Period Pain and Constipation
If you’re struggling with constipation and/or period pain, you’re in the right place. Keep reading to learn all things menstrual health and bowel health.
Spoiler: bowel health is hormone health and vise versa.
Understanding the Link Between Menstrual Pain and Digestive Issues
What causes constipation before your period?
The luteal phase of your cycle is the second half of your cycle that happens after you ovulate. During the luteal phase, progesterone is higher.
Progesterone is the “pregnancy hormone” (pro-gestation).
It is secreted by the ovaries after ovulation, and if pregnancy occurs then the placenta begins to secrete it. If not, the progesterone levels fall and bleeding begins and the cycle starts over.
Progesterone levels are highest right before your period starts, during pregnancy, and if using prescribed progesterone for fertility purposes.
Hormonal changes and bowel function
Progesterone is a smooth muscle relaxant, which affects the GI tract. This slows down peristalsis (digestion) and allows stool to sit in the large intestine longer and reabsorb more water, which also hardens the stool. Harder stool means harder to poop.
Prostaglandins and gut motility
Maybe you’re someone that leans more towards the period poops end of the spectrum rather than period constipation? You can thank prostaglandins for that.
When you are bleeding, your uterus is producing prostaglandins. Prostaglandins help your uterus contract to shed the lining of your uterus (bleeding). But they don’t just help your uterus out. They also help move things along your GI system (this one reason that women often poop during birth).
High prostaglandins lead to diarrhea (and increased pain and inflammation).
Managing Digestive Symptoms During Menstruation
Natural remedies for period-related constipation
A few of my favorite natural remedies for constipation that I recommend daily as a pelvic floor PT include:
Hydration: 60-80 oz/day to be exact
Aloe vera juice: 1-2 oz added to water
Flax seed: easy to add to a smoothie
Magnesium citrate: more on this below
Specific foods: two kiwis/day OR prunes/prune juice (helps improve transit time)
Gentle movement after meals
Abdominal massage: start at your right hip and massage your abdomen in a clockwise fashion
Best diet for constipation during period
The best diet to help with pain is the anti-inflammatory diet.
Think foods like:
Salmon
Berries
Walnuts
Colorful veggies
Quinoa and brown rice
Green tea
Turmeric and ginger
Healthy oils like EVOO, coconut oil, and avocado oil
And avoiding foods like:
Processed meat
Added sugar
Alcohol
Fried foods
Pasta and white bread
Fiber is also super important when it comes to period pain and constipation. Let me explain: when I am seeing patients for pelvic pain, the first thing I try to address is constipation. Constipation always makes pelvic symptoms worse (pain, leakage, etc.). The rectum sits right on top of the pelvic floor and if full of stool it can lead to more pain. Similarly, the rectum sits right behind the uterus. I’ve found that addressing constipation in my patients with period pain helps alleviate some of the pain. You want to be aiming for 25-35 g fiber/day – especially if you are prone to constipation.
Foods that worsen period bloating and constipation
How unfortunate that the comfort foods we always want on our period (ice cream, pizza, french fries, and a burger anyone?) are the ones that make our pain and constipation worse.
Typically, highly processed foods are going to make bloating worse. Maybe just try minimizing these foods if you’re prone to bloating/pain/constipation when you’re bleeding or right before.
Oh, and easy on the kale there girlie because it might make your bloating worse too. You’re welcome for that.
Pelvic Floor Dysfunction and Bowel Symptoms
Pelvic floor dysfunction and constipation
How does the pelvic floor contribute to constipation? The pelvic floor is a group of three layers of muscles that support the pelvic organs and also help maintain continence among many other things. These muscles contract and relax and should be coordinated with other core muscles.
The problem with the pelvic floor in regards to constipation is usually because these muscles are too good at maintaining constipation.
This is usually because they are too tight or not coordinated when it comes to pooping.
Kegels get all the rage when it comes to the pelvic floor, but in reality the emphasis should be on coordinated pelvic floor muscles (relaxing when you poop and have sex so it doesn’t hurt, and contracting when you laugh, jump, cough or sneeze).
