The progesterone IBS connection

For many women, going to the toilet becomes an issue exactly a week before their period is due to arrive. Digestion slows, and they are unsure why. The answer is lies in the relationship progesterone has with your bowel tissue.

An overview of the reproductive cycle

During female reproductive years, a normal cycle is characterized by predictable cyclical changes in hormonal activity that influence bowel habits.

The cycle begins with the hypothalamus triggering the pituitary gland to secrete both Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). Together these two stimulate the ovaries to produce estrogen and progesterone, and their  interplay directly affects the timing, presence or even absence of a period, as well as PMS, pregnancy and menopause.

At mid cycle, estrogen peaks and triggers ovulation. If pregnancy does not occur, estrogen drops off, progesterone begins to build and dominate the second half of the cycle (up to the onset of menses). This second half of the cycle is referred to as the Luteal phase.

How the hormonal cascade affects your bowel habits

It is the interplay between estrogen and progesterone throughout the cycle that may cause alternating constipation and diarrhea that is often diagnosed as IBS.

Progesterone has been shown in studies to delay gastric emptying and cause constipation. This is especially apparent during the luteal phase in the last two weeks of the cycle when many women experience delayed transit times, indigestion, bloating, increased gas and harder than normal stools.

The most dramatic changes however in bowel habits occur at the very start of the menstrual flow. When a woman begins to bleed (or a few days before for many),  she may experience sudden diarrhea  for a day or two. This is caused by the sudden drop off in progesterone and a a rise in prostaglandins (inflammatory chemicals) that stimulate the contractility of both the bowel and uterus. For those that have been constipated for the week before, this can come as somer relief.

10 Natural remedies for constipation

To resolve constipation, many head to the chemist to buy often harmful laxatives that further irritate the bowel or  worse yet, create a lazier bowel that becomes dependant on them.  If staying regular throughout your cycle is a struggle for you, you may like to try some of these little-known natural constipation remedies that will help you get going. Tried, tested and have passed the test with women who have bowels of steel, like me.

Yellow dock and Dandelion (root) tea

Both Yellow dock (Rumex Crispus) and Dandelion (root) teas stimulate bile flow. This assists stool excretion via the digestive tract by mildly irritating the colon mucosa and stimulating peristalsis (meaning it brings function back to the colon).

Oils 

Oils (and fats generally) stimulate the gall bladder to release bile which in turn stimulates bowel movements (as described above). Eat oily salads, add coconut oil to smoothies and/or drizzle flaxseed oil on your cereal. If you are really backed up, mix a tablespoon of cold pressed flaxseed oil with a tablespoon of ground flaxseed (fresh) and eat it as it is on an empty stomach before breakfast.

Squatting

Improper posture may lead to improper potty habits, thus changing the way you sit on the toilet may help you do a poo. In squatting (or simply holding both legs to your chest), the body is aligned in a way that promotes easy emptying of the bowel. If squatting sounds too hard, instead try just holding the right knee to your chest as you try to go.

Probiotics

Most people do not know that good bacteria in the bowel forms a significant part of the bulk of a stool. Without bulk, the stool cannot pass and constipation may occur. With the modern day lifestyle, most are deficient in good gut bacteria and the amount required to replenish levels is not something that can be fixed with your daily hit of yogurt. Opt for a broad-spectrum probiotic powder instead, taking a teaspoon first thing in the morning in room temperature water.

Fibre mixes

Guar gum is a fibre made from legumes called guar beans. It acts as a natural prebiotic fibre that supports the production and diversification of your good gut bacteria (therefore reduces inflammation and boosts the immune system).  Guar gum helps constipation by softening the stool, and normalises constipation by absorbing excess liquid. It has also been shown to help with blood sugar regulation and to help keep you feeling fuller for longer.

Motion Potion is also a good go-to for constipation. It puts motion back into your gut by soothing the internal lining, making it easier for food to pass through.  It is a naturopathic formula rich in beneficial fibres, cereal grasses, friendly bacteria and other nutrient-dense bowel food. Take a tsp in room temperature or warm water preferably on an empty stomach. Available at most health food stores.

Castor oil

Castor oil consists of 80% ricinoleic acid that causes contractions in the gut (thus works as a stimulant laxative). For this reason, it should never be used regularly or when pregnant, as it may create dependancy and/or trigger muscles of the uterus to also contract (hence instigating labor). Take 1 tablespoon on an empty stomach first thing in the morning, preferably a few hours before breakfast. And if possible, plan to be near a toilet over the coming few hours. Sometimes castor oil works quicker than you think.

Abdominal exercises

Exercise generally helps constipation by speeding up the time it takes food to move through the large intestines. Aerobic exercise speeds up breathing and the heart rate that in turn stimulates the natural contraction of the intestinal muscles. Yoga poses such as twists, forward folds and inversions may also assist in getting things moving along.

Vitamin C

Vitamin C in large doses can have a laxative affect on the bowel. This is known as a Vitamin C flush. Each individual will carry a different tolerance for the amount required, so it is best to start with 500mg of absorbic acid with 250mg of bioflavonoids every hour until your bowel movements become loose. Once you reach this point reduce it by 500mg and this is your maintenance dose. If you experience gas with this take the Vitamin C after food. You body will eventually adapt the amount you take, and it is not something you want to be doing long term, so after your bowel movements have returned to relative normality, start gradually reducing the dose every day, as sudden discontinuation of high doses of vitamin C may cause rebound scurvy.

Magnesium 

Magnesium is a super nutrient beneficial to both hormone-induced stress such PMS and hormonally driven constipation. It works by:

1.    Drawing water into the gut, rehydrating hard to pass faecal matter

2.   Assisting the smooth muscle tissue of the colon to contract helping things to move along more easily.

Magnesium citrate is the most useful form for constipation. Take 400mg before bed in water. If you don’t have a bowel movement in the morning, take another 400mg and wait four hours. If there is still no bowel movement do the same again with another 400mg. Do not exceed this dose. If it hasn’t worked by this point you might like to consider one of my other recommended remedies.

Warm water

Warm water assists relaxes the smooth muscle tissue of the colon and according to Ayurvedic medicine, helps dislodge digestive toxins that may be interfering with efficient body function. Drink warm water all throughout the day but start out with a big glass of warm water and apple cider vinegar, which will also stimulates digestion and gives the metabolism a kick.

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