Be Well: The Hormone-Digestion Connection
The Hormone-Digestion Connection: From Postpartum to Perimenopause (and Beyond)
From Mpls.St.Paul Magazine
After giving birth last fall, the moments blur together in a montage of happy (and trying) times marked with around-the-clock nursing, 24/7 bouncing, and day-to-night babywearing. But one thing I can viscerally recall is the lingering discomfort I felt for months afterward. And I’m not just talking about my puffed-up hands and feet.
My stomach was in a state of near-constant upset, regardless of what I did—or didn’t—consume. Uncomfortably roiling first thing in the morning, and even more so after a meal. I chalked the tummy troubles up to sleep deprivation and inconsistent eating times. There was another mouth to feed in this house and what mattered most was that he was receiving optimal nutrition.
So I decided to just grin and bear it for a while, a thing we women have a habit of defaulting to, no matter what the “it” is. Because we’re busy because we’re too tired to do anything out of our normal scope of daily things because we so often relegate ourselves to the bottom of our priority lists.
But there’s a time and place for everything. Sometimes the dishes can wait and Baby can cry it out just a little longer if it means giving ourselves a moment to come up for air and recalibrate. In my case, it meant eventually talking out my symptoms with girlfriends, who, across the ages and stages of life, related to my pattern of digestive issues. What I took away from our conversations was that the major milestones in our lives are usually associated with (literal) bellyaching.
It’s Not All in Your Head. It’s Hormones.
Anne Spicer, DC, DACCP, professor and clinician at Northwestern Health Sciences University’s Bloomington Clinic, eventually confirmed our suspicions—we’re all dealing with various levels of fluctuating hormones, which happen to hold a whole lot more power and influence over our physiology than we realize. “Hormones play a role in digestion,” says Spicer. “And as hormones shift during the month, a woman may have times of either constipation or diarrhea.”
As she explains it, progesterone is a hormone shared by both sexes, but it plays a greater role for women. Progesterone rises and falls, most pronounced during our monthly cycles, pregnancy, and in the postpartum period. “Progesterone slows the digestion and this can lead to constipation and gas and bloating, sometimes known as ‘PMS Belly,’” she says. When progesterone peaks before our cycles, she notes, it’s also the catalyst for acne, headaches, weight gain, and other PMS-related gripes.
On the other hand, “estrogen tends to increase the speed of digestion, so women may experience looser stools as estrogen circulation increases.” Because of the hormonal ups and downs that take place month to month between these two hormones, the intestine becomes prone to spasms where the muscles momentarily contract and tighten. That’s when “women may have pain, and alternate between constipation and diarrhea––especially in the week or so before her period begins,” she adds.
Alyssa Anderson, MD, gastroenterologist at HealthPartners, seconds Spicer’s remarks, saying that while the connection between hormones and the gut has also been long suspected in the Western medicine world—one may even call it a gut feeling!—the medical community is just finding stronger evidence for this link in recent years.
“We know that estrogen and progesterone affect gastrointestinal tract motility [the movement of food through the gastrointestinal tract], amongst other things, and this can cause significant symptoms such as bloating, pain, constipation, and diarrhea,” she says.
For menopausal women, reduced levels of estrogen and progesterone mean a slower travel for food through the gut, predisposing them to constipation, gas and bloating, and even weight gain. “This is typically accompanied by changes in the intestinal microbiome, which may further aggravate those digestive symptoms,” says Spicer. Overall, the shorter the time it takes for food to move through the gut, a better sense of well-being.
DYK? Add to all of this, in order to accommodate the uterus and ovaries, women have a longer intestinal tract than men, causing a higher pain sensitivity in the intestine. Spicer says it’s because of these anatomical differences that women are also six times more likely to have irritable bowel syndrome (IBS) than men.
Food, Fiber + Other Fix-its
In order to ease the effects of hormonal bloat and digestive comfort, Anderson and Spicer recommend the following:
Exercise. We know it’s good for us, but did you also know it aids digestion? The days you work out are likely also the days you’re feeling pretty, err, regular. Spicer says, “Exercising vigorously an average of five times per week for 45-60 minutes can enhance bowel function and reduce bloating and gas.” If that doesn’t sound doable, start with a half-mile walk and work it up to two miles.
Drink up. Water, that is. How many more reasons do we need to learn once and for all that it’s a workhorse for a bevy of symptoms? Fill that XL Contigo up, like, yesterday. Anderson says to aim for 32-64 ounces of the good stuff per day.
Whole foods. Spicer says a diet that consists of 50 percent fruits and vegetables helps to keep the colon clean and healthy. Fermented foods—think: natural sauerkraut, natural pickles, kimchi, and kombucha—as well as cultured foods and beverages, lay the groundwork for probiotic growth. “Sometimes, adding soluble fiber or taking a gentle osmotic laxative, like Miralax, is necessary to help keep things regular during times of hormonal changes,” says Anderson. But yoga and acupuncture are just as helpful if you’d rather shy away from any manmade add-ons, she adds.
See the doc. It’s important to stay up-to-date on colon cancer screenings, Anderson says. Guidelines now suggest screening average-risk patients starting at the age of 45 [formerly 50].
If symptoms outlast the hormonal periods and start becoming chronic, you may be dealing with food sensitivities or allergies. Spicer says a visit to an allergist may be in order to identify the specific foods flaring up chronic digestive symptoms. “See your medical doctor right away if you have significant changes in bowel habits, or if there’s any blood in your stool.”