Here's the thing about constipation and the pelvic floor: it usually comes along with other symptoms like urinary urgency and frequency, pain with sex, and potentially chronic pelvic pain.
Pelvic floor therapy for period-related bowel issues
Pelvic floor therapy for period related bowel issues takes a very comprehensive approach. To know if it is actually cyclical, we would have you track your cycle and your symptoms to know if it is consistent with a specific phase in your cycle each month. There would likely be supplements recommended depending on the phase of the cycle.
And to address the pelvic floor component, we would want to know exactly what is happening regarding pelvic floor pain and why, and muscle function and why.
Three yoga poses we generally recommend for tight pelvic floor muscles include:
Happy baby
Child’s pose
Deep squat
But after an exam you would likely have exercises more specific to your body and your symptoms.
Medical Conditions That Link Period Pain & Bowel Changes
Endometriosis and bowel symptoms
Endometriosis is an inflammatory condition where endometrial-like tissue grows outside of the uterus. This is a very painful condition and most women experience pain so intense they are unable to go to work/school when they are on their period. How unfortunate that this diagnosis takes 8-10 years on average for women to be diagnosed.
Of note, this condition usually has a bowel component. There is a small space between the vagina and the rectum where endometriosis is prone to grow and adhere. This tends to make bowel movements especially painful. Women with endo are also likely to experience significant bloating.
I encourage my patients with endo to consume little-to-no processed sugar, especially when their period is approaching. This will usually significantly impact pain for the better.
IBS vs period-related constipation
Is it IBS or is it period-related constipation? The easiest way to figure this out is tracking your symptoms. Is it occuring throughout your entire cycle, or just around your period?
Tracking your symptoms is really a game changer and can give so much information. Get access to my free cycle tracker HERE.
Adenomyosis and digestive issues
Adenomyosis is like a cousin to endometriosis. With adenomyosis, the endometrial-like tissue grows in the muscle layer of the uterus. Similar to endo, women with adeno usually experience very extreme bloating and heavy bleeding on their period. The uterus usually becomes very enlarged with adenomyosis.
⚖️ Adenomyosis vs Endometriosis:
Lifestyle & Hormonal Support
Exercise and constipation relief during periods
My favorite mode of exercise to relieve constipation is walking – it’s such an underrated way of exercising. Bonus points for walking while on your period because it’s usually a way of exercising that seems and feels realistic while bleeding as energy levels are usually low.
So how does walking help with constipation? Let’s talk anatomy:
Your rectum sits pretty closely to your left hip flexor, and when you are walking you are repetitively moving your hip flexor, which conveniently gets other things moving.
My advice: shoot for a 10 minute walk. If you don’t have time for a ten minute walk, standing next to the wall and swinging your left leg 10-20 times can be helpful too.
Supplements for period-related constipation
I think supplements are super helpful when used appropriately. Fortunately, I have Jordan (my pharmacist husband) to source for these. Here are a few recommendations and why each one is recommended:
Magnesium citrate: 200-400mg daily – relaxes intestinal muscles and draws water into the colon. Very helpful in the luteal phase.
Probiotic: as directed – supports the gut microbiome with hormone fluctuation
Omega 3 fatty acids: 1000-2000mg daily – helps reduce prostaglandin driven inflammation that can slow gut motility in some people
Magnesium oxide: 250-500 mg at night – stronger laxative than mag citrate; only use short term if nothing else is getting things moving
Fiber supplement: 5-10 g/day; can help bulk and move stool but avoid if you have IBS-C as it can worsen symptoms
As always, consult with your healthcare provider before adding new supplements. Find supplements I recommend HERE.
If you’re struggling with period pain and/or constipation good news! We are currently accepting new patients and Texas Pelvic Health is here to help. At Texas Pelvic Health, we offer specialized pelvic floor physical therapy to help with both period pain and constipation. We are currently accepting new patients in Rockwall, Canton, and Sulphur Springs. If you are interested in scheduling an appointment, please request an appointment here and someone from our team will reach out to you to get you scheduled.
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