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Irritable Bowel Syndrome & the Menstrual Cycle

Irritable bowel syndrome causes chronic abdominal discomfort or pain, bloating and gas, along with constipation or diarrhea, or both. The condition involves abnormal muscle action and increased nerve sensitivity in the colon. Women are about three times more likely than men to have irritable bowel syndrome, and symptoms can be worse during menstruation.

  1. Symptom Worsening

    • IBS Research Appeal notes that nearly half of women with irritable bowel syndrome report a worsening of their symptoms during menstruation, including pain, gas and diarrhea. One study indicating this appeared in a 2003 issue of the American Journal of Gastroenterology. Because women report more symptoms during their periods, researchers theorize that reproductive hormones may have an impact on the disorder.

    The Cycle

    • The menstrual cycle begins with the follicular phase on the first day of menstruation and usually lasts from 10 to 14 days, when ovulation occurs. The premenstrual, or luteal, phase follows. The follicular phase is marked by rising levels of estrogen and low levels of progesterone, while the luteal phase has a corresponding rise in progesterone. If pregnancy does not occur, these hormone levels drop and are at their lowest during menstruation.

    Hormone Fluctuations

    • According to research cited by IBS Research Appeal, in both the follicular and the luteal phase, average transit time for food to move through the entire digestive system is similar. Rising estrogen and progesterone levels do not seem to affect irritable bowel syndrome symptoms, except for a trend to constipation during the luteal phase in some women. During menstruation, when these hormone levels are low, women report more bowel movements. Women prone to constipation in particular experience more frequent bowel movements during menstruation

    Rectal Sensitivity

    • A study published in the journal Gut in 2002 found that women with irritable bowel syndrome experienced increased rectal sensitivity during their periods, while women without the syndrome did not. The study compiled responses to balloon distension of the rectum during four different time frames of the menstrual cycle.

    Further Significance

    • Patients in the Gut study also kept diaries to track abdominal pain and bloating, and frequency and consistency of bowel habits. Among participants with irritable bowel syndrome, menstruation was linked with a worsening of abdominal pain and bloating, and more frequent bowel habits. The study showed that even in women without the syndrome, stools were looser and occurred more often during menstruation.

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