Diarrhea during Menstruation
Diarrhea, constipation, abdominal pain or bloating – menstruation can keep our digestive tract quite busy. Today I would like to explore with you why diarrhea is a frequent companion and what promises relief. I’ll also tell you what endometriosis has to do with diarrhea.
How common is Diarrhea during Menstruation?
We like to compare ourselves to others because it gives us an assessment of whether what happens to us each month is ordinary or possibly a cause for concern. The good news first: diarrhea during menstruation is not uncommon.
A study provides exact figures. Researchers investigated the extent to which emotional symptoms and gastrointestinal complaints (symptoms that affect the gastrointestinal tract) are related. The scientists chose the period before and during menstruation. A total of 156 women were surveyed. A whopping 73% of them suffered from gastrointestinal symptoms either before or during their period. Now you can guess which problems were the most common. That’s right, abdominal pain and diarrhea [1].
The following figures were obtained:
- 58 % suffered from abdominal pain before and 55 % during menstruation [1].
- 24 % reported having diarrhea before menstruation and 28 % during menstruation [1].
It was also interesting to note that those women who had emotional symptoms had more frequent problems with their gastrointestinal tract [1].
Good to know!
Diarrhea can be a symptom of endometriosis. However, this does not necessarily mean that there are adhesions in the rectum. Your body can also react to endometriosis with diarrhea, although the lesions appear in a completely different place.
Diarrhea: Hormones are to blame
Depending on the day of your cycle, the mixture of hormones in your body is different. In the infertile period, your organism delivers a completely different cocktail than when it is preparing for pregnancy. Hormones have a great influence on our well-being. This is not only true for the psyche, but can also be shown pragmatically by possible complaints. When it comes to diarrhea, two different hormones stand out in particular, which accompany us in every cycle. We are talking about prostaglandins and progesterone.
Prostaglandins stimulate the Digestive Tract
These are tissue hormones. They are not produced by selected glands, but by cells located in the tissue. Prostaglandins can intensify the perception of pain [2]. During menstruation, they have a special function. They trigger the classic abdominal cramps in you by the tissue hormones signaling your uterus to contract [3]. This is important to remove the excess mucous membrane from the body, if fertilization has not occurred, and thus prepare it for a new cycle. The intestine may also be affected by the increased muscular activity, since the intestinal wall contains smooth muscle just like the uterine wall. The food pulp now passes through the digestive tract more quickly, which can lead to abdominal pain and diarrhea. It is not yet clear whether the tissue hormones prostaglandins are transported into the intestine or whether the generally high prostaglandin levels stimulate digestive activity [1].
Progesterone makes the Intestine tired
The second hormone that is important in diarrhea is progesterone. This hormone plays a special role in the luteal phase, i.e. the time between ovulation and menstruation. It has the important task of preparing the uterine lining so that a fertilized egg can implant well [4]. There is only one catch: progesterone makes the intestines sluggish and can thus lead to constipation. During pregnancy, you have a significantly increased progesterone level. This helps maintain a stable pregnancy, but unfortunately also leads to constipation. But how does diarrhea occur in conjunction with progesterone? Quite simply, during menstruation your body has significantly less progesterone available. Sluggish digestion picks up speed again. The mixture of progesterone and prostaglandins can also cause softer stools or even diarrhea in addition to the sudden drop in progesterone.
Diarrhea as a Symptom of Endometriosis
In endometriosis, endometrial tissue grows where it does not belong. In addition to the normal mucosal colonization in the uterus, so-called endometriosis lesions are found inside or outside the pelvis [5]. This can lead to the classic symptoms such as pain and infertility [6]. Menstrual irregularities, back pain and digestive problems may also occur [5]. However, endometriosis does not only show up in typical locations such as the ovaries, but can also be observed in the intestines. Adhesions located in the rectum are capable of causing diarrhea. Endometriosis lesions settle comparatively readily in the gastrointestinal tract when they occur outside the pelvis [7]. One study showed that gastrointestinal symptoms were common in 290 patients diagnosed with endometriosis by laparoscopy. More specifically, 90% reported such problems. However, only 7.6% of the study participants were actually found to have endometriosis in the bowel [8].
Diarrhea and gastrointestinal symptoms in endometriosis have not yet been definitively explained. Inflammatory processes and food intolerances are suspected as reasons for gastrointestinal complaints in endometriosis.
Good to know!
Heat, drinking enough fluids, avoiding fatty, sweet and spicy foods as well as alcohol, meditation and relaxation exercises can be particularly helpful for diarrhea.
