Why Constipation and Cramps Hit Before Your Period

The Link Between Constipation and Menstrual Cycles

It's common for women to experience gastrointestinal issues like constipation, diarrhea, and bloating before or during their monthly periods. The hormonal fluctuations related to the menstrual cycle can contribute to these digestive troubles for some women.

Why Constipation Occurs Before Your Period

Constipation refers to infrequent, difficult, or incomplete bowel movements. Stools are often hard, dry, and difficult to pass. It's not unusual for women to deal with some level of constipation in the days leading up to their periods. There are a few key reasons why:

• Progesterone levels rise after ovulation, peak during the week before your period, and then drop sharply when menstruation starts. Higher progesterone relaxes smooth muscle tissue throughout the body, including the intestines. This can slow down digestion.
• Estrogen also declines swiftly right before your period begins. This shift can alter gut motility and allow more water to be reabsorbed from stool, leading to harder, drier stools.
• Inflammation may increase slightly prior to menstruation. This can disrupt normal gastrointestinal activity.
• Some women simply feel less thirsty during the premenstrual phase. Dehydration can make constipation worse.

Other Digestive Problems and PMS

Along with constipation, cramping, bloating, and slight diarrhea are also common premenstrual complaints. Researchers believe hormones likely play a role in these issues as well:

• Estrogen and progesterone help control the alternation between contraction and relaxation of smooth muscle tissue in the intestine. Shifting levels of these hormones may dysregulate normal patterns of muscular contraction.
• Changes in progesterone can slow transit time in the colon, allowing more water absorption and gas production from waste - contributing to bloating.
• Stress hormones may rise as part of premenstrual syndrome (PMS), and stress can exacerbate gastrointestinal symptoms like diarrhea.

Tips for Dealing With Constipation Before Your Period

If you routinely struggle with constipation, bloating, or other digestive issues in relation to your menstrual cycle, there are some things you can do to help alleviate discomfort:

Adjust Your Diet

Focus on getting more fiber, fluids, and probiotics into your diet in the week or two leading up to your period. Some helpful strategies include:

• Eat plenty of high-fiber foods like fruits, vegetables, whole grains, beans, nuts and seeds.
• Stay well hydrated by aiming for about 2 liters of total fluid intake per day.
• Consume probiotic foods like yogurt, kefir, sauerkraut, and kimchi to support healthy gut bacteria.
• Limit inflammatory foods that may trigger gut issues like processed meat, fried fare, alcohol and sugary items.

Exercise Regularly

Being physically active most days can help prevent constipation and keep your digestion regular due to effects like:

• Increased muscle contractions in the intestines.
• Stimulation of nerves that influence gut motility and stool movement.
• Release of hormones that support bowel regularity.
• Reduced stress and anxiety.

Try Over-the-Counter Remedies

There are many OTC products available to help address constipation. Some options to try include:

• Stool softeners like docusate to allow stools to absorb more water.
• Osmotic laxatives like polyethylene glycol to draw fluid into the colon.
• Stimulant laxatives with senna or bisacodyl to promote contractions and bowel movements.

Ask Your Doctor About Prescriptions

For recurring hormone-related constipation and other severe symptoms, prescription medications may help. These may include:

• Prokinetic agents like prucalopride to enhance intestinal contractions.
• Antispasmodics like hyoscyamine to ease muscle spasms and cramps.
• Low-dose antidepressants to modify pain signaling.

Is There a Connection With IBS?

Many women find their irritable bowel syndrome (IBS) symptoms like abdominal pain, constipation, diarrhea, and bloating get worse in the days right before their period starts. IBS occurs due to hypersensitivity in the nerves of the large intestine, which causes abnormal gut function and motility changes in response to various triggers.

How Estrogen and Progesterone Affect IBS

Research indicates that the hormonal shifts related to the menstrual cycle can serve as key triggers for IBS issues. Estrogen and progesterone help coordinate contractions and relaxations of intestinal smooth muscle tissue. As levels of these hormones rise and fall, symptoms may flare:

• High estrogen prior to ovulation can stimulate muscle tissue, leading to cramping and loose stools.
• Elevated progesterone after ovulation slows gut motility, potentially causing constipation.
• Progesterone withdrawal and estrogen dips before menstruation can spasm muscles, cause diarrhea.

Managing Menstrual-Related IBS Problems

If you experience worsening of chronic IBS issues around your period, or you have symptoms like recurring abdominal pain and changes in bowel habits that mainly occur before or during your menses, you may have menstrual-related IBS. Strategies to help ease symptoms include:

• Taking medications to address pain, constipation, or diarrhea during symptomatic periods.
• Identifying and limiting food triggers.
• Prioritizing stress-reducing self-care around your period.
• Considering oral contraceptives to stabilize hormones.

Discuss your options with your healthcare provider to develop an individualized treatment plan tailored to your needs and symptom patterns.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.