By the time you reach your twenties, you probably have your own way of detecting an incoming period. For many women, it’s the dreaded menstrual cramps. For some, it’s when you start to wince while running or going down stairs because your breasts have become oh-so-tender. For others, it’s when a few random pimples abruptly appear on your chin. And for others, the big clue is—yep—your bowel movements. Or in some cases, the lack of ‘em.
Cramps and mood swings tend to get most of the attention when it comes to PMS symptoms, so you might worry that the wonky BMs you experience before and during your period are abnormal and problematic.
Fear not: Upset stomach at this time of the month is totally normal. “It’s very common for patients to complain of constipation right before their period, and then diarrhea or frequent bowel movements during their period,” says Jennifer Wu, MD, an ob-gyn at Lenox Hill Hospital.
How common? A 2014 study tracked the gastrointestinal (GI) symptoms of adult women before and during their periods. In the study, 73 percent of participants reported at least one GI symptom, especially abdominal pain and diarrhea. Participants who experienced mood changes before their periods were significantly more likely to experience abnormal BMs than those who didn’t have mood changes.
The digestive distress comes down to hormonal changes during your cycle, according to Dr. Wu. “Changes in estrogen and progesterone before your period and during your period can alter how fast food moves through your intestines,” explains Dr. Wu. Food moving slowly through the intestines can cause constipation, and quick movement through the intestines can cause diarrhea, or just more frequent bowel movements (a.k.a. “period poops”).
For women who experience GI distress on the regular—such as those with irritable bowel syndrome or inflammatory bowel disease—their symptoms may worsen during their periods. Furthermore, researchers have found that women with IBS and IBD are generally more likely than other women to report PMS symptoms beyond changes in their BMs, according to a 2015 study in Gastroenterology Report.
Like other PMS symptoms, one solution to deal with period-related bowel changes is hormonal birth control, such as the Pill, the patch, or hormonal IUDs. These options may reduce cramps, mood changes, and upset stomach by evening out the release of hormones throughout your menstrual cycle, according to Dr. Wu. If that’s a solution that appeals to you, talk to your doctor to explore which birth control option is best for you and your specific lifestyle.
However, many patients simply accept constipation and diarrhea as part of their monthly routine and make adjustments to their diet and exercise habits. Avoid foods that trigger constipation, and focus on getting more fiber in your diet. Here are more habits to help relieve and prevent constipation.