The Links Between Gut Health and Menstruation

Women's Health | | Clara Wang
4 min read

Our bodies are mysterious machines made up of complex systems that are all interconnected. Many women are familiar with how uncomfortable PMS is, but they may not be aware of how gut health can impact their hormones, directly affecting their menstrual cycles – and vice versa.

Our bodies are home to a vast community of fungi, bacteria, and viruses that mostly reside in the skin and large intestine. This microbiome and their various genes contribute to a number of processes in your body, such as your immune system, digestion, and mood. Your hormones affect your gut microbiome, and since hormones direct your menstrual cycle, your gut microbiome plays a significant role with your period. 

How Estrogen and Your Gut Impact Each Other

Estrogen metabolism is managed by a specific group of bacteria in your gut known as the estrobolome. Most of the estrogen in your body is produced in your ovaries and then circulated all throughout your body, where it interacts with other organs and tissues. That active estrogen eventually will end up being filtered by your liver, where it is deactivated, and then sent off to your gut. When your estrobolome is balanced, most of the deactivated estrogen is processed efficiently through the large intestine and leaves the body through your stool. 

However, if your gut isn’t functioning properly, your estrogen levels can become nonoptimal. Certain types of gut bacteria produce an enzyme called beta-glucuronidase which has the effect of reactivating the inactive estrogen that was sent to your gut.

If you have an overpopulation of this type of bacteria in your gut, then active estrogen gets sent back and recirculated in your body at much greater levels than what your body was designed for. This can result in a host of problems, because the system that is supposed to reduce the estrogen levels in your body is doing the reverse.

An Unbalanced Gut Can Exacerbate PMS Symptoms

Since your gut health and microbial diversity impacts how well your body is handling estrogen, if your estrobolome is unbalanced, your estrogen levels may be too high and cause your periods to be much more uncomfortable than they should be. 

Estrogen Dominance 

Estrogen dominance is when your body’s estrogen levels are too high in relation to progesterone. While estrogen is a necessary and important hormone in the body, an imbalance in the body is bad news (just like with most other hormones). In this case, it can cause excess bloating, mood swings, headaches, etc.

You may be surprised to know that since PMS is directly correlated to your hormonal balance, PMS can actually improve when your estrogen and progesterone levels are balanced properly. This pathway of elevated estrogens released from the gut has such a significant impact on your body that a recent study even connects breast cancer development to gut dysbiosis.

Everybody’s sensitivity to estrogen levels differ, as do symptoms of estrogen dominance, but some common symptoms include:

  • Water retention
  • Irregular or heavy periods
  • Headaches, migraines
  • Weight gain
  • Hair loss
  • Fibrocystic breast changes
  • PMS
  • Painful periods
  • Mood swings
  • Low thyroid hormone

Period Symptoms Can Become Gut Issues

The gut impacts your menstrual cycle, and your menstrual cycle can also impact your gut. Like we said before- it’s all interconnected! Diseases that you may not think are connected to your hormones such as inflammatory bowel disease, irritable bowel syndrome, and Crohn’s Disease often flare up, worsen, or change as you go through your menstrual cycle.

PMS may bring on flu-like symptoms such as diarrhea or nausea in some women, which may be mistaken for purely gut problems. If you often experience changes in your gut condition during or in the days leading up to your period, you should record any patterns you see and speak to an OB/GYN or other specialist medical provider since it may be a sign of certain hormonal imbalances.

Period Poop: It’s Real

If you’ve noticed that your bowel movements change with your menstrual cycle, you’re not alone! “Period poops” are a completely normal thing to experience. Let’s break it down. Your progesterone levels rise in the week leading up to your period, which can cause the muscles around your digestive tract to relax. This helps balance the estrogen levels in your body, but can make you constipated.

The opposite may happen due to another hormone that comes into play- leading up to your period, levels of fatty acids called prostaglandins increase. Prostaglandins help to relax the smooth muscle tissues inside your uterus, causing the uterine contractions that are fondly known as cramps. These prostaglandins also have a similar effect on your digestive tract, which is why you may be running to the bathroom more often.

Although symptoms like constipation and diarrhea may feel like a stomach bug, they may not necessarily be due to gut issues. However, your gut is not only responsible for absorbing nutrients but also to make the hormones you need and break down the excess hormones, so doing your best to foster a healthy gut microbiome has the positive effect of allowing your body to regulate other hormone levels properly. 

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