Written by John Immel, Asheville, NCIf you are one of many women who suffer from gut problems associated with their menstrual cycle, you are not alone.

Women walk into our digestive clinic every week with questions about heaviness, gas, diarrhea and constipation. Or with concerns about how PMS and pre-PMS affect their digestion.

Many are baffled as they try to sort out what to eat for health & well-being throughout their cycle.

It's hard enough to figure out the menstrual cycle, no less how it affects a system as vast and complex as the gut.

So, we've laid out the basics and what exactly you can do to address the most common period-related complaints.

Here's how it all works.

Digestion & The Phases of Your Menstrual Cycle

Your menstrual cycle impacts both digestion and elimination.

Many women regularly experience constipation, gas, and bloating before their period and diarrhea once their cycle begins.

And these symptoms may be accompanied by heaviness, mood swings, acne, cramping and fatigue at one point or another in their cycle.

Yet many women don't know why there is a strong connection between their digestive issues and their cycle.

Hormonal changes during your cycle affect not only your reproductive system; they also impact your circulatory and nervous systems. This is why your menstrual health affects your whole body but especially your gut.

There are many nerves in the gut, and the gut is also greatly affected by blood flow.

Second, notice the similarities between your uterus and your gut.

Both are made up of smooth muscle tissue. So it makes sense that hormones affecting blood flow, nerves, and smooth muscle tissue in your uterus also impact your digestive tract.

And they do!

Western medicine also recognizes that hormones affect digestion, but the biochemical jury is still out on exactly how.

How to Find the Patterns in Your Menstrual Cycle

The symptoms you experience may differ from those presented here, as everyone has a unique body.

To find your personal patterns, track your bowel habits through your cycle. Most period tracking phone apps allow for this.

At the same time, keep a food journal to see how what you eat aggravates your symptoms.

Building awareness is the first step to improving your digestive health.

Ayurveda & Your Menstrual Cycle

The uterus is a muscle, and just like all muscles it can contract and release (relax).

It's impossible to talk about the menstrual cycle in Ayurveda without introducing apana vayu, a function of Vata that regulates release of muscles, including the uterus, in the body.

Apana vayu relaxes the muscles designed to release the four F's: fetus, flatus, feces, and fluids. (In relation to the menstrual cycle, the important fluids are urine and menses.)

Sometimes--such as when you are anxious--udana vayu becomes active instead and holds things in causing constipation. Other times--such as when you are relaxed--apana vayu releases them without issue.

When irritated, inflamed or anxious, apana vayu can also become overactive, causing excessive release (diarrhea). Let's see how all of this relates to menstruation.

No matter your menstrual cycle affects your digestion, it is important to address the root cause, hormonal imbalance.

Yarrow, Ashoka and Chastetree are 3 herbs that normalize hormone levels. Yarrow is also a bitter alterative that helps the liver clear hormone buildup.

The system regulating menstruation, in Ayurvedic terms, is called rajah vaha srotas.

Menstrual Cycle Phases & Digestion

The following is a graphic of a menstrual cycle. It describes the process from day one of menstruation through day 28 when menstruation begins again if the egg is not fertilized.

Ayurveda offers insights about possible digestive issues you may experience at different phases of your cycle.

Your Body Early in Your Menstrual Cycle

The first phase of the menstrual cycle, from Ayurveda's point of view, is the building phase which starts when menstruation ends. It lasts until ovulation, or days 5-13 of your cycle.

This phase loosely corresponds with the follicular (pre-fertile) phase in Western medicine. Estrogen rises during this time, which triggers ripening of the egg and building of the uterine lining.

Estrogen's building effects make this the Kapha phase of the cycle.

Usually, women do not have digestive problems during this time. However, Kapha women may notice slightly longer bowel transit times.

Eat a light, Kapha pacifying diet with plenty of green veggies and legumes during this building phase when you are estrogen dominant.

Avoid salt and dairy to prevent water retention, sluggishness, and congestion later in your cycle.

