We all know about IBS AND MENSTRUAL CRAMPS, the pain, the bloating, the wind, the diarrhea and the constipation.
Have you noticed that your symptoms are worse when you have a period?
This is quite a common problem, but why should they worsen?
Well, we know HORMONES have a significant effect on your body.
Whether you have Irritable Bowel Syndrome or not, pregnancy often precipitates gut symptoms.
If you have been pregnant before, you will be well aware that you can experience constipation, haemorrhoids, nausea, vomiting and reflux.
This is thought to be due to the effect of oestrogen on the bowel muscles and the way they contract.
It’s no surprise then that, with changes in the levels of the hormones oestrogen and the progestogens, your bowel should change.
Women find emotions change with emotional volatility (you only have to suffer from PMT or premenstrual tension to realise this) around the time of their period.
They also have a heightened awareness of symptoms during menstruation.
What other evidence have we got for the hormonal effect on the bowel? Well, there are other hormone conditions that can affect the bowel too.
Steroid deficiency problems such as Addison’s disease can cause diarrhea issues.
An overactive thyroid can cause diarrhea and constipation occurs when the gland is underactive.
There have been a few STUDIES that have looked at menstruation issues.
One study looked at young Taiwanese women with Irritable Bowel (Gastroenterol Nurs. 2011 Jul-Aug;34(4):277-86. The association between the exacerbation of irritable bowel syndrome and menstrual symptoms in young Taiwanese women. Jane ZY, Chang CC, Lin HK, Liu YC, Chen WL).
This was a questionnaire study of 971 female high school students.
The researchers found that the prevalence rate for Irritable Bowel in this group was 16.2%, a figure that is compatible with the known rate of 1:5.
In these women, they ranked abdominal pain as their worst symptom with bloating coming second worse during their period.
Another study looked at 46 women with IBS and menstruation symptoms (Am J Gastroenterol. 1998 Oct;93(10):1867-72.
The menstrual cycle and its effect on inflammatory bowel disease and irritable bowel syndrome: a prevalence study. Kane SV, Sable K, Hanauer SB) and found that 93% of the women had heightened pre-menstruation problems.
These findings were also confirmed by a review of the literature seen in the published paper: Gend Med. 2009;6 Suppl 2:152-67.
Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome? Heitkemper MM, Chang L. This looked at 16 studies related to menstrual changes and the effect on IBS. They found evidence for heightened symptoms with changing levels of oestrogens and progesterone.
You would think that the use of the oral contraceptive pill might have an effect.
However, the evidence for this is lacking. Some sufferers do feel their intestine is affected by the pill, but I have been unable to find any studies to back this up.
As for the future, sometimes symptoms improve with the menopause.