General symptoms of IBS in women include:

  • Constipation or incomplete bowel movements (feeling like you still need to go)
  • Diarrhea with frequency and urgency
  • Bloating
  • Stomach pain and cramping
  • Gas
  • Nausea 

But IBS can have other symptoms that also mimic what you might experience with PMS and your period, like:

  • Body pain
  • Increased urinary frequency
  • Impaired sexual function
  • Insomnia

As you probably noticed, most of these symptoms can result from normal hormonal fluctuations on your period. But if you have GI distress all month long, that would indicate your period isn’t the primary culprit.

If you don’t have a definitive diagnosis of IBS, it’s worth seeing a trustworthy health care practitioner to see if the diagnosis fits. Although IBS is common (affecting up to 20% of US adults), there are also other causes of similar symptoms, so it’s a good idea to rule out other causes instead of assuming.

IBS and Birth Control

Since IBS symptoms can be exacerbated due to changing hormones, some doctors may advise using birth control pills to help control symptoms. But there’s no evidence supporting using the pill to manage symptoms.

In fact, certain birth control pills may make symptoms worse. A study on drospirenone, an active ingredient in some birth control pills, concluded that women taking these were more likely to be diagnosed with IBS. 

The pill can also lead to inflammatory changes in your gut by disrupting the balance of your normal gut flora. It’s even associated with an increased risk of inflammatory bowel disease. You’re likely better off finding other natural ways to support your IBS symptoms.

IBS and Small Intestinal Bacterial Overgrowth (SIBO)

For a long time IBS was thought to be a psychological condition. As it turns out, there may be an infectious component that triggers a temporary autoimmune response that impacts gut motility. You can learn more about SIBO here.

How to Support IBS Symptoms During Your Menstrual Cycle

The same interventions that help with IBS at all times of your cycle can help support your gut health during your period. 

There are several ways you can adjust your diet and lifestyle habits to help you feel better.

Eat More Fruits and Vegetables

A diet rich in vibrant fruits and veggies filled with fiber and phytonutrients to support healthy levels of inflammation is oh-so-important when it comes to IBS and your period. 

Phytonutrients are natural compounds found in plants that help protect against oxidative damage and inflammation. They can help calm down those prostaglandins that contribute to pain. To include more phytonutrients, think bright colors like berries, green veggies, squash, and sweet potato.

If you need more help getting started with a hormone supporting diet, we’ve simplified things for you with our free hormone starter kit that includes a free 7-day meal plan.

Try Eating More Fiber

Fiber is necessary for healthy hormone balance, especially healthy estrogen detoxification and regulation. 

If you tend towards constipation, make sure you are getting enough fiber to get things moving. 

However, keep in mind that fiber can be tricky with IBS as it can worsen symptoms for some people. 

Start slow and consider starting with soluble fiber like oats or bran instead of insoluble options like leafy greens if you aren’t used to eating fiber. 

Support Your Microbiome

Microbiome-supporting foods like fermented vegetables, kefir, and yogurt (if you tolerate dairy) can all support healthy diversity of bacteria in your gut.

Different probiotic foods work for different people, so it’s worth experimenting. Probiotic supplements are another research-backed option to support gut health.

Stay Hydrated 

Hydration is also so important to keep things moving. Dehydration can cause constipation. 

Plus, it’s always a good idea to increase your water intake as you add more fiber to your diet.

Whether or not you're feeling dehydrated, try setting hydration goals. One easy way is to carry around a liter water bottle and be sure to fill and drink the entire thing (with purified or spring water, preferably) twice per day, or more if you're very active or perspire a lot. 

Move More

Movement is beneficial for healthy bowel function. It can stimulate the muscles in the intestines and help you pass stool more easily. 

Studies also suggest that regular exercise can help reduce symptoms related to your period

For best results, aim for about 30 minutes of movement five times a week. Try moving in different ways like stretching, yoga, swimming, dancing.

Manage Stress

Stress can worsen your IBS, so it’s essential to find healthy ways to cope with stress (like exercise or meditation). 

You may also want to consider a yoga practice with a focus on gentle breathing and stretching.

Focus on Sleep

Sleep is so vital for all aspects of health, including the wellness of your gut. Plus, lack of sleep just makes everything worse, including period and IBS symptoms. Try working on avoiding screen time before bed, sticking to a sleep schedule, and attempting bedtime yoga (or gentle stretches) to help you unwind.

Keep a Symptom Journal for a Month or Two

As you work on solving your IBS and period symptoms, you may also want to consider tracking food, lifestyle, and symptoms with a journal to note any patterns. It’s not difficult and can provide an excellent way to measure the impact of what you’re doing.