As your body temperature is cool during the building phase, favor warming spices such as cinnamon and ginger.

The Pitta phase occurs during days 13-18.

This is the fertile phase of your cycle around ovulation. Estrogen peaks early in this phase and progesterone is on the rise. Digestive complaints are not common during this phase of the menstrual cycle either.

Ovulation offers the most flexibility in your diet because your body is normally strongest and most exuberant at this time.

Enjoy it! You'll feel your best and your skin may glow during this phase.

Now onto some potential problems.

Digestive Problem #1: Heavy, Sluggish & Slow Bowels After Ovulation (Stagnant Kapha Type)

Right after ovulation your body holds things in.

It doesn't want to lose the egg!

During this phase it makes more progesterone to prepare the womb for fertilization.

For many women, high progesterone causes sluggish bowels starting four days after ovulation. This is at the end of the fertile phase (day 18) when progesterone peaks (days 18-22) and then slowly starts to decline.

Digestive problems generally occur from day 18 until day 4 of your next cycle, the Vata phase.

Foods that stimulate the release of bile (such as bitters) are helpful during this phase to keep things moving.

When progesterone remains too low in this phase, estrogen dominance results. Estrogen dominance causes the uterine wall to thicken and the body to retain water. This causes mild heaviness and achiness in the pelvic area.

Hormones, Gas & Stagnation

Studies show that when progesterone levels are high, it takes significantly longer for food to pass through your digestive tract, compared to earlier in your cycle when they are much lower.

One reason is that progesterone is a smooth muscle relaxant, which reduces spasm. As a muscle relaxant, it is commonly given to pregnant women to delay labor and preterm birth--it's relaxing effects are so effective it can reduce uterine contractions.

Unfortunately, this has the frustrating side effect of slowing down contractions of the bowel as well.

Estrogen is highest just before ovulation and seems to affect the sigmoid colon (the end of the colon) more than the cecum (beginning of the colon). Studies show that estrogen can also make the bowels sluggish.

When these hormones cause apana vayu to be excessively relaxed and lacking in tone, stagnation results. This slows the movement of food through the digestive tract causing gas.

The stagnation can also cause buildup so you feel bloated and backed up. These symptoms of sluggish digestion correlate with manda agni (slow digestive fire) and are associated with Kapha dosha.

The sluggishness also affects other sites including the colon, gallbladder, and lower esophageal sphincter or LES (the valve that prevents stomach acid from going up into the esophagus).

When the LES is sluggish, you may experience acid reflux. In the gallbladder sluggishness creates bile deficiency, which also causes constipation for both Vata and Kapha doshas.

Bile (a natural laxative) accelerates bowel transit time by irritating the walls of the intestines. When the gallbladder is sluggish and bile is deficient, constipation results and stools will be light colored.

Remedies for Hormonal Causes of Sluggish Bowels After Ovulation

Food and herbs with bitter taste generally relieve bowel stagnation because they increase bile flow and contraction of intestinal muscles.

When bowels are sluggish before menstruation accompanied by water retention, swelling, and heaviness (Kapha type), bitter emmenagogues such as blue cohosh, mugwort will relieve the hormonal cause of heaviness as well as stimulate bowel movements.

Food and herbs with a stimulating, laxative effect that pacify your dominant dosha, are supportive.

Vata individuals should use a smaller amount of bitter taste together with some sour taste.

Sour taste aids light, dry Vata individuals because it both increases bile flow and directly lubricates the intestines.

In all constitutions, a teaspoon of olive oil helps encourage elimination by encouraging bile flow.

Pungent taste may offer needed stimulation. High fiber will also encourage regular elimination.

Rye bread contains a type of fiber that, when it ferments in the intestines, causes them to contract. This makes rye bread ideal for sluggish bowels.

Take care to ensure that your rye bread doesn't have wheat. If it does, choose instead a breakfast of rye berries cooked with cranberries.

Twisting stretches and vigorous breathing exercises like kapala bhati can keep things moving during this stage as well.

