The IBS cycle: periods and IBS
If you have IBS and want to gain clarity around less-known IBS triggers and understand why your symptoms are so variable and can feel better or worse around your period, keep on reading!
There are twice as many women who live with IBS as men. This difference in how common IBS is in men and women appears in early puberty, but something interesting happens when women enter peri-menopause or menopause- the numbers of women diagnosed with IBS start to decrease. By the time women reach 70, the rates of diagnoses become the same as in men! In contrast, there is no such fluctuation in the numbers diagnosed in men; it seems to not change much throughout their lifespan. These differences in the prevalence and the rates of diagnosis between men and women across the lifespan encouraged the thinking that IBS is a sex hormone-sensitive condition.
Your sex hormones, oestrogen and progesterone, impact the movement of the gut; specifically, these hormones are known to reduce the muscle contractions in the bowel lining, which in turn slow down bowel movement, making it more sluggish. Oestrogen rises just before ovulation, then drops down again after. Both oestrogen and progesterone rise up in the luteal phase and drop down again a couple of days before your period. So what does this all mean in terms of IBS symptoms? If you tend to have diarrhoea, the second part of the cycle (ovulation to a couple of days before menses) may feel more comfortable for you. If you tend to lean towards constipation, this is when you will feel most uncomfortable. There is no 'one-size-fits-all' advice for how to manage this part of the cycle, but most women would benefit from considering the following 5 tips:
- Avoid large meals and instead go for ‘little & often’, e.g. 3 small meals and 3 nutritious snacks a day.
- Don’t overindulge fermented foods- they are tasty and healthy, but can worsen bloating.
- Limit gas-producing foods e.g. beans and pulses, sprouts, cauliflower, and also sugar-free mints/chewing gum.
- Make sure to have plenty of vegetables and whole-grains, but don’t increase the amount you eat all of a sudden- this can make your symptoms worse. Also, don’t add extra wheat bran, it can actually make your bloating and constipation-related symptoms worse.
- Food digestion starts in the mouth- take time to eat in a calm environment and chew your food well.
Oestrogen and progesterone also impact pain perception. Research tells us that low levels or rapid decreases in these hormones make the gut and the body more sensitive to pain. Oestrogen and progesterone levels drop just before the menses and remain low in the early menses, and many women report abdominal pain around this time. When my clients experience IBS symptoms, they automatically tend to run through what they ate before or find another explanation for the symptoms. Understanding that you may be more sensitive to what's going on in your digestive system may help reduce the worrying, which by its very nature can help prevent the worsening of the symptoms. Instead, you can plan dietary changes and use helpful strategies, like breath-work, prioritising sleep and gentle movement to manage this trickier part of the month.
IBS can be challenging and difficult to predict, but I hope that with this information you will be able to understand your symptoms better and can make a plan for dietary and lifestyle strategies specific to your 'IBS cycle’.