Periods & IBD - why can IBD symptoms get worse around our period?

IBD can impact many aspects of our lives including the food we can eat and our daily activities, and as if that wasn’t enough, it can have an impact on our periods as women too.

It is common for women to experience changes in gut function and gut symptoms during the menstrual cycle, but studies have found when we have IBD these are often worse (aren’t we lucky!) (1).

How do hormones and periods affect our bowels?

Changes in hormones during our cycle each month can alter how our bowels contract, how quickly food moves through our intestines, how much pain we experience when our bowel expands because of poo and gas, and the amount of digestive enzymes we produce that help us break down our food (1).    

How can periods impact IBD symptoms?

Studies show that gut symptoms in women with IBD commonly worsen in the run up to and during our period (2).

There may be two reasons for this; sex hormones and prostaglandins.

Research has shown that we have oestrogen and progesterone receptors along our intestines so as these hormones increase and decrease during our cycle their impacts may be felt in our bowels (1).

The phase after ovulation and the run up to our period is called the luteal phase and oestrogen and progesterone are at their highest together during this phase hence why we may experience more bowel symptoms like pain and diarrhoea during this time when we have IBD or IBS (3).    

During our period, it is thought that increased bowel symptoms may be due to an increase in prostaglandins which are compounds our body produces that are involved in increasing muscle contraction, pain, inflammation, and blood flow. Prostaglandins also play a role in inflammation in IBD so higher levels of prostaglandins produced in the uterus during our period might exacerbate Crohn’s and colitis symptoms because our uterus and bowel live right next door to each other (1).

Luckily, there are ways we can help to manage these symptoms, if they are causing problems, through adjusting what we eat during these times to help reduce bowel symptoms and by focusing on lifestyle factors too.

There may be instances where there is also an underlying gynaecological issue occurring in addition to IBD, for example, endometriosis may be more common in women with IBD (4). Therefore, if you are worried about your symptoms ask for further investigations to be carried out.

Take Aways

  • Hormones and compounds involved in our menstrual cycle can worsen IBD and gut symptoms.

  • Generally, symptoms can be worsened in the run up to and during out period.

  • Food and lifestyle adjustments during these times may help reduce symptoms.

  • Ask for further investigations if you are worried about your symptoms around your cycle.

If you’d like help with your IBD, lets have a chat. You can book a (free) 20 minute no obligation phone call with me to find out how I can help you. During this call I’d love to hear about you; your journey, your struggles, your life, and we can chat about the best route forward for you.

If that sounds interesting click below and find a time that works for you.

References

  1. Lahat, A., Falach-Malik, A., Haj, O., Shatz, Z., & Ben-Horin, S. (2020). Change in bowel habits during menstruation: are IBD patients different?. Therapeutic advances in gastroenterology, 13, 1756284820929806. https://doi.org/10.1177/1756284820929806

  2. Bernstein MT, Graff LA, Targownik LE. (2012) Gastrointestinal symptoms before and during menses in women with IBD. Aliment Pharmacol Ther; 36: 135–144.

  3. Reed BG, Carr BR. The Normal Menstrual Cycle and the Control of Ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/bo

  4. Chiaffarino F, Cipriani S, Ricci E, Roncella E, Mauri PA, Parazzini F, Vercellini P. Endometriosis and inflammatory bowel disease: A systematic review of the literature. Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:246-251. doi: 10.1016/j.ejogrb.2020.06.051. Epub 2020 Jun 26. PMID: 32629225.

Clemmie Macpherson