How Your Menstrual Cycle Can Affect Your IBS

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If you are a woman, you may have you noticed that your IBS symptoms change depending on the time of the month. You are not imagining things -  your menstrual cycle and the severity of your IBS symptoms are definitely linked.

Like many things having to do with IBS, the connection between IBS and the process of menstruation is not clear-cut. Many women find that their IBS seems to get worse just before they get their period.

For other women, their IBS symptoms are worse when they have their period.

One thing that is for certain is that a woman's menstrual cycle and the functioning of her digestive system are definitely connected. Let's take a look at why this is and how it affects how you feel.

Hormones and Your Digestive System

First a quick biology lesson. There are two main hormones associated with menstruation: estrogen and progesterone. These hormones do not just affect the sex organs. In fact, there are receptor cells for these hormones throughout your gastrointestinal tract. This is why many women -- even those without IBS -- experience digestive symptoms related to their menstrual cycle.

Symptoms Throughout the Cycle

Whether or not you have IBS, researchers have found that the different phases of the menstrual cycle put women at risk for unwanted digestive symptoms.

In the days of the month immediately following ovulation, all women are more likely to experience bloating and constipation.

Things change as you get closer to and start menstruation. In the days just prior to menstruation (pre-menstrual) and for the first day or two when bleeding starts, women are more likely to experience abdominal pain, diarrhea, and nausea.

IBS and the Menstrual Cycle

For many women with IBS, their across-the-board IBS symptoms worsen when they have their periods.

For some, their systems are more reactive to food in the days surrounding menstruation, particularly gassy foods. (Interestingly, one survey found that a small number of women actually experience an improvement in IBS symptoms during menstruation.)

In addition to worsening of IBS symptoms, having IBS also appears to put women at a higher risk for experiencing the following symptoms associated with menstruation:

  • Dysmenorrhea (painful cramping)
  • Backache
  • Difficulty concentrating
  • Fatigue
  • Insomnia, 
  • Water retention

However, there is some good news. Women with IBS are not at higher risk to experience the mood-related changes commonly associated with premenstrual syndrome (PMS), and the rest of the menstrual cycle.

Why are women who have IBS at higher risk for menstrual-related digestive and other unpleasant symptoms? Currently, there are no good answers to that question. Studies have not found any difference in the hormone levels of women with and without IBS. And in spite of the fact that the sex hormones appear to play a role in GI symptoms, birth control pills and hormone replacement therapy have not been found to be of any help in alleviating them (nor do they do any harm in terms of worsening one's IBS).

What You Can Do

1. Keep a symptom diary: This doesn't have to be anything complex - just keep a running record of your symptoms as it relates to where you are at in your menstrual cycle. This will allow you to look for patterns and to identify when your symptoms are likely to be at their worst.

Having some sense of what to expect on each day of your cycle can help you to plan. Perhaps you tweak your diet so that you avoid gassy foods and choose non-gassy foods on your worst days. You can also try to adjust your schedule so that you postpone events that might be more stressful to days when your symptoms are more likely to be quiet.

2. Invest in a heating pad or hot water bottle: Continuous heat can be quite soothing, both in easing menstrual cramps and soothing IBS pain.

3. Take a calcium supplement: This recommendation is of particular help to those of you who experience diarrhea as part of your IBS. Calcium supplementation has been shown to be effective in reducing menstruation-related symptoms and has some "word of mouth" buzz as being helpful for reducing diarrhea symptoms in people who have IBS. 


Jacobs, S., et. al. "Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group. American Journal of Obstetrics & Gynecology 1998 179:444–452.

Palsson, O. & Whitehead, W. "Hormones and IBS" The UNC Center for Functional GI & Motility Disorders. Accessed February 5, 2010

Palsson, O., Whitehead, W., Turner, M., van Tilburg, M. & Kanazawa, M. "Results of a National Survey on the Effects of Changes in Female Sex Hormones on Irritable Bowel Syndrome" The UNC Center for Functional GI & Motility Disorders. Accessed February 5, 2010.

Heltkemper, M. & Jarrett, M. "Gynecological Aspects of Irritable Bowel Syndrome" International Foundation for Functional Gastrointestinal Disorder Fact Sheet. Accessed February 5,2010.

"Women and Irritable Bowel Syndrome (IBS)." The UNC Center for Functional GI & Motility Disorders. Accessed February 5, 2010.

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