Introduction: Gut-Related Period Pain & A Stressed Out Digestive Tract

Oftentimes, female clients in my practice report an aggravation of symptoms around and during their menstrual cycle. Considering 90% of women experience premenstrual syndrome (PMS), and the widespread impact of hormones on many biological processes, this makes sense.

Some of the most common complaints women experience, besides mood, are gastrointestinal issues. In fact, it is estimated that one-third of healthy women experience digestive disturbances before and throughout their period.

In this article, I highlight the powerful connection between the gastrointestinal tract and the endocrine system. Next, I discuss how the menstrual cycle affects the gut (based on my published article on Rupa Health). Finally, I offer some naturopathic and functional medicine tips for managing hormone-related gut distress.

Although a large part of this post is geared to the biological ladies, all genders can benefit.

This is for several reasons:

  • The gut-hormone link is important to be aware of, as sex hormones exist in all bodies.
  • It can provide an understanding between partners as to why one’s symptoms may be aggravated during certain times of the month.
  • All humans should be familiar with how stress and hormones impact the functioning of our gut, as no one escapes stress these days.
  • It provides an appreciation for nature’s delicate and intricate regulation of the human body.

So, everyone…

Let’s now review the interplay between our hormones and our digestive tract.

The Powerful Influence of the Hormone-Gut Relationship

Hormones are powerful chemical messengers that have receptor sites throughout the whole body. They are responsible for coordinating many vital bodily interactions. These include regulating:

  • homeostatic balance (e.g. blood pressure, blood sugar, temperature, digestion and metabolism, cellular energy, etc.)
  • reproduction, fertility, and sex drive
  • growth and development
  • responses to injury, stress, infections, and/or environmental factors
  • mood

This is why hormonal fluctuations during one’s menstrual cycle can result in the observed premenstrual syndrome (PMS) symptoms of mood swings, cramps, and gastrointestinal (GI) issues.

When these hormonal shifts specifically impact the gut, a cascade of unwanted responses can become amplified. This is because the digestive tract is a key area for maintaining health, resiliency, and emotional tone. Furthermore, the GI tract helps regulate hormone excretion and secretion. This means the resulting gut symptoms can exacerbate hormonal and reproductive symptoms (in both sexes).

For example, besides supporting the assimilation and absorption of nutrients and excretion of wastes, the GI system also contains over 70% of our immune cells, produces 90% of our serotonin, makes various neurochemicals, communicates with our brain to help supervise various bodily functions (through the gut-brain axis), and even impacts the skin.

Understanding the ramifications of how these two systems can have such systemic impact will give you an appreciation of how an imbalance in either can compound symptoms. Therefore, both need to be addressed for lasting digestive and hormonal harmony.

With that in mind, I’ll now get into more specific details on how a woman’s hormonal fluctuations throughout the month impact her digestive processes. Stress effects on our gut will also be reviewed.

6 Ways the Menstrual Cycle (and Hormones) Impacts the Gut

As stated in my article on Rupa Health:

Before and during the menstrual cycle, women often experience gastrointestinal discomfort, constipation, diarrhea, and alterations in the frequency of bowel movements. These changes have been referred to as “period poop.”

The gastrointestinal shifts during a women’s cycle occur for several reasons. They can differ in severity based on a woman’s overall health and underlying reproductive and gastrointestinal conditions.

Below are the six ways the menstrual cycle impacts the gut.


1. Prostaglandins Signal Uterine and Gut Muscle Contractions

During one’s period, more compounds called prostaglandins are released. Prostaglandins have diverse roles in the body including modulating inflammation, stimulating muscle contractions in the gut and uterus, and repairing tissue damage. They also regulate several reproductive processes such as shedding the uterine lining during menstruation.

Prostaglandins signals to the GI tract can lead to increased bowel movements, diarrhea, softer stools, and menstrual cramping. The resulting increase in contractions can also amplify existing gut and menstrual discomfort and further alter bowel frequency.


2. Sex Hormones Influence on the Gut

Hormones impact the gastrointestinal (GI) tract’s motor, sensory, and immune function. This is through their interaction with neurotransmitters via the gut-brain axis.

As a result, the fluctuations in hormonal levels during the monthly cycle can contribute to alterations in pain sensitivity, motility, gut permeability, local and systemic inflammation, and immune imbalances:

This can lead to a worsening of bowel symptoms and uterine discomfort.

Emotional symptoms can also occur in conjunction with GI symptoms via the gut-brain axis. These can exacerbate distress.

