Constipation in the days leading up to a menstrual period is a common occurrence, often called premenstrual constipation. This digestive slowdown is a recognized symptom of premenstrual syndrome (PMS). The temporary change in bowel habits, which can include bloating, is directly linked to the fluctuation of reproductive hormones. This phenomenon usually resolves naturally once menstruation begins and hormone levels drop.
How Hormones Slow Down Digestion
The primary driver behind this period-related constipation is the hormone progesterone, which sees a significant rise during the luteal phase of the menstrual cycle. This phase begins immediately after ovulation and lasts until the start of the next period. The main function of this increase in progesterone is to prepare the uterine lining for a potential pregnancy.
Progesterone acts as a natural relaxant on smooth muscles throughout the body, and this effect is not confined to the uterus. The intestinal tract, including the colon, is lined with smooth muscle that is responsible for moving waste through the body. Higher levels of progesterone cause these muscles to relax, diminishing their ability to contract forcefully.
The wave-like muscular contractions that propel waste through the digestive system are known as peristalsis. When progesterone relaxes the intestinal muscles, peristalsis slows down, increasing the transit time of stool through the colon. This slower movement allows the large intestine more time to absorb water from the waste material. The result is stool that becomes harder, drier, and more difficult to pass, which defines constipation.
Managing Period-Related Constipation
Actionable steps can be taken in the luteal phase to counteract the muscle-relaxing effects of progesterone and promote regular bowel movements. Increasing your dietary fiber intake is one of the most effective strategies, as fiber adds bulk to the stool, which helps stimulate the colon to move waste along. Focusing on both soluble fiber, found in oats, beans, and apples, and insoluble fiber, present in whole grains and vegetables, can help soften and normalize stool consistency.
Hydration is a powerful remedy, as drinking sufficient water helps fiber work by keeping the stool soft and preventing excessive water absorption in the colon. Prioritize water intake, and consider avoiding excessive caffeine or alcohol, which can have a dehydrating effect. Aim for half of your body weight in ounces of water daily, increasing that amount slightly during the premenstrual phase.
Gentle physical activity, such as a brisk walk or light aerobic exercise, can also stimulate the bowels and aid in relieving sluggish digestion. Movement helps improve circulation and encourages the natural muscular contractions of the intestines. If diet and lifestyle adjustments do not provide sufficient relief, short-term use of over-the-counter remedies might be considered.
Stool softeners, such as those containing docusate sodium, work by drawing water into the stool, making it easier to pass. Osmotic laxatives, like polyethylene glycol, also retain water in the colon to soften the stool. Consult with a healthcare provider before starting any new medication, including over-the-counter options, to ensure they are appropriate for your needs.