And regardless of when digestive problems occur during your cycle, eat easy to digest foods whenever you experience symptoms. And, include high-fiber foods, whole grains, and cooked vegetables to stay regular.

Generally avoid sugar because it can cause hyperglycemia (excess blood sugar).

The ups and downs of blood sugar levels will lead to instability in mood plus the potential for intense cramping.

Digestive Problem #2: Constipation & Gas in Your Premenstrual Phase (Cold Vata Type)

From day 22 until just before menses on day 28, constipation and gas are dominant as progesterone and estrogen hit their low points.

The drop in hormone levels leads to low body temperature, general blood stasis (slowing or pooling of blood), and dryness.

These symptoms create coldness and dryness in the digestive tract as well.

Vata is high during this catabolic phase of the cycle when the uterine lining is deteriorating. Characterized by vishama agni (irregular digestion associated with Vata), this phase may leave you feeling bloated and backed up.

Many women experience cramping with constipation just before their period. The cramping is caused by ischemia (inadequate blood supply) in the uterus, which makes it sore.

Excess gas during the latter part of your cycle, can cause a build up of ama or toxicity. This shows up as acne and can also intensify uterine colic and cramping when menstruation starts. So, be sure to address gassiness if you have it. Constipation, gas, and bloating resolves when menstruation starts.

Remedies for Premenstrual Phase Digestive Problems

Vatas should add salt to their diet during the latter phase of their cycle and during menses. Salt softens stools, counteracts dryness, and rebuilds electrolytes lost with menses.

They should follow a Vata pacifying diet including warming, supportive foods like soups and stews to nourish their body during this phase.

Your appetite for burgers and other blood builders may be strongest right before you begin bleeding as your body prepares for menses. Avoid raw foods and legumes.

Eat easy to digest foods if you experience gas and bloating.

Warming, vasodilating herbs such as dong quai, turmeric, cinnamon, cloves, and manjistha will encourage blood flow to the uterus during this phase. A hot water bottle to the abdomen also encourages blood flow and alleviates constriction.

Vata pacifying, moisturizing herbs like licorice root and marshmallow root are helpful to lubricate the intestines for smooth bowel movements. A mild, supportive laxative such as haritaki will encourage regular flow and keep your system detoxified.

To stabilize your mood, roast or bake sweet root vegetables like sweet potatoes and carrots as a bit of sweetness will relieve irritability due to your estrogen dip.

Complex carbs such as whole grains also help stabilize your mood. Hyperglycemia and volatility of blood sugar levels, on the other hand, create more instability and discomfort, so avoid refined sugars and flours.

Vitex, turmeric, thyme, and oregano all increase progesterone which can help you to feel more comfortable as can supplementing with B vitamins.

Magnesium has been shown to relieve cramps and constipation as it helps your system relax.

Belly breathing, massage and gentle movement can help keep things moving during this stage.

Digestive Problem #3: Purging During Your Menstrual Cycle (Pitta Type)

There is outward flow from your body when you menstruate.

And that includes the bowels.

So, frequent bowel movements and softer stools may coincide with bleeding during menses days 1-3.

Apana vayu is fully active and may be overactive at this time.

You may also notice that you pee more during this phase, since a drop in hormones means the end of water retention.

For some people, this natural cleanse of fluids and the bowels releases all the heaviness they've been feeling prior to menses.

Suddenly they feel light and refreshed.

For others, especially Vata individuals (who may already be deficient and dehydrated), this phase can leave them feeling exhausted, depleted, and cold.

Prostaglandin's Role

Loose stools during menses are caused by prostaglandins.

Prostaglandins, known as "local hormones," play a role in the normal injury process. When any part of the body is damaged, the cells produce prostaglandins, which increases sensitivity to pain.

In the uterus, this means more pain from menstrual cramping.

Western medicine relieves these symptoms using NSAIDS (aspirin, etc) because they block prostaglandins, reducing nerve sensitivity.

