Constipation is a common symptom of PMS. Eating fibre, drinking enough water, aerobic exercise, avoiding dehydrating drinks like coffee and alcohol, and removing gluten from your diet can all help relieve premenstrual constipation. It is also important not to hold a bowel movement in when you feel the urge. You can also try linseeds and herbal bitters.
How PMS causes constipation
Before we even look at how constipation and PMS are connected, let's just define constipation. If you are not pooing every day you are constipated in my books. Ideally, having 1-3 bowel movements a day is a sign of good digestion. Healthy poos are like brown sausages! If you have to really strain, or if your poos are more like Maltesers than sausages, you are likely constipated as well.
So many people are constipated and they don't even know it! But many women have regular bowel movements most of the time but tend to get constipated in the week before their period. Many experts attribute this premenstrual constipation to the rise in progesterone in our luteal phase. Progesterone is a relaxing hormone, so it can potentially slow contractions in the digestive tract. But other scientists suggest that oestrogen is actually to blame. Their study was done by testing mice instead of humans though, so it's hard to know if that's also the case in humans. (1) The jury is out, and like many things when it comes to period health, there isn't enough research to base our understanding on that alone.
For me, like all PMS symptoms, this is a great example of the magic powers of your menstrual cycle as a feedback system for areas of your health that may need more support. If you are getting constipated in the days leading up to your bleed, it is a good sign that your digestion needs some support. It may be that your body manages with your not-so-healthy diet for most of the month but before your period your body just can't hack it. Sometimes I find that certain foods, particularly gluten or wheat products, can be tolerated most of the time, but cause a problem in the premenstrual days. It depends on each individual but, if you are constipated before your period, it is worthwhile listening to your body and making changes throughout the month to support your digestion.
My 9 tips to help premenstrual constipation
If you get constipated the week before your period you can try some of the following suggestions in your premenstrual days or week, depending on when you tend to get constipated. You may also want to incorporate these tips into the rest of your month to help support your digestion and avoid constipation in future.
1. Eat more fibre
Eating more fruit and veg is generally a good idea, and they are full of fibre as well as containing loads of other health-promoting nutrients, vitamins and minerals. It is also a good idea to swap out any refined grains, white pasta, white rice, or white bread with wholegrain options. Nuts and seeds are great sources of fibre too.
2. Drink more water
You might get away with not drinking enough at other times of the month, but premenstrual constipation might be a great warning from your body to get that water into you! Being dehydrated can make your stools harder and more difficult to pass.
My favourite way to find out if you are drinking enough water for your body is to multiply your weight in kg by 0.033. Add another glass of water for every cup of tea or coffee or glass of alcohol, and drink more again if you are exercising to the point of sweating, or if the weather is very hot.
3. Exercise
Moving your body helps to move your digestion. Lack of movement is a huge contributor to constipation, unsurprisingly really! One study found that aerobic exercise was helpful in easing premenstrual constipation, as well as many other physical PMS symptoms (2) I find simply walking to be really helpful whenever you're bunged up. Even a 30-minute walk is helpful, and if you can be more active throughout the day that is great too!
4. Avoid dehydrating drinks
Coffee, black tea, alcohol and fizzy drinks are dehydrating. If you are already not drinking enough water, these can make your constipation worse again.
Some people do find coffee to be a bit of a laxative. Even if you find coffee works as a laxative for you, make sure you are drinking enough water and drink an extra glass of water for every cup of coffee.
5. Don't hold it!
We have wonderful bodily urges which tell us when we need to make our way to a bathroom. When you hold in a number two you basically squeeze it back inside, and in doing you also squeeze out a lot of the water content, making it hard and more difficult to come out when you do eventually make it to the toilet. So do yourself a favour: once you get the urge, go to the toilet straight away!
6. Try linseeds
Linseeds are wonderful herbal bulking laxatives. Eating ground linseeds can be a great source of fibre, but soaking whole linseeds is a grand way of adding mucilage to the diet. Cover one tablespoon of whole linseeds in hot water and leave to soak for an hour or more. You can soak them overnight and take them first thing in the morning, or soak them at dinner time and take the seeds before bed. Soaking linseeds gives them a gooey coat of mucilage which is really helpful for easing the transit, so to speak!
7. Take bitter herbs
Dandelion, artichoke and gentian are some bitter herbs which can help to ease constipation. They have a very gentle laxative effect by supporting the liver and increasing digestive enzymes and bile secretion. You can eat bitter foods, like dandelion leaves and rocket, or arugula, artichoke hearts and radicchio. You can also try these as herbal tinctures, and simply add a few drops to some water before a meal. With bitter herbs the taste is really important as it activates your digestive tract from the tastebuds, as well as more systemically. So, for an added bonus you can swish the bitter herbs around your mouth before swallowing to get even more taste bud activation!
8. Try removing gluten
For many women who have a mild gluten intolerance, it shows up in bloating and constipation in the premenstrual phase. It often contributes to other symptoms including painful periods and endometriosis, and even infertility and early menopause; so, if avoiding gluten in the days before your bleed helps, then you may want to consider cutting it out full time for a few months to see if any of your other symptoms resolve. To learn more about how gluten affects your period check out my recent blog on the topic.
If you are someone who eats a lot of wheat products, you may even find that just reducing the amount you eat can help. Many people have toast for breakfast, sandwiches for lunch, pasta for dinner and crackers as a snack maybe. That is a lot of wheat in a day! So, if this sounds familiar to you, you may not need to cut out gluten altogether. You could probably benefit from just eating wheat once a day during your premenstrual phase. But try it out and see what works for you and your body.
9. Try a squatty potty
Our modern toilets put our bodies in a suboptimal position for emptying our bowels. Getting a stool to prop your legs up into a squatting position can help make it easier to poo without straining! There is even scientific research now showing how these "Defecation Posture Modification Devices" can help constipation. (3)
To learn more about constipation relief check out this article from our nutritionist Alison Cullen.
