Illustration by Marta Pucci
The truth about your period poop: your menstrual cycle and bowel movements
Does your poop change on your period?
Top things to know:
In the last year, 36% of Clue users tracked digestion or stool-related issues.
You’re more likely to experience changes in your bowel movements, including period poops, at the beginning of your period.
Hormonal fluctuations in progesterone, estrogen, and prostaglandin may trigger period-related gastrointestinal symptoms.
People already living with some gastrointestinal discomfort may be more likely to experience period poops.
Have you ever felt like everything you eat during the beginning of your period seems to upset your digestive system? Do you find that gas is especially problematic right before menstruation? Or do you notice bloating or bowel issues that your diet can’t explain?
Good news: It’s not all in your head. Your gastrointestinal tract, or your stomach and intestines, is influenced by your menstrual cycle and can affect your digestion and bowel movements. Let’s talk about the whys and hows of the menstrual cycle and gastrointestinal symptoms.
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Period poop is a real phenomenon
You’re more likely to hear about period cramps or PMS when people talk about their period woes, but bowel habits can also change throughout the menstrual cycle and be bothersome. Women and people with cycles often report abdominal pain, loose stools, indigestion, constipation, and reflux around the time of their periods, particularly on the first day of their period, also known as menses (1). People with existing irritable bowel syndrome (IBS) may have more gastrointestinal symptoms, leading up to and during their period (2).
Substances called prostaglandins can cause period poop
Prostaglandins are hormone-like substances that exist all around the body. They are involved in inflammation, and in this case, in the process of menstruation, but could also be a contributing factor to changes in digestion and the way you poop (3).
Menstruation occurs due to the normal localized inflammation process in the uterus (3). This inflammation, involving the reproductive hormone progesterone, and the hormone-like substances prostaglandins, helps the uterine lining break down (3). When your body releases prostaglandins and other hormones, the smooth muscle in your uterus is stimulated to contract, and your endometrial lining, or uterine lining, releases from your uterus (4). As the lining breaks down, it exits through the vagina as the bleeding that we call the period (3).
Prostaglandins, combined with a sharp drop in the ovarian hormones progesterone and estrogen, may be responsible for gastrointestinal symptoms before and during menstruation (6). This could be because prostaglandins may also act on the nearby intestinal tissue, causing inflammation (6). Changes in estrogen and progesterone may also change your perception of pain (6).
Hormonal fluctuations may be responsible for changes in your bowel movements surrounding your menstrual cycle (2). Elevated levels of prostaglandins cause the digested food in your gastrointestinal tract to move faster than usual (2). Typically, progesterone slows down your food's journey through your tract. It relaxes the smooth muscles responsible for moving digested food (2). When your period begins, your levels of progesterone drop and prostaglandin levels rise, which may cause gastrointestinal symptoms like diarrhea (2).
‘Bloated’ was the top digestion symptom tracked in Clue last year. Tracking digestion and stool can help you know when to expect it
One study found that 58% of women with regular bowel movements experienced period-related changes in their bowel movements before, during, and after menstruation (7). This means that while not everybody experiences period poops, constipation, or other gastrointestinal symptoms during menstruation, many people do. If a person already has some bowel discomfort, they may be more likely to have bowel movement changes around menstruation (2,8). One study found that 27% of people with irritable bowel syndrome (IBS) experienced constipation during the luteal phase of their menstrual cycle due to hormonal changes (2). People with inflammatory bowel disease (IBD) may also see a significant change in their bowel movements around menstruation (8). One study found that 72% of participants with Crohn’s disease saw a change in their gastrointestinal symptoms during menstruation (8).
Prevent premenstrual bloating and period diarrhea by avoiding certain foods and making lifestyle changes
There isn’t a lot of research on how to treat the specific type of stomach complaints that accompany menstruation.
As a rule of thumb, when you have diarrhea, it’s good to drink fluids to replace what you lose through your period poop (9). If you have three loose stools in 24 hours, you may experience electrolyte imbalances (10,11). Electrolytes are charged minerals that help control your blood pressure, heartbeat, nerve impulses, and muscle contraction (12). Sipping sports drinks and eating soup might help manage electrolyte imbalances due to diarrhea (9,10). Avoid coffee, which can have a laxative effect.
If you experience constipation, temporarily increasing your fiber intake may help (13). Dietary fiber makes your stool larger (13). When you drink water throughout the day, it helps the fiber soften your stool (13). Larger, softer stools make it easier for your gastrointestinal tract to pass. Foods that are high in fiber include whole wheat bread, chickpeas, whole grains, almonds, and broccoli (13).
Experiencing bloating or trapped gas can feel like menstrual cramps. What you eat when you are bloated or have gas will be different from person to person (15). Some people may have difficulty digesting certain carbohydrates, which can worsen bloating and gas (15). If you’re lactose intolerant, avoid dairy products (15). If you’re usually symptomatic after sugary foods or drinks, you may have an intolerance to fructose (15). Avoid anything that normally upsets your stomach and try yoga poses that release trapped wind.
If your period poop or other gastrointestinal symptoms last for longer than a couple of days, check in with your healthcare provider for medical advice (9). If you are experiencing other symptoms of premenstrual syndrome, such as pain, they may advise you to take over-the-counter medication like ibuprofen.
Tracking digestion throughout your cycle
Tracking your digestive experiences can help you to keep an overview of your gastrointestinal symptoms throughout your cycle. With the Clue app, you can track when you’re feeling bloated or gassy, monitor constipation or diarrhea, and customize additional tags to track the experiences that matter to your unique cycle.
Speaking to your healthcare provider about your period-related digestion issues
Reporting your experiences and discomforts to your healthcare provider from memory often doesn’t reflect the true condition of your health and might not be the most reliable. Tracking your digestion and experiences daily and over a longer period helps you and your healthcare provider analyze patterns. When do your bowel movements change? Is there a relationship between your menstrual cycle, levels of stress, and food cravings? Do you notice that your abdominal pain is worse at a certain time of the month? Your healthcare provider might advise you about starting a form of birth control that can help you skip your periods, like oral contraceptive pills, the IUD, the shot, or the implant. Always ask about side effects before taking new medication.
Article originally published on September 25, 2018.
