PMS and Digestive Distress, What's the deal and what to do about it!

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Do you experience excessive bloating, constipation and or diarrhea when you’re about to get your period?

Does this aggravate your pelvic organ prolapse?
Cause you to lose confidence in your body?
Do you avoid activity?
Or maybe just get SUPER annoyed with your unpredictable digestion and elimination?

Well let’s talk about why this happens and what you can do about it!

PMS and Digestive Distress:

We experience pre-menstrual syndrome (PMS) 7-14 days before we start to shed the uterine lining, i.e. bleed.

The menstrual cycle is divided into to major phases, the
Follicular phase, this is we develop the follicle that will ultimately release the egg at ovulation.

The Luteal Phase, takes place AFTER ovulation,

PMS occurs during the END of the Luteal Phase, while
menstruation marks day 1 of the new cycle, AKA,, the beginning of the first have of the cycle, the Follicular Phase.

This time period in which we are ending one phase and beginning another our bodies are SUPER busy and so we see some hormonal shifts and changes in biochemistry that can cause some digestive troubles.

Major hormone at play: Progesterone is high right before your period, and drops immediately when your period begins at which times the body is signaled to release prostaglandins to stimulate uterine contractions. 

Impact on the digestion and gut:

High levels of progesterone produced by the body right before menstruation stalls peristalsis (the natural contractions of the gut that help to move and eliminate waste) and this slowing of elimination can lead to mild to severe constipation in the days leading up to your period.

Progesterone levels decline quickly when we finally shed the lining of the uterus, i.e. “get” our periods.
This decline triggers the release of other hormone-like chemicals called prostaglandins.

Prostaglandins contract the uterus to help excrete the lining, and since the uterus is proximal to the bowels, the prostaglandins can also cause increased contractions in the bowel causing diarrhea.

Isn’t that sort of wild!

Ok, so then what can we do about it??!!

Nutrition and supplements:


When PMS-ing, slightly increase your insoluble fiber intake, veggies, fruit, high fiber carbs!

Fibrous carbohydrates can be used strategically here to help keep serotonin levels up (improve mood!), but pay attention to the quality.
Remember that carbs aren’t just chips, bread, pasta and cookies, there’s rice, veggies, fruit, and tubers too!
These foods typically have less of a dramatic impact on your blood sugar (you won’t buzz, but you won’t crash either) and contain more fiber.

Prioritize protein and adequate water intake as well and consider
Your body excretes used hormones via bowel movements, therefore for optimal hormonal health and minimal PMS symptoms, you really want to poop daily throughout your cycle!

Increasing your magnesium supplementation will also help if you tend to experience PMS-induced constipation when progesterone levels are high.

And BONUS, magnesium is also great for improved sleep and reducing cramping!

Many women find that increasing their probiotic intake around when PMS-ing can help keep elimination regular and also prevent and vaginal microbiome imbalance!


If once your period begins, you experience lots of cramps and discomfort, keep up that magnesium intake, but also check your fat intake!

Go ahead and increase your Omega 3 fatty acid consumption Omega 3’s help to counteract the prostaglandins that cause pain and discomfort during your period. This should ALSO reduce the incidence of diarrhea.

Vegetable oils like corn, safflower, sunflower, canola (also known as rapeseed), peanut, sesame and soybean oils and inflammatory.
These foods inflammatory for the body and can aggravate your mood, headaches and migraines, cramps and aches.


Since progesterone levels can be high UNTIL your period begins, pay close attention to how your body feels in exercise. Relaxed muscles can easily become injured muscles.

That being said, routine movement is
going to aid digestion and continue to support you in your fat-loss goals, so continue to exercise, now is just not the necessarily time for personal bests and lots of intensity or heavy load.
Once your period has begun and progesterone levels have decreased, you are less susceptible to injury and  you might find that short bouts of intense exercise improves your mood and reduces cramps.

Additional notes: Women with pelvic organ prolapse can experience an increase in symptoms right before menstruation.
Since constipation can be problematic and a nuisance for ALL forms of POP, tracking your cycle, anticipating when you are in that that PMS zone and adjusting your diet or supplements accordingly, can be helpful!

Listen to your body and scale back on load and intensity in your workouts during this time if need be.

***Note, Unbearable PMS can be a sign of estrogen dominance in which case you will want to do some work to balance your hormones, improve your gut health and liver function.

Go check out this article by Dr. Jolene Brighten for more info!

Article Link


Sarah Smith is a personal trainer, level two Russian Kettlebell Instructor, postnatal fitness specialist and pelvic floor and gut health advocate with a Masters in Agricultural Science.
She works online and in Raleigh, North Carolina. 
Sarah specializes in helping women online and in-person feel strong, confident and capable in their bodies!

She is a mom to three boys and one English Bulldog. She loves soil, coffee and not folding laundry. Come follow her on Instagram or Facebook.

For more from Sarah join her Strong Guts N’ Butts community and get free workouts, content and support sent RIGHT to your inbox!