SOS-Tips for Diarrhea during Menstruation
Menstruation can be exhausting, both for the body and for the psyche. During this time you should pay special attention to yourself. If you are struggling with diarrhea, the following tips can help you.
- Apply heat to your abdomen: Heat is considered pleasant for cramps and aches. Your intestines calm down, which brings a little peace into everyday life.
- Drink enough: During diarrhea, your body loses a lot of fluid. Prevent a lack of fluid by drinking plenty of water or unsweetened herbal tea. Fennel or chamomile tea is best for this.
- Avoid irritating foods or drinks: Your body cannot use fatty, sugary or spicy foods at this time. The same applies to alcohol. Gentle foods such as cooked carrots, grated apples or mashed potatoes are suitable at this time. By the way: Cola and salt sticks are no panacea. Cola can even increase diarrhea due to the large amount of sugar.
- Meditate where possible: Your body now needs rest. Give it especially restful breaks during small meditation exercises. With just 10 minutes of meditation you will feel more balanced and for a few moments you may succeed in ignoring the annoying discomfort. In addition, the intestine is also connected to the nervous system. Just as stress irritates it, relaxation can also calm it.
When to see a Doctor for Diarrhea during Menstruation?
A doctor should be consulted if the diarrhea is very severe or does not stop when menstruation stops. Then it should be checked whether an infection or a serious disease is behind the symptoms. If the diarrhea occurs persistently during menstruation or even in between menstrual cycles AND is accompanied by other symptoms such as menstrual irregularities or severe pain, it may be worth discussing endometriosis with your doctor. It is best to discuss this with your gynecologist. He or she will know which examinations make sense.
In a Nutshell
Diarrhea is not uncommon during menstruation. The hormones prostaglandins and progesterone can cause the annoying symptom. However, diarrhea in combination with other complaints can also indicate endometriosis. The lesions do not always have to occur in the intestine. If you repeatedly suffer from diarrhea in combination with other symptoms such as pain or menstrual irregularities, it may be worthwhile to consult a doctor about endometriosis. First aid tips for diarrhea during menstruation include rest, drinking plenty of fluids, warmth and a gentle diet.
Wondering what symptoms are also common with endometriosis? Then download the Endo-App and benefit from the extensive knowledge of our endometriosis experts.
References
- Bernstein MT, Graff LA, Avery L, Palatnick C, Parnerowski K, Targownik LE. Gastrointestinale Symptome vor und während der Menstruation bei gesunden Frauen. BMC Womens Health. 2014 Jan 22;14:14. doi: 10.1186/1472-6874-14-14. PMID: 24450290; PMCID: PMC3901893.
- Gesundheitsinformation.de: Prostaglandin
- Reavey J et al. Physiologie der Menstruation. Inherited Bleeding Disorders in Women (2019): 29-44.
- Diedrich, Klaus. Gynäkologie und Geburtshilfe (Springer-Lehrbuch) (German Edition) (S.65). Springer Berlin Heidelberg. Kindle-Version.
- Diedrich, Klaus. Gynäkologie und Geburtshilfe (Springer-Lehrbuch) (German Edition) (S.303). Springer Berlin Heidelberg. Kindle-Version.
- Ulrich U, Buchweitz O, Greb R, Keckstein J, von Leffern I, Oppelt P, Renner SP, Sillem M, Stummvoll W, Schweppe KW. Interdisziplinäre S2k-Leitlinie zur Diagnostik und Therapie der Endometriose: Kurzfassung – AWMF-Register-Nr. 015-045, August 2013. Geburtshilfe Frauenheilkd. 2013 Sep;73(9):890-898. doi: 10.1055/s-0033-1350810. PMID: 24771938; PMCID: PMC3975317.
- Charatsi D, Koukoura O, Ntavela IG, Chintziou F, Gkorila G, Tsagkoulis M, Mikos T, Pistofidis G, Hajiioannou J, Daponte A. Gastrointestinal and Urinary Tract Endometriosis: Ein Überblick über die häufigsten Lokalisationen der extrapelvinen Endometriose. Adv Med. 2018 Sep 26;2018:3461209. doi: 10.1155/2018/3461209. PMID: 30363647; PMCID: PMC6180923.
- Maroun P, Cooper MJ, Reid GD, Keirse MJ. Relevanz von gastrointestinalen Symptomen bei Endometriose. Aust N Z J Obstet Gynaecol. 2009 Aug;49(4):411-4. doi: 10.1111/j.1479-828X.2009.01030.x. PMID: 19694698.
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