Cycle and diarrhea

Not all women experience their menstrual cycle in the same way. For some the different phases flow without any particular problems, while for others abdominal cramps, pelvic pain and swelling mark like a clock every day of the cycle.

For many women, moreover, the cycle is also accompanied by gastrointestinal symptoms, in particular stomach pain and episodes of diarrhea. But what is behind the association between cycle and diarrhea? Should I consult a gastroenterologist?

In fact, the link between what happens in the reproductive system and what happens in the intestine is closer than you might think. This relationship is in fact bidirectional. Proof of this are on the one hand some common gynecological infections (for example at the vaginal level), whose onset is closely linked to alterations in the intestinal bacterial flora, and on the other hand the incidence of gastrointestinal symptoms during the menstrual cycle, which can exceed 70% even in women who do not suffer from digestive system disorders.

Cycle and diarrhea: when it affects

In the past, it was believed that dealing with intestinal problems during the menstrual cycle was more frequent among women with gastrointestinal disorders.

This misconception has been disproved by studies that have revealed that diarrhea and other symptoms that affect the intestine are quite widespread throughout the female population of childbearing age.

The association between cycle and gastrointestinal problems continues to be significant even when symptoms that could be traced back to the gynecological sphere, such as bloating, are excluded.

The frequency of gastrointestinal symptoms or the intensity of disorders tend to increase during the premenstrual phase and during menstruation. In particular, about one in three women has to deal with alterations in intestinal transit during menstruation. Among these alterations, diarrhea is more frequent than constipation.

Gastrointestinal problems associated with menstruation are more common among women who experience painful cycles. In addition, the appearance of diarrhea and other intestinal disorders during the cycle is more frequent in the presence of psychological discomfort, especially depression, anxiety and fatigue.

Cycle and diarrhea: the main causes

The association between painful menstrual cycles, psychological distress and gastrointestinal disorders leads to research the causes of the link between cycle and diarrhea towards factors that may play a role both in the regulation of intestinal motility and in the control of mood and pain.

This is the case, for example, of serotonin, the neurotransmitter often also known as the “hormone of happiness” or “good mood”. In fact, serotonin is produced in the brain, but also in the intestine, and influences both mood control and pain perception.

Hormonal changes could also play a role in this phenomenon. In fact, gastrointestinal and psychological symptoms seem to depend on a greater local sensitivity to steroid hormones, with a peak of effects during the menstrual cycle.

The main suspects as responsible for the appearance of diarrhea during the cycle, however, are other molecules, prostaglandins. These are mediators of inflammation that regulate the contraction of the uterus. Their levels increase before the onset of menstruation, when the cells of the inner lining of the uterus produce large amounts of it. As a result, the muscles of the uterus contract, promoting the expulsion of menstrual blood.

All this occurs cyclically from menarche (the first menstruation) until menopause: while in the ovary all the phenomena concerning ovulation occur, the uterus, its mucosa and blood vessels are prepared to welcome a possible embryo and, in the absence of fertilization, menstruation occurs. The latter allows the wall of the uterus to regenerate and prepare again for the eventuality of receiving an embryo.

Before menstruation the prostaglandins produced by the uterus can cause an inflammatory response that leads to the appearance of painful symptoms.

During menstruation, then, the contractions stimulated by prostaglandins can be so intense as to cause cramps; The higher the secretion of prostaglandins, the more the uterus contracts and menstruation can be painful.

In the intestine there are smooth muscle fibers similar to those present in the uterus; Prostaglandins can also stimulate their contraction. The result of this phenomenon is the promotion of intestinal peristalsis and early elimination of the contents of the intestine. The action of prostaglandins can therefore cause abdominal pain and episodes of diarrhea, reducing nutrient absorption and increasing mineral loss.

Cycle and diarrhea: other symptoms

Particularly high levels of prostaglandins can trigger other symptoms associated with the cycle in addition to diarrhea. The most common affect, once again, the gastrointestinal district and include abdominal bloating, nausea and vomiting. To these can be added another disorder often associated with the menstrual cycle: headaches.