As hormones rise and fall, changes in stool consistency and frequency can be predicted. In healthy women, stools are often looser and more frequent with their period but firmer during the luteal phase (post ovulation to the first day of one’s menstrual cycle). During the luteal phase, delayed gastrointestinal transit and constipation can also ensue.


3. Hormonal Aggravations of GI Conditions

Women with various bowel disorders likely respond differently to hormonal variations and increased prostaglandin signaling. Gut conditions that can worsen during hormonal shifts include irritable bowel syndrome (IBS) and irritable bowel disease (IBD).


4. Gut Issues Aggravated by Hormonal Conditions

Women with endometriosis, a painful condition in which the tissue lining the uterus grows outside of it, often experience more digestive issues with their period.  As stated in my Rupa Health article:

Inside the uterus, this tissue builds and sheds each month during the menstrual period. But in endometriosis patients, the endometrial-like tissue also builds up and sheds, but it does not have a way to exit the body. This can cause pain, spasms, and gastrointestinal disturbances.


5. Cravings and Dietary Shifts

In my article, I explain the connection between cravings, dietary shifts, and how the gut is affected:

The brain has receptors for estrogen, which suppresses hunger by lowering ghrelin levels and stimulating cholecystokinin, an appetite-suppressing hormone.

When estrogen drops and progesterone peaks about one week before menstruation begins, hunger increases, and cravings kick in. As a result, a shift in diet occurs, which can impact the microbiome.

These changes can cause differences in the consistency, regularity, or smell of the stool before or during one’s period.


6. Stress on the Gut

Stress has the following impacts on the gut:

  • affects gut motility
  • increases pain sensation in the organs
  • alters intestinal secretions
  • influences gut permeability and blood flow
  • shifts the microbiota

The hormonal variations before and during one’s period influences the brain’s response to stress and changes one’s mood. This can modify the communication between the gut and brain and affect the “rest and digest” branch of the autonomic nervous system. As a result, the digestive process is hindered and discomfort in the GI tract can be exacerbated.

Functional Medicine Lab Tests for Assessing Hormone-Gut Health

In my article, I review several laboratory tests a practitioner may choose to run to analyze the correlation between hormonal changes and GI distress (and vice versa). These include the following:

  • a comprehensive stool test
  • a neurotransmitter test
  • comprehensive hormonal panels


Functional and Naturopathic Medicine Approaches to Ease Menstrual Cycle and Stress-Related Digestive Symptoms

Nutrition, exercise, sleep, stress reduction, essential oils, and specific herbs and supplements are highlighted in my article published on Rupa Health. Some botanicals are more specific for the biological female, but many of these benefit digestive health for everyone. I encourage you to access the specific details on Rupa Health’s website.

I’ve excepted some parts from the essential oils section below:

Aromatherapy, which includes clary sage, lavender, geranium, rose, and neroli, has been shown to help to balance hormones by supporting estrogen levels.

Peppermint oil has been found in many trials to be useful for a variety of general digestive-related complaints. Peppermint oil contains L-menthol. This compound can block calcium channels in smooth muscle which creates an antispasmodic effect on the gastrointestinal tract. It also possesses antimicrobial, anti-inflammatory, antioxidant, immunomodulating, and pain-relieving properties. These characteristics can help calm the bowels and reduce the discomfort associated with IBS.


Summary on the Gut-Hormone-Stress Link

In summary:

The hormonal shifts that occur with the menstrual cycle influence the gastrointestinal tract for various reasons. Changes in prostaglandins, sex hormones’ interactions with gut and brain neurotransmitters, underlying gut and endocrine issues, stress, cravings, and dietary shifts all impact a woman’s experience…during her cycle.

Thankfully, addressing the root cause with lifestyle medicine, stress reduction, mind-body modalities, nutrition, herbs, and supplements can help to bring the hormones and gut back into balance.

These modalities can also ease stress and hormone-related digestive health issues in all genders.

What are your thoughts? Please share your comments below.

Naturopathic Medicine and Holistic Resources for Hormonal and Mood Support

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Many blessings.



Access all references in the original Rupa Health article here.

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Disclaimer: This material is for information purposes only and is not intended to diagnose, treat, or prescribe for any illness. You should check with your doctor regarding implementing any new strategies into your wellness regime. These statements have not been evaluated by the FDA. (Affiliation link.)

This information is applicable ONLY for therapeutic quality essential oils. This information DOES NOT apply to essential oils that have not been tested for purity and standardized constituents. There is no quality control in the United States, and oils labeled as “100% pure” need only to contain 5% of the actual oil. The rest of the bottle can be filled with fillers and sometimes toxic ingredients that can irritate the skin. The studies are not based solely on a specific brand of an essential oil, unless stated. Please read the full study for more information.

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