the link between PCOS and IBS

Have you ever noticed changes in your bowels around the time of your monthly bleeding? It can feel hellish and confusing when you already have hormonal bloat and then your gut expands even more from digestive discomfort. But that’s only part of the endless interaction between our intestine and reproductive system.

“The menstrual cycle is a complex system controlled by female sex hormones, primarily estrogen and progesterone. Levels of these hormones rise and fall throughout the menstrual cycle and can affect the gut in different ways,” explains Dr Claire Shorttnutritionist and scientific manager at digestive health brand FoodMarble.

How do our periods affect our gut health?

“When progesterone levels begin to rise after ovulation, it can cause constipation and gas buildup. This is because it reduces intestinal muscle contractions and can slow down digestion, as well as the movement of gas in the stomach. digestive system,” says Dr. Shortt. This explains why you may be a little less regular in the days leading up to your bleeds.

“In contrast, fatty acids called prostaglandins are released during your period and can cause intestinal cramps. This can lead to more frequent bowel movements and sometimes diarrhea,” she adds. uterus and bowel can be painful, which can be further aggravated by a change in sex hormones lowering your pain threshold during this time.”

And the drop in progesterone can also alter your appetite, which is why we crave salty or sweet foods. To add to this, the body retains more water and salt, which explains the bloating.

What is the connection between PCOS and IBS?

If all of these huge changes occur in women with normal menstrual cycles and gut health, what happens to those who are already dealing with conditions in one system or the other?

“Due to the impact of estrogen and progesterone on bowel movements, your pain threshold, and inflammation, menstruation can trigger symptoms of irritable bowel syndrome (IBS) in people with the condition,” explains Dr. Shortt.

Statistics also show that 42% of women with PCOS – polycystic ovary syndrome – also suffer from IBS or some type of gastrointestinal (GI) disorder.

“People with PCOS have different levels of certain hormones, including luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. Elevated levels of these hormones can contribute to IBS symptoms, and Hormonal imbalances can slow down our motility (how quickly food moves through the gut), which can lead to constipation,” says Dr. Shortt.

A 2020 study proved this, showing that the majority of PCOS patients have constipation-dominant IBS, with “the cause of this variant [being] due to high hormone levels in PCOS that interfere with bowel function.

Illustration of a woman holding her stomach in pain
Your Menstrual Cycle Can Also Influence Your Gut Health

The researchers also reported that stress is also a huge influencer in both conditions. “The onset and severity of IBS symptoms are linked to acute and chronic stress. Therefore, patients with IBS have stress hyperactivity,” they wrote.

It has also been shown that chronic stress can lead to a change in the “hypothalamic-pituitary-adrenal axis” – the way the hormonal systems of the brain, ovaries and stress glands link – in patients with Alzheimer’s disease. both IBS and PCOS.

The huge influence that the gut microbiome has on our overall health also cannot be overlooked, says Dr. Shortt. “Other common symptoms of PCOS include acne, inflammation, and bloating — all of which are microbiome-related,” she says.

In a 2021 reviewresearchers reported that “changes in gut microbiota correlate with hyperandrogenism [excessive levels of testosterone, androsterone and androstenedione in women], indicating that high levels of testosterone may regulate the composition of the gut microbiome in women. They even found preliminary evidence that taking pre- and probiotics helped some PCOS symptoms by leveling out gut bacteria.

How to Take Care of Your Gut and Reproductive Health

The first step to supporting your body is to notice the patterns so you don’t panic when your bathroom routine changes completely before and during your period. While you can’t do much about these fluctuations, there are ways to ease symptoms and take care of your hormonal and gut health.

“If bloating and gas retention are an issue for you, light exercise can help improve digestion and remove excess gas from the gut,” says Dr. Shortt. Exercise is also a long-term way to improve the gut microbiome and reduce PCOS symptoms. “Regular exercise (at least three times a week, 30 minutes a day) or simply increasing your daily step count can help keep cortisol levels low and reduce androgens (characteristic triggers of PCOS)” , she adds.

“Limiting alcohol and caffeine have been shown to relieve symptoms in people with both PCOS and IBS, as both are intestinal irritants and can increase motility. And stress relief also helps relax muscles and aid digestion.

Whether it’s through yoga, meditation, or breathing exercises, finding something that helps you stay calm is crucial for hormonal health. Some other methods, like peppermint tea, anecdotally work to soothe an upset stomach. If you are worried about your gut and your menstrual cycle, be sure to talk to your GP. Otherwise, know that you are not alone with your toilet-related PMS symptoms.

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