The endometrial cells in the lining of the uterus produce lots of prostaglandins just before your period begins. These are released as the uterine lining breaks down causing the uterus to contract.

And the contractions help expel the sloughed uterine lining during the bleeding phase of menstruation.

Unfortunately, during a contraction blood supply to the uterus is cut off, which deprives it of oxygen. The result is soreness and lactic acid build up, similar to soreness in any muscle after prolonged use. The result is that you experience cramps.

The more prostaglandins a women has, the more pain and bleeding she will experience during menses since prostaglandins cause vasodilation.

Unfortunately, some rogue prostaglandins may make their way into the bloodstream and over to the digestive tract. This can cause contractions of the intestines and the loose stools or diarrhea common during menses.

Prostaglandins also cause headaches, nausea, and vomiting.

Since the released prostaglandins increase pain sensitivity, inflammation, and diarrhea, Ayurveda suggests this condition is both a vata and a pitta imbalance.

Remedies for Purging During Your Menstrual Cycle

If you feel exhausted during your period, remember that's how tired your digestive system is.

Support your body with easy to digest, fiber rich, nurturing foods during this time. Rice pudding and other sweet comfort foods are on the menu!

And be sure to replenish electrolytes lost from menstrual blood and loose stools with coconut water or a banana, lime and coconut smoothie.

If you have diarrhea during menses as well as heavy bleeding and painful periods, you may need a vata-pitta pacifying diet and lifestyle.

These will support and soothe your body, while they reduce the effects of prostaglandins.

Continue to avoid refined sugar, however.

For a list of herbs that can help relieve menstrual symptoms, click here.

It also helps to avoid certain foods.

Alcohol & coffee are inflammatory and may increase pain and cramping. Minimize processed foods and animal fats, both of which increase the negative (series two) prostaglandins.

Series two prostaglandins cause inflammation, increased pain perception and womb contraction.

It's also best to avoid fried foods, which may overload your liver, which is busy processing lots of hormones.

Favor foods that encourage positive prostaglandins (known as series one and series three), which are anti-inflammatory.

Such foods are high in linoleic acid and include tuna, salmon, evening primrose oil, and starflower oil.

Other foods that pacify Pitta and reduce inflammation include green veggies, blueberries, cranberries and turmeric.

Foods rich in Omega 3 fatty acids such as ghee, coconut oil, avocado, olive oil, flax and chia seeds are a good choice as well. And consider taking B vitamins to help create more anti-inflammatory prostaglandins.

Finally, the bromelain found in pineapples may also bring relief. And calcium may work to slow elimination.

Ama Worsens Menstrual Cycle Symptoms

Amais toxicity, often due to fermentation and gas in the digestive tract.

Apana vayu governs the release of feces, urine, flatus, fetus and menstrual blood. When working properly, it ensures the fluid wavelike contractions of smooth muscle tissue promoting effortless elimination of menses and poop.

When ama is present, though, muscles can become colicky, contracting irregularly and causing tension and cramping. It can also disrupt hormones and increase prostaglandins.

For these reasons, the first step to regulating the menstrual cycle is always a simple cleanse.

The easiest way to cleanse is by reducing sugar, caffeine & alcohol in your diet.

Or, if you aren't menstruating and have a few days where you can take it easy, eat a light diet of kitchari. This allows the digestive system to reset and enhance your digestive fire (agni).

A stronger digestive fire will also burn up residual toxins.

While a laxative can flush out toxins before menstruation, avoid them during menstruation.

Antispasmodics like dark chocolate and aromatic herbs like asafoetida & cinnamon can help relax the uterus when contractions become too strong or colicky.

The herb Cramp bark is ideal.

Get gentle movement in, but don't push your body to its physical limits.

Say No to Digestive Discomfort

Your menstrual cycle should not be a painful experience. Don't ever accept digestive discomfort as just part of life, something you have to put up with because you have no other choice.

Rather, use the remedies outlined in this article to address your specific problems.

Then breathe a sigh of relief.

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