Experiencing Diarrhea or Pain During Your Period Is Not Uncommon

PMS Calendar
Premenstrual syndrome can last several days and be anywhere on the spectrum from annoying to debilitating.. Image © Julia Nichols / E+ / Getty Images

If you've found that your irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) acts up when you have your period -- you're not alone. The several days before a menstrual period can bring with it the symptoms of premenstrual syndrome (PMS). Many women with IBD or IBS find that they experience more severe symptoms, such as diarrhea and pain, before or during their menstrual cycle.

What Causes PMS Symptoms?

Researchers think that this increase in symptoms such as abdominal pain and diarrhea has a connection to the hormones that regulate the menstrual cycle.

The amount of diarrhea experienced by some women who have either IBD or IBS increases during the days immediately before and during their period. Two compounds have the potential to cause this effect -- prostaglandins and progesterone.

There are several different types of prostaglandins that have various functions in the body. Some, called Series 2 Prostaglandins, are associated with changes in the bowel that stimulate diarrhea during menses. They can actually stimulate pain and interfere with the absorption of vitamins and minerals that takes place in the intestines. These prostaglandins could also be responsible for causing the smooth muscle in the intestine to contract, which results in symptoms of pain and diarrhea.

The fluctuation of hormones before and during a women's period may also be to blame. It has been theorized that the colon could be reacting to the increase or the decrease in progesterone in the body.

What Is The Treatment For PMS?

There is no one proven treatment for PMS, although there are several ways to ease symptoms.

Evening Primrose Oil. Evening primrose oil (EPO) was found to help women decrease IBS symptoms during the pre-menstrual and menstrual phases of their cycle. EPO contains an essential fatty acid called gamma linolenic acid (GLA).

 The body does not produce essential fatty acids -- they can only be ingested through food. GLA and omega-3 fatty acids together produce a second type of prostaglandins, called E1 series. This type of prostaglandin helps reduce inflammation and aids in digestion.

The optimum dose of EPO per day is still unknown, but 3,000 mg to 6,000 mg of EPO (given over 3 separate doses during the day) can contain 270-540 mg of GLA. This is the amount of GLA often used in research. EPO is generally considered safe, but it should be taken with food to avoid nausea. People with temporal lobe epilepsy should never take EPO.

Calcium. A calcium supplement may be helpful in reducing some of the symptoms of PMS. The dose that has been found to be effective is 1200 mg a day, in the form of calcium carbonate. 

Selective serotonin reuptake inhibitors. Selective serotonin reuptake inhibitors (SSRIs) might be used to treat moderate-to-severe symptoms of PMS. These drugs are often used as anti-depressants, but they have many other uses too.

In some cases, an SSRI is only given during the luteal phase, which starts when ovulation occurs. In others, the SSRI is given every day. 

Many other potential treatments have been studied, but most have not shown any positive effects on reducing the diarrhea and other symptoms associated with PMS. Living a healthy lifestyle -- eating enough fruits and vegetables, exercising, reducing sugar and caffeine -- may help in a very general way, because these lifestyle measures are associated with better overall health. Women's health, in general, is understudied, and therefore much is still unknown about PMS and associated conditions. Talk to your gynecologist and your gastroenterologist about diarrhea and PMS, especially if it is severe and limits your enjoyment of life. It's possible that other treatment methods might be worth trying in your particular case.


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