The dreaded period poop

What the heck - isn't there enough going on without your bowels going off the rails?  Sheesh!

Period poops refers to a temporary change in your bowel habits (and poop) that can occur just before and during the first few days of your period. This is usually due to changes in your diet and activity levels as we all changes in your hormone and prostaglandin levels. For some women it isn’t really an issue but for others it's a bigger issue than the actual period. 

Loose goosey?

Having loose bowels or diarrhoea may be because of increased amounts of prostaglandins which can cause your bowels to contract more. This causes the stool to move through the bowel more quickly and so it is loose or even liquid when you pass it.

Prostaglandins can also cause period cramps, and they are what NSAIDS (e.g. ibuprofen) work on.  Prostaglandins are hormone-like molecules that are involved where there is tissue trauma or injury, including menstruation.  They have a range of roles in the body, including affect the contraction and relaxation of smooth muscle, the dilation and constriction of blood vessels, control of blood pressure, inducing labour, platelet function and control of bleeding, as well as influencing inflammation.

In the couple of days before a period the endometrial cells (that make up the lining of the uterus) produce a lot of prostaglandins and when those cells break down during menstruation they release prostaglandins which ideally help the small arteries in the uterus contract and so control bleeding.  What can also happen is they cause constriction of blood vessels in the muscle of the uterus (the myometrium) and this causes cause pain by reducing oxygenated blood to the myometrium as well as causing it to contract and cramp.

Those prostaglandins can also affect the bowel, causing it to contract and relax, and the more you have the more likely it is you’ll have loose bowels, or period diarrhoea.  Prostaglandins might affect your absorption of food and your electrolytes (including sodium and potassium) which can influence how much liquid goes into you bowels and how much is reabsorbed into your blood; the more liquid in your bowel, the more bloated you feel and the more likely you will have loose bowels.  Some women can also feel a nauseated at this time (which can also be cause by pain). Phew, it's a lot!

Or constipated?

This is where progesterone comes in.  Progesterone is made in the corpus luteum, the shell that is left once you ovulate, so it is highest in the week or two before your period (the luteal phase).  One of progesterone’s jobs is to keep your uterus nice and relaxed so it doesn’t contract too much and potentially expel an embryo.   Progesterone also relaxes the muscles of the digestive tract making it more sluggish and increases the chances of being constipated.  Apart from calming down your uterus, progesterone can help you feel more relaxed and makes PMS milder.

Some women will have both.  They might have constipation as the progesterone increases during the luteal phase, and then just before the period as the progesterone drops the prostaglandins increase and bazinga, now you’ve got diarrhoea. 

Having endometriosis or adenomyosis, or any gut issues like IBS or Crohn’s disease can make bowels changes with your period more significant.

Conquering period poops

• Take notice of how your bowels are throughout the whole cycle, and also what affects them.  For instance, does coffee make you have your bowels open?  If so, then maybe cut back around your period if you get diarrhoea.
• Try to eat your regular diet – if you eat veges and protein 3 weeks of the month and then for one week you live off chips and chocolate, even without your period this is going to make things a bit tricky.
• As always, have lots of soluble and insoluble fibre: think, veges and fruit (especially whole, with the skin where you can), wholegrains, legumes, nuts and seeds.
• Avoid saturated and transfatty acids, especially in fried foods; these can increase the prostaglandin effect.
• Include foods rich in omega 3 fatty acids, like oily fish, chia seeds, linseeds and their oils.
• Minimise sugar and refined foods.
• Including ginger and green tea may reduce prostaglandins.
• Green leafy veges and wholegrains are good for magnesium which helps muscle relaxation and can reduce diarrhoea and cramps.
• Move your body – run, go to the gym, do the gardening, walk the dog, dance – whatever you enjoy.
• Seek treatment for any underlying gut issues or endometriosis or adenomyosis

And if you need further help, then seek support form a health professional.  I also use nutritional supplements and herbal medicine to help even out prostaglandins and progesterone.