Periods and IBD

Guess what time it is!  It is that time of the month – we are discussing periods and IBD!

Scientifically speaking, the important topic of periods and IBD has been largely unstudied.  There have been a few prospective studies done that have shown some interesting results.

It has been reported that 40% of IBD patients experience some change to their symptoms during menstruation.  So this is definetely a topic worth talking about!

This week we look into, 

• Is it normal for your period to make IBD worse?
• What causes these changes?
• Other effects of periods and IBD
• My personal experience with periods and IBD

Is it Normal for your Period to Make IBD Worse?

Yes!  Unfortunately it is.  It is actually common for many diseases to become worse during a woman’s menstrual cycle.   Although this may not be occurring exactly as we expect.

This prospective study actually has some interesting results on this topic.  They found that IBD patients reported more abdominal pain, diarrhea, and nausea than controls, while menstruating. 

But it was not found that symptoms specific to IBD were made worse during a woman’s period.  These symptoms include blood in the stool, nocturnal bowel movements, and fecal incontinence.

This implies that it may not be IBD symptoms getting worse.  But symptoms that are similar or overlap with menstruation symptoms that are worse than in control groups.

Many people with IBD experience this phenomena.  I have seen it widely discussed in support groups, and amongst people I know with IBD.

 

What Causes These Changes

Although scientists think that these changes are due to hormonal fluctuations.  The exact mechanisms are unclear.  

Evidence suggests that the hormonal fluctuations of estrogen and progesterone can affect digestion and digestive disorders like IBD. 

It has been found that period pains are not actually making IBD specific symptoms worse.  But it may be that having IBD makes period pains and symptoms worse.  

And because these pains are often so similar to each other and overlap.  It can be difficult to differentiate from the two.   So our IBD symptoms are not necessarily worse, but our period symptoms are.

It has been found that the pathophysiologic mechanisms that cause IBD abdominal pain, and period abdominal pain are similar.  Possibly because uterine contractions experienced during menstruation.  And abdominal contractions experienced during IBD pain are so similar.

It is also speculated that due to the heavy overlap in symptoms between IBD and period pain, “symptom confusion may occur”.  

I have told friends and family before, that the closest thing I can attribute to IBD abdominal pain too, is to really bad period pains.  So I can understand how some overlap of symptoms may occur.

It has also been found that other digestive issues like IBS may become worse during menstruation.  And because many people with IBD also have IBS this may also worsen your digestive symptoms.  And make you feel generally unwell.

 

Other Effects of Periods and IBD

There appears to be a link between IBD patients, and irregular periods.  And it has been seen that irregular periods are  linked to pathological conditions in general.  So having an irregular period, may indicate other imbalances in your body.

This study also found that in the year leading up to diagnosis, women’s menstrual cycles may become more irregular.  But this irregularity tends to improve over time.  

If you experience your period while in and IBD flare, I feel like the symptoms are made all the more worse.

While in a flare, I am fatigued, I am run down, I feel malnourished and tired.  My mental health is also usually not in a good place.

Now couple all of that with hormonal (mood) fluctuations, normal period fatigue, and the general run down feeling you may have on your period.  As you can imagine it is not a good combination.  

 

My Experience with Periods and IBD

A few days before my period is due, some of my IBD symptoms appear to get worse.  The day I get my period I tend to have really bad diarrhea, and more frequent bowel movements.  I can also experience pretty bad abdominal pain that can last for hours.

These symptoms could be attributed to either my periods and IBD.  But my experience does coincide with the research that I have read.  

It appears that many of my IBD symptoms overlap with period symptoms.  Such as diarrhea, abdominal pain, and nausea.  These are the symptoms that seem to become worse during my period.  I do not necessarily have more blood in my stool, or nocturnal bowel movements.  

I can thus conclude that IBD is making my period pains worse, not my period making my IBD pain worse.

 

Research shows that periods and IBD are linked.  And that IBD makes our period symptoms worse.  Rather than our periods making our IBD symptoms worse.

I personally have experienced an increase in diarrhea, bowel movements, and abdominal pain during my period and the week leading up to it.  It is comforting to know that many other women experience this as well.