Laxatives: A Period Trigger?

can laxative pills cause period

Many women experience changes in bowel function during their menstrual cycle, which can last for a few days. This is known as menstrual constipation and can be caused by fluctuations in the hormones progesterone and estrogen. Certain health conditions, such as irritable bowel syndrome (IBS) and endometriosis, can also increase the likelihood of constipation during menstruation. To relieve constipation, it is recommended to increase fibre and water intake, stay active, and use the toilet when needed. If these lifestyle changes do not help, laxatives may be recommended for short-term use.

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Hormonal changes during menstruation

The menstrual cycle is a series of regular, natural changes in the body. The menstrual cycle has two main phases: the follicular phase, or proliferative phase, and the luteal, or secretory, phase. The first day of the menstrual cycle is the first day of your period. The follicular phase normally makes up the first 10–16 days of the cycle. The luteal phase comes right after ovulation and lasts for about 14 days, ending with menstruation if pregnancy didn’t occur. Generally, menstrual cycles that last from 21–35 days, with a typical duration of 28 days, are considered normal.

The menstrual cycle is regulated by the complex interaction of hormones: luteinizing hormone, follicle-stimulating hormone, and the female sex hormones estrogen and progesterone. The menstrual cycle has three phases: follicular (before egg release), ovulatory (egg release), and luteal (after egg release).

During the follicular phase, levels of estrogen and progesterone are low. As a result, the top layers of the thickened lining of the uterus (endometrium) break down and are shed, and menstrual bleeding occurs. About this time, the follicle-stimulating hormone level increases slightly, stimulating the development of several follicles in the ovaries. (Follicles are sacs filled with fluid.) Each follicle contains an egg. Later in this phase, as the follicle-stimulating hormone level decreases, usually only one follicle continues to develop. This follicle produces estrogen. Estrogen levels increase steadily.

The ovulatory phase begins with a surge in luteinizing hormone and follicle-stimulating hormone levels. Luteinizing hormone stimulates egg release (ovulation), which usually occurs 16 to 32 hours after the surge begins. The estrogen level decreases during the surge, and the progesterone level starts to increase.

During the luteal phase, luteinizing hormone and follicle-stimulating hormone levels decrease. The ruptured follicle closes after releasing the egg and forms a corpus luteum, which produces progesterone. During most of this phase, the estrogen level is high. Progesterone and estrogen cause the lining of the uterus to thicken more, to prepare for possible fertilization.

If the egg is not fertilized, the corpus luteum degenerates and no longer produces progesterone, the estrogen level decreases, the top layers of the lining break down and are shed, and menstrual bleeding occurs (the start of a new menstrual cycle).

If the egg is fertilized, the corpus luteum continues to function during early pregnancy. It helps maintain the pregnancy.

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Irritable bowel syndrome (IBS)

IBS is classified as a neurogastrointestinal disorder, indicating problems with how the gut and brain coordinate to support the digestive system. This can lead to dysmotility, where the GI muscles have difficulty contracting and moving food through the GI tract, and visceral hypersensitivity, where the nerves in the GI tract are extra sensitive.

Several factors can contribute to IBS, including gut bacteria, severe infections, food intolerance, and childhood stress. People with IBS may have altered bacteria in their GI tract, and some develop the condition after a severe infection. Food sensitivities or allergies can also trigger IBS symptoms. Additionally, IBS is more prevalent in individuals who experienced severe stressors during childhood, including physical, sexual, and emotional abuse.

IBS symptoms can be managed through medications, diet, and lifestyle changes. A diet rich in fibre, such as fruits, vegetables, grains, prunes, and nuts, can help with constipation. Limiting dairy products and gluten, as well as following a low FODMAP diet, may also alleviate symptoms. Regular exercise, relaxation techniques, and adequate sleep can further help manage IBS.

While there is no cure for IBS, most people can effectively manage their symptoms by avoiding triggers and taking medications when necessary.

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Endometriosis

The exact cause of endometriosis is not known, but several theories exist. One theory suggests that during a woman's period, some of the endometrial tissue may back up through the fallopian tubes into the abdomen, where it can implant in the pelvis or be transported through the bloodstream or lymphatics to other parts of the body. Another theory posits that genetic factors are responsible, with certain genes causing cells to transform into endometrial tissue. Current research is also exploring the potential role of the immune system in the development of endometriosis.

Women with a family history of endometriosis, those who gave birth for the first time after the age of 30, and women with an abnormal uterus are at an increased risk of developing the condition. The symptoms of endometriosis can vary but often include pain and cramps in the belly or lower back during menstruation, abnormal or heavy menstrual flow, painful urination and bowel movements during periods, and other digestive problems such as constipation, diarrhea, or nausea. It is important to note that the amount of pain experienced by a woman with endometriosis may not always correlate with the severity of the disease.

The diagnosis of endometriosis typically involves a review of the patient's health history, a physical exam, and a pelvic exam. A laparoscopy, which involves inserting a thin tube with a lens and a light through an incision in the abdominal wall, is often used to visualize the pelvic area and identify the locations, extent, and size of the misplaced tissue. Other diagnostic tests may include a biopsy, ultrasound, CT scan, or MRI.

Treatment options for endometriosis include medication, surgery, or a combination of both. Mild cases may only require pain medication, while hormone-based medications such as birth control pills can be used to stop ovulation and slow the progression of endometriosis. Surgery may be recommended to remove abnormal tissue growths, and in some cases, a hysterectomy may be considered.

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Painful periods

Fluctuations in the hormones progesterone and estrogen are a likely factor in painful periods. Before a period starts, progesterone builds up in the body, which can slow down the digestive system and lead to constipation. There is also a theory that rising estrogen, not progesterone, is the main cause of constipation.

Underlying conditions such as irritable bowel syndrome (IBS) and endometriosis can increase the risk of constipation during a period, especially in the first few days. People with IBS may experience more bowel sensitivity and react more to things that upset their stomachs. Endometriosis can also cause painful periods.

To manage constipation during your period, it is recommended to increase your intake of fiber, which helps to increase the size of your stool and move it more easily through your digestive system. However, it is important to do this gradually, as rapidly increasing your fiber intake can cause gas and bloating. Staying hydrated is also important, as not drinking enough water may contribute to constipation. Warm water with lemon is a popular home remedy, and carbonated beverages may also help. Gentle exercise, such as a 20-minute walk, can get your intestines and their contents moving.

If you are experiencing painful periods, there are some over-the-counter and prescription treatments that can help. Anti-inflammatory medicines such as Advil or Motrin can help with pain relief, although if you have IBS, drugs related to acetaminophen, such as Tylenol, may be better. Antispasmodics may also help with cramping, and if constipation is severe, a laxative may be recommended. Bulk-forming laxatives, which increase the bulk of stools, are usually recommended as a first-line treatment. However, it is important to read the directions on the package to avoid using laxatives too often or for too long, as they can be habit-forming and may have side effects such as abdominal cramps and dehydration.

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Natural laxatives

  • Chia seeds: These are particularly high in fiber, with 9.