A good journaling practice can also help identify food sensitivities or other factors that may make your symptoms worse.

Can Supplements Help with IBS?

Yes. In many cases, depending on your IBS symptoms, some supplements can add support on top of diet and lifestyle. 

Hormone balancing supplements can support a healthy foundation, while some other options can provide additional support.

Magnesium

Magnesium can be especially helpful for those who struggle with body pain. It can also help with relaxation and PMS

But if you tend to have diarrhea, choose magnesium glycinate or malate because they are less likely to cause loose stools.

@drjolenebrighten #duet with @chefjonkung not all #magnesiumsupplements are equal #magnesiumdeficiency #healthylivingtips #tiktokdoc #youdontknow #hormones ♬ original sound – Jonathan Kung

Probiotics

Probiotics can support your gut health, which may be helpful for hormone related fluctuations in gut symptoms or gut symptoms in general. 

Your gut is a primary part of hormone detoxification and balance. Certain strains like Bacillus subtilis support your gut barrier, microbial diversity, and a healthy inflammatory and immune response. 

Multiple studies point to the benefit of probiotics for IBS.

You can view our Women’s Probiotic that contains probiotics that support a healthy gut, hormones, and menstrual cycle.

Curcumin

Curcumin is an anti-inflammatory, antispasmodic compound found in turmeric. 

It can help with reducing PMS and IBS symptoms through its impact on neurotransmitter and anti-inflammatory activity.

Ginger

Ginger contains phenolic components that are high in antioxidants. It may help to reduce inflammation and help improve digestion for people with IBS. 

One study suggested that ginger’s anti-inflammatory activity could benefit those with IBS-D (the type with predominantly diarrhea) by lowering the inflammatory response

Digestive Enzymes

Digestive enzymes can support healthy digestion and may help with symptoms of IBS around your period and throughout your cycle. 

They are especially helpful for feelings of gas, bloating, or discomfort associated with food intake. 

Taken with a meal, enzymes can make it easier to break down food so you can absorb the nutrients more effectively.

IBS and Menstruation: You Don’t Have to Suffer

There is a clear relationship between our digestive system and our period. If you have IBS, this connection can make things worse.

But you shouldn’t have to suffer. If you feel miserable around your period or anytime, try some of the lifestyle changes listed above. I encourage you to really focus on food, movement, sleep, and stress management as they are all powerful tools—especially when combined. 

Supplements like probiotics can also help support your healing process. If you feel like you’ve tried it all and still don’t feel well, consider reaching out to a women’s health care practitioner for extra support.

Questions or stories to share? Leave a comment below, I love hearing from you!

Share this article:

Get Your FREE Hormone Starter Kit with

7 Day Meal Plan & Recipe Guide

This starter pack is exactly what every woman needs to bring her hormones back into balance!

