Hormones and Gastrointestinal Problems: How Periods and Menopause Affect Your Gut

Hormones like estrogen and progesterone can affect digestion, overall gut health, and symptoms of irritable bowel syndrome.

If you have ovaries (organs attached to the uterus), you likely produce hormones called estrogen and progesterone. These chemical messengers affect all parts of your body, including your gut. Changes in your hormone levels can cause gastrointestinal (GI) symptoms⁠— and stomach or intestinal conditions can affect your period, too.

Changes in your hormones can cause or worsen symptoms of irritable bowel syndrome (IBS), a condition with symptoms of constipation, diarrhea, bloating, and gas. Since these symptoms are affected by changes in your hormones, you may expect to notice them at different times around your period or when starting menopause.

To learn more about hormone-gut interactions and how to ease your symptoms, Health spoke to Shilpa Ravella, MD, assistant professor of medicine at Columbia University Medical Center.

GI Symptoms Before and During Your Period

Your hormone levels change during and between your periods. One week before your period arrives, your progesterone levels spike. "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," Dr. Ravella said. Then, your estrogen levels dip just before your period, which can slow down digestion.

After your period, your estrogen levels start increasing again. These changes may cause your digestive tract to spasm and increase gastric motility, or the movement of food through your system. This can lead to diarrhea.

Your period can be very different throughout your life depending on whether you take birth control, give birth, or are just getting older. However, this pattern of hormone changes will still occur when you have periods.

What You Can Do: "Drink lots of water, and eat a diet high in fiber," Dr. Ravella said. "That will help with diarrhea and constipation." Move daily, too—according to a 2015 Breast Cancer Research article, exercise can lead to lower levels of sex hormones like estrogen and progesterone. If your gut symptoms impact your daily life, see a gastroenterologist or your ob-gyn.

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GI Symptoms Before Menopause

The transition to menopause (which is when you haven't had a period in a full year) involves gradually decreasing levels of hormones like estrogen and progesterone. That can trigger issues like bloating and constipation, according to 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," said Barbara Soltes, MD, a gynecologic endocrinologist at Rush University Medical Center in Chicago. "It can feel like a cascade effect."

What You Can Do: "There's actually a lot you can control," Dr. Soltes said. "It's crucial to eat whole foods, especially fresh vegetables, and exercise regularly." These behaviors can prevent weight gain, improve your gastric motility, and benefit the health of your gut microbiome.

If you are worried about your hormone levels, it may be helpful to see a certified menopause practitioner. Many people also say they feel better once they no longer have their periods.

How Your GI System Affects Your Hormones

Your gut can affect your hormones, too. "It secretes an enzyme that increases free estrogen in your system, which we believe may contribute to estrogen-related diseases," Dr. Soltes said. These changes may be due to your gut microbiome, the helpful organisms in your gut.

What You Can Do: 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 recommended a probiotic supplement to ensure you get enough of the helpful microbes.

Erika Schwartz, MD, author of The New Hormone Solution, also recommended asking your healthcare provider about digestive enzymes, "which help your body metabolize and process food better—all of which improves your gut biome and your hormonal balance."

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