Polycystic Ovarian Syndrome (PCOS) and IBS are two conditions with similar symptoms. Statistics show that 42% of women with PCOS also suffer from IBS or some gastrointestinal (GI) disorders.
PCOS is a complex hormonal disorder, whereas IBS is a functional gastrointestinal disorder. There is no real cause or cure for either of these disorders. Those with PCOS experience different levels of certain hormones, including luteinising hormone (LH), follicle-stimulating hormone (FSH), and testosterone.
Elevated levels of these hormones can contribute to symptoms of IBS, and hormone imbalances can slow down our motility (how fast foods move through the gut), resulting in constipation. Women with PCOS may also have infrequent or prolonged periods or develop follicles on their ovaries, leading to a failure to release eggs. Therefore, PCOS can not only affect infertility, but it can also affect the bowel system to a large extent.
Researchers also reported that stress is a massive influencer in both conditions. The start and the severity of the symptoms of IBS are related to acute and chronic stress. Therefore, patients with IBS have hyperactivity to stress.
It was also shown that chronic stress can change the “hypothalamic–pituitary–adrenal axis” – the way the hormone systems in the brain, ovaries, and stress glands link – in patients with IBS and PCOS.
How does your period impact your gut health and IBS?
Many women (with and without IBS) experience variations in gastrointestinal (GI) symptoms during their menstrual cycle, including:
- Abdominal pain
- Diarrhoea
- Bloating
- Constipation
Between 35 to 45% of women with IBS also experience dysmenorrhea and PMS, respectively. Women with IBS reported higher uterine cramping pain when menstruating than women without IBS. Women with IBS also report other more frequent and bothersome symptoms, such as fatigue, backache, and insomnia. They may have greater sensitivity to foods, such as those that are gas-producing, around the time of menstruation.
Because of the impact of oestrogen and progesterone on bowel movements, pain threshold, and inflammation, periods can trigger irritable bowel syndrome symptoms in those with the condition.
When progesterone levels rise following ovulation, it may cause constipation and gas build-up. This is because it reduces the contractions of the intestinal muscles and can slow down digestion and the movement of gas through the digestive system. That explains why you may be a little less regular in the days leading up to your period.
In contrast, fatty acids called prostaglandins are released around your period and can cause intestinal cramps. This can lead to more frequent bowel movements and sometimes diarrhoea. For some women, this cramping of the uterus and gut can be painful, which may be further increased by a change in sex hormones, lowering your pain threshold during this time.
The drop in progesterone can also cause changes to your appetite – explaining why we crave salty or sugary foods. Additionally, the body retains more water and salt, which explains the bloat.
Between 35 to 45% of women with IBS also experience dysmenorrhea and PMS, respectively. Women with IBS reported higher uterine cramping pain when menstruating than women without IBS. Women with IBS also report other more frequent and bothersome symptoms, such as fatigue, backache, and insomnia. They may have greater sensitivity to foods, such as those that are gas-producing, around the time of menstruation.
For many women, the link between GI symptoms and their menstrual cycle may not be intuitive. Using a daily diary where both menstrual cycle days and symptoms are tracked often helps women see patterns in their symptoms.
If you’re worried about your gut and menstrual cycle, talk to your GP.
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