Bloating, cramps, moodiness and headaches are just a few of the many uncomfortable symptoms of menstruation, but periods can be even more complicated for women who suffer from inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS).
Menstrual cycles are regulated by hormones like estrogen and progesterone, as well as hormone-like chemicals called prostaglandins. When these hormones are off-balance, it can affect a woman’s monthly cycle.
Data shows that hormonal changes and irregular cycles are often associated with IBD diagnoses. One study of 121 women with IBD found that 25 percent experienced a change in their menstrual cycles the previous year. This could mean that menstrual irregularities could be a precursor to IBD in females, so it may be advisable to screen newly-diagnosed IBD patients for menstrual irregularities (Everyday Health).
Not only do menstrual irregularities often accompany IBD/IBS diagnoses, digestive disorders can make symptoms worse. Some women claim having IBD or IBS intensifies premenstrual symptoms. They report increased levels of abdominal discomfort, tiredness, mood swings and depression compared to women who do not have digestive disorders.
There is also a clear relationship between hormonal changes and digestive motility. Women with digestive disorders like Crohn’s disease or ulcerative colitis are more likely to have gastrointestinal problems like diarrhea during their monthly cycles. So IBD/IBS can make both period symptoms and GI symptoms worse during periods.
These intensified symptoms are due to the increase of progesterone and prostaglandin levels during the premenstrual phase, and prostaglandins stimulate muscle contractions. The hormone that is responsible for contractions in labor pain and menstrual cramps is the same hormone that contracts the large intestines and causes diarrhea (National Library of Medicine).
While everyone is different, some women have found relief from menstrual and GI symptoms through one or more of these methods:
Supplementing with evening primrose oil — Evening primrose oil acts as a prostaglandin blocker, which can help reduce abdominal contractions that cause cramping and intestinal contractions that cause diarrhea. It also has high levels of gamma-linolenic acid (GLA), an essential fatty acid that has been shown to reduce inflammation.
Taking prescribed SSRI medication — Medications called selective serotonin reuptake inhibitors (SSRIs) can provide relief from premenstrual or menstrual symptoms like mood swings, insomnia and appetite disturbances.
Taking oral contraceptives — Birth control pills prevent ovulation and block high premenstrual levels of progesterone.
Never start a new medication or supplement before talking with your doctor. If you notice that your periods are irregular, that your GI symptoms get worse during your period, or that your premenstrual symptoms are more intense than before, make an appointment with a gastroenterologist. A GI specialist can recommend a specific treatment plan based on your symptoms and medical history.