It is also possible that menstruation-related diarrhea adds to the symptoms of concomitant health problems. Generally these are disorders that affect the intestine. In particular, women living with inflammatory bowel diseases are more subject to a premenstrual syndrome that includes, in addition to the classic discomfort in the lower abdomen and breast tension, also symptoms of the gastrointestinal tract; Fortunately, however, the typical disorders of their inflammatory bowel disease do not vary significantly during the menstrual cycle.

Different is the case of those who have to do with the so-called irritable bowel syndrome (or irritable bowel): with the cycle the feeling of being swollen, pains and other discomforts can increase significantly.

Finally, women living with endometriosis may also experience an increase in gastrointestinal symptoms during menstruation. In patients suffering from endometriosis, the tissue that lines the inner wall of the uterus (the endometrium) grows outside, sometimes anchored to other organs of the body (such as ovaries, fallopian tubes, vagina, bladder and even the intestine). Gastrointestinal symptoms are very common in endometriosis and may include intestinal cramps, painful bowel movements, bloating, nausea, constipation or, again, diarrhea. Other typical symptoms of this pathology are:

• painful menstrual cramps (dysmenorrhea)
• persistent pain in the pelvic region and back pain in the lumbar region
• pain in the stomach or intestines
• pain when urinating
• blood in the stool or urine
• intense pain during or after sexual intercourse
• bleeding between menstruation
• fertility problems
• exhaustion.

Cycle and diarrhea: effective remedies

Often to keep menstrual pain at bay, the administration of an over-the-counter drug, such as NSAIDs (non-steroidal anti-inflammatory drugs), is sufficient. Heat can also help combat discomfort in the lower abdomen, which can sometimes even extend to the legs.

In the event that the cycle is associated with diarrhea, however, it is also good to implement some eating habits that help not to promote gastrointestinal disorders and to cope with the loss of water and minerals associated with diarrhea.

The diet should be light: a broth, rice or even vegetables are fine, as long as they are cooked and possibly deprived of the peel and seeds. However, all vegetables that tend to favor meteorism or that can have a laxative effect, such as broccoli, beans, peas, chickpeas, green leafy vegetables and plums, should be avoided. It is better not to consume food rich in fat and milk and dairy products.

It is also important to drink plenty, so as to avoid dehydration. The best way to rehydrate is by drinking water or mild infusions with a calming action, for example based on chamomile. Or you can rely on specific supplements based on vitamins and minerals such as potassium and magnesium.

Drinks that contain caffeine are contraindicated, as it can stimulate intestinal activity, or alcohol; It is also better to avoid carbonated drinks.

Even a few salty crackers can help to recover the sodium lost with the episode of diarrhea and, consequently, to retain more water in the body. Bananas, on the other hand, can be useful both to stop diarrhea and to recover lost potassium.

In case of severe dehydration, intense pain in the abdomen or rectum, blood in the stool or dark color and high fever, however, acting on nutrition is not enough and it is good to contact a doctor.

Cycle and diarrhea: prevention

When the cycle tends to be associated with episodes of diarrhea it is possible to try to limit the risk of finding yourself struggling with this intestinal disorder by avoiding the substances, foods and drinks that can promote it.

For the prevention of diarrhea, however, acting on the mind also seems to be useful. Reducing stress and anxiety could also alleviate gastrointestinal symptoms that depend on a stressful life. It can be useful, for example, to practice disciplines such as yoga or meditation, but not only. Even ensuring regular and quality rest, sleeping at least 8 hours a night, could help relieve menstrual symptoms associated with problems that affect psychological well-being, while physical activity can help dissolve tensions, but it is good not to overdo it. Too intense exercise can in fact alter intestinal function.

Finally, the birth control pill can help to eliminate, at least in part, the symptoms associated with the cycle. To take it, however, it is necessary to have a prescription from the attending physician or gynecologist.