Hormone Starter

Kit

References

  1. Bernstein MT, Graff LA, Avery L, Palatnick C, Parnerowski K, Targownik LE. Gastrointestinal symptoms before and during menses in healthy women. BMC Womens Health. 2014. 14. 14.
  2. Mihm M, Gangooly S, Muttukrishna S. The normal menstrual cycle in women. Anim Reprod Sci. 2011. 124(3-4). 229-236.
  3. Wald A, Van Thiel DH, Hoechstetter L, et al. Gastrointestinal transit: the effect of the menstrual cycle. Gastroenterology. 1981. 80(6). 1497-1500.
  4. Kim YS, Kim N. Sex-Gender Differences in Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2018. 24(4). 544-558.
  5. Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine.. World J Gastroenterol. 2014. 20(22). 6759-5773.
  6. Bharadwaj S, Barber MD, Graff LA, Shen B. Symptomatology of irritable bowel syndrome and inflammatory bowel disease during the menstrual cycle. Gastroenterol Rep (Oxf). 2015. 3(3). 185-193.
  7. Jung HK, Kim DY, Moon IH. Effects of gender and menstrual cycle on colonic transit time in healthy subjects. Korean J Intern Med. 2003. 18(3). 181-186.
  8. Yildirir A, Kabakci G, Akgul E, Tokgozoglu L, Oto A.. Effects of menstrual cycle on cardiac autonomic innervation as assessed by heart rate variability. Ann Noninvasive Electrocardiol. 2002. 7(1). 60-63.
  9. Smith YR, Stohler CS, Nichols TE, Bueller JA, Koeppe RA, Zubieta JK. Pronociceptive and antinociceptive effects of estradiol through endogenous opioid neurotransmission in women. J Neurosci.. 2006. 26(21). 5223-05.
  10. Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas. 2017. 103. 45-53.
  11. Roomruangwong C, Carvalho AF, Geffard M, Maes M. The menstrual cycle may not be limited to the endometrium but also may impact gut permeability. Acta Neuropsychiatr. 2019. 31(6). 294-304.
  12. Pati GK, Kar C, Narayan J, et al. Irritable Bowel Syndrome and the Menstrual Cycle. Cureus. 2021. 13(1). E12692.
  13. Bharadwaj S, Barber MD, Graff LA, Shen B. Symptomatology of irritable bowel syndrome and inflammatory bowel disease during the menstrual cycle. Gastroenterol Rep (Oxf). 2015. 3(3). 185-193.
  14. Pati GK, Kar C, Narayan J, et al. Irritable Bowel Syndrome and the Menstrual Cycle. Cureus. 2021. 13(1). e12692.
  15. Pati GK, Kar C, Narayan J, et al. Irritable Bowel Syndrome and the Menstrual Cycle. Cureus. 2021. 13(1). e12692.
  16. Whitehead WE, Cheskin LJ, Heller BR, et al. Evidence for exacerbation of irritable bowel syndrome during menses. Gastroenterology. 1990. 98(6). 1485-1489.
  17. Heitkemper MM, Jarrett M, Cain KC, Shaver J, Walker E, Lewis L. Daily gastrointestinal symptoms in women with and without a diagnosis of IBS. Dig Dis Sci. 1995. 40(7). 1511-1519.
  18. Bird ST, Liu W, Brophy JM, Bressler B, Delaney JA, Etminan M. Irritable bowel syndrome and drospirenone-containing oral contraceptives; a comparative-safety study.. Curr Drug Saf. 2012. 7(1). 8-15.
  19. Ortizo R, Lee SY, Nguyen ET, Jamal MM, Bechtold MM, Nguyen DL. Exposure to oral contraceptives increases the risk for development of inflammatory bowel disease: a meta-analysis of case-controlled and cohort studies. Eur J Gastroenterol Hepatol. 2017. 29(9). 1064-1070.
  20. Khalili H. Risk of Inflammatory Bowel Disease with Oral Contraceptives and Menopausal Hormone Therapy: Current Evidence and Future Directions. Drug Saf. 2016. 39(3). 193-197.
  21. Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas. 2017. 103. 45-53.
  22. Zhu F, Du B, Xu B. Anti-inflammatory effects of phytochemicals from fruits, vegetables, and food legumes: A review. Crit Rev Food Sci Nutr. 2018. 58(8). 1260-1270.
  23. Armour M, Ee CC, Naidoo D, et al. Exercise for dysmenorrhoea. Cochrane Database Syst ReV. 2019. 9(9). CD004142.
  24. Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014. 20(39). 14126-14131.
  25. Jehan S, Auguste E, Hussain M, et al. Sleep and Premenstrual Syndrome. J Sleep Med Disord. 2016. 3(5). 1061.
  26. Mori S, Tomita T, Fujimura K, et al. A Randomized Double-blind Placebo-controlled Trial on the Effect of Magnesium Oxide in Patients With Chronic Constipation. J Neurogastroenterol Motil. 2019. 25(4). 563-575.
  27. Marzorati M, Abbeele PVD, Bubeck SS, et al. Bacillus subtilis HU58 and Bacillus coagulansSC208 Probiotics Reduced the Effects of Antibiotic-Induced Gut Microbiome Dysbiosis in An M-SHIME® Model. Microorganisms. https://pubmed.ncbi.nlm.nih.gov/32664604/. 8(7). 1028.
  28. Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010. 15(Suppl 1). 401-405.
  29. Khayat S, Fanaei H, Kheirkhah M, Moghadam ZB, Kasaeian A, Javadimehr M. Curcumin attenuates severity of premenstrual syndrome symptoms: A randomized, double-blind, placebo-controlled trial. Complement Ther Med.. 2015. 23(3). 318-324.
  30. Bundy R, Walker AF, Middleton RW, Booth J.. Turmeric extract may improve irritable bowel syndrome symptomology in otherwise healthy adults: a pilot study. J Altern Complement Med. 2004. 10(6). 1015-1018.
  31. Zhang C, Huang Y, Li P, Chen X, Liu F, Hou Q. Ginger relieves intestinal hypersensitivity of diarrhea predominant irritable bowel syndrome by inhibiting proinflammatory reaction. BMC Complement Med Ther. 2020. 20(1). 279.
About The Author

Dr. Jolene Brighten

Instagram Facebook

Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.