Experts are just starting to understand this powerful connection—and what it really means for your digestive system.

By Camille Noe Pagan
April 23, 2020
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Around your period

Familiar with PMS belly? Blame progesterone, which spikes about a week before your period arrives. “It’s a muscle relaxant that can relax the colon and slow transit time of food in your intestines, [so] you might experience bloating and constipation,” says Shilpa Ravella, MD, assistant professor of medicine at Columbia University Medical Center. Likewise, a dip in estrogen just before your period can also slow down digestion.

But not all women get backed up at this time of the month—some have to deal with diarrhea. One reason is that shifting estrogen levels may cause spasms in the digestive tract and increase motility, or the movement of food through your system.

Ease the symptoms: “Drink lots of water, and eat a diet high in fiber,” says Dr. Ravella. “That will help with diarrhea and constipation.” Move daily, too—in addition to lowering levels of gut-agitating hormones, exercise helps keep you regular. If your GI woes make it impossible to live your life, see a gastroenterologist or your ob-gyn.

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During Perimenopause

The transition to menopause (which is when you haven’t had a period in a full year) involves gradually waning levels of female hormones. That can trigger issues like bloating and constipation throughout the month, says Dr. Ravella. On top of that, “estrogen changes impact your metabolism, which can lead to [more] fat, which may affect your weight and gut biome—causing more gut problems,” says Barbara Soltes, MD, a gynecologic endocrinologist at Rush University Medical Center in Chicago. “It can feel like a cascade effect.”

Ease the symptoms: “There’s actually a lot you can control,” says Dr. Soltes. “It’s crucial to eat whole foods, especially fresh vegetables, and exercise regularly.” In addition to staving off weight gain—which isn’t inevitable, says Dr. Soltes you’ll improve your gastric motility and the health of your microbiome. Worried your hormones are really out of whack? It may be helpful to see a certified menopause practitioner (look up providers at menopause.org). Happily, many women say they feel better once they’re no longer getting their periods.

Bugs with Benefits

Turns out your gut might affect your hormones, too. “It secretes an enzyme that increases free estrogen in your system, which we believe may contribute to estrogen-related diseases,” says Dr. Soltes. And your gut flora appear to be key, because changes in those bacteria are tied to changes in estrogen levels. The good news: Your daily habits can go a long way toward nourishing a healthy intestinal ecosystem. Aside from eating nutritious fare, including plenty of probiotic rich foods, Dr. Soltes recommends a probiotic supplement to ensure you get enough of the helpful microbes. Erika Schwartz, MD, author of The New Hormone Solution, also suggests asking your doc about digestive enzymes, “which help your body metabolize and process food better—all of which improves your gut biome and your hormonal balance.”

This article originally appeared in the May 2020 issue of Health Magazine. Click here to subscribe today!

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