Many women complain about stomach cramps, muscle soreness, and mood swings before or during periods. Constipation before period is another common symptom of premenstrual syndrome (PMS). Constipation is a prevalent digestive condition in which a person has trouble passing stools or has infrequent bowel movements. Are you wondering why this happens to you? Let's explore the causes of constipation before periods and ways to prevent it.

What is constipation?

Constipation is a common digestive condition in which a person experiences difficulty passing stools or has infrequent bowel movements, as per a study published in StatsPearls. It is generally characterised by -

• Fewer than three bowel movements per week.
• Hard, dry, or lumpy stools that are often difficult or painful to pass.
• Even after having a bowel movement, there may be a sensation that the bowels have not been completely emptied.

Constipation can be occasional or chronic and is often accompanied by other symptoms like bloating, abdominal discomfort, and a sense of fullness. Various factors, including a low-fiber diet, dehydration, and lack of physical activity can cause it.

Hormonal changes may lead to constipation before periods. Image courtesy: Freepik

What are the causes of constipation before periods?

Constipation before periods is a common issue that many women experience, primarily due to hormonal changes and other factors associated with the menstrual cycle. "Prostaglandins released during menstruation increase intestinal motility and can lead to mild diarrhea around periods,” says gynaecologist Dr Pratibha Singhal. Constipation can lead to pelvic congestion, leading to severe menstrual cramps. Here are the causes of constipation after periods:

1. Hormonal fluctuations

During the luteal phase of the menstrual cycle (the time between ovulation and the start of the period), progesterone levels rise. Progesterone relaxes the smooth muscles of the body, including those in the digestive tract. This relaxation can slow down the food movement through the intestines, leading to constipation. Also, estrogen levels fluctuate throughout the menstrual cycle, as per a study published in Gender Medicine. While high levels of estrogen can lead to water retention and bloating, the interplay between estrogen and progesterone can also affect bowel movements, sometimes contributing to constipation.

2. Reduced intestinal motility

Before menstruation, the body produces prostaglandins, which help the uterus contract to shed its lining. These chemicals can also affect the digestive tract, slowing down intestinal motility (food movement through the intestines) and contributing to constipation.

3. Water retention

Hormonal changes before a period can lead to water retention in the body. "This retention can reduce the water content in the stools, making them harder to pass, thus leading to constipation,” explains the expert.

4. Dietary and lifestyle factors

Many women experience cravings for salty, sugary, or processed foods before their periods. These types of foods can contribute to dehydration and reduced fiber intake, both of which can lead to constipation. Also, premenstrual symptoms like fatigue, bloating, and discomfort may lead to reduced physical activity. Lack of movement or exercise can slow down digestion and contribute to constipation, as per a research published in Harvard Health Publishing.

5. Stress and emotional factors

Premenstrual syndrome (PMS) can lead to increased stress and anxiety. Stress can be a major cause of constipation. When your body is under stress, it activates the ‘fight or flight’ reaction, which redirects blood flow away from the digestive system and towards essential organs such as the heart and brain. The result of this decrease in intestinal function is constipation.

6. Impact of iron supplements

Some women take iron supplements before or during their periods to prevent or treat anemia. "Iron supplements can lead to constipation, especially if not taken with adequate fluids or if the type of iron is not well tolerated by the digestive system,” explains the expert.

Is constipation before periods a cause for concern?

Constipation before periods is usually not a cause for serious concern. It is a common symptom experienced by many women due to the hormonal fluctuations that occur during the menstrual cycle. However, there are some situations where it might be worth paying closer attention.

When not to worry

• Mild and temporary: If constipation is mild and only occurs in the days leading up to your period, it's typically a normal part of premenstrual syndrome.
• Resolves after menstruation: If constipation goes away once your period starts or shortly thereafter, it is usually just a response to the hormonal changes and not something to worry about.
• No severe symptoms: If there are no additional severe symptoms, such as intense abdominal pain, significant bloating, or blood in the stool, then it is likely just a normal premenstrual symptom.

When it might be a cause for concern

• Severe or persistent constipation: If constipation is severe, causes significant discomfort, or persists beyond your menstrual cycle, it might indicate an underlying issue that needs attention.
• Accompanied by other symptoms: If constipation before your period is accompanied by other troubling symptoms like severe pain, unexplained weight loss, nausea, or vomiting, it could be a sign of a more serious condition, such as endometriosis, irritable bowel syndrome (IBS), or other gastrointestinal disorders.
• Impact on quality of life: If premenstrual constipation is significantly affecting your quality of life or daily activities, it is worth discussing with a healthcare provider to explore potential treatments or underlying causes.

How to prevent constipation before periods?

Preventing constipation before periods involves making some dietary and lifestyle adjustments to support healthy digestion during this time. Here are several strategies that can help -

1. Increase fibre intake

Eat more fibre-rich foods such as fruits, vegetables, whole grains, legumes, nuts, and seeds. Fiber adds bulk to the stool and helps it move more easily through the digestive tract. Also, increase your fiber intake gradually to avoid gas and bloating. Aim for at least 25-30 grams of fiber per day.

Stay hydrated to prevent constipation. Image courtesy: Adobe Stock

2. Stay hydrated

Drink plenty of water as adequate hydration is essential for preventing constipation, as per a study published in the Nutrients journal. Water helps to soften the stool, making it easier to pass. Aim to drink about 8 glasses (about 2 litres) of water per day, but you may need to drink more if you are physically active or stay in a hot place. Reduce the intake of caffeine and alcohol, as they can lead to dehydration and worsen constipation.

3. Regular physical activity

Engage in regular physical activity, such as walking, jogging, yoga, or swimming. "Exercise stimulates intestinal activity and can help keep your digestive system moving. Try not to remain seated for long periods, as this can slow down digestion,” suggests the expert.

4. Manage stress

Practice stress management techniques such as deep breathing, meditation, or yoga. Stress can affect your digestive system, so reducing stress can help prevent constipation. "Also, ensure you get enough sleep, as lack of rest can exacerbate stress and digestive issues," says the expert.

5. Monitor diet and cravings

Reduce your intake of processed foods, which are often low in fiber and high in unhealthy fats and sugars. These can contribute to constipation. Salty and sugary foods can lead to water retention, which can harden stools and contribute to constipation.

6. Include probiotic-rich foods

Consuming foods rich in probiotics, such as yogurt, kefir, sauerkraut, or other fermented foods, can help maintain healthy gut flora and improve digestion, and prevents constipation, as per a study published in the Molecules journal. You might also consider taking a probiotic supplement, particularly if you experience frequent digestive issues.

7. Avoid iron supplements if not necessary

If you are taking iron supplements, you should know that they can cause constipation. If possible, consult your healthcare provider to see if you can switch to a different form of iron or reduce the dosage.

How to treat constipation before periods?

If constipation occurs despite preventive measures, here are some ways to treat it:

• Over-the-counter laxatives or stool softeners can be used temporarily to relieve constipation. However, they should not be used regularly without consulting a doctor.
• Magnesium supplements or magnesium-rich foods like spinach, nuts, and seeds can help soften stools and promote regular bowel movements.
• Certain herbal teas, such as ginger or peppermint, can help soothe the digestive tract and encourage bowel movements.
• A warm bath can relax the muscles in the abdomen, potentially easing constipation.
• Consuming probiotics through supplements or fermented foods like yogurt, kefir, or sauerkraut can improve gut health and promote regular bowel movements.

If these methods do not alleviate the problem, or if you experience severe symptoms, consult a healthcare professional for further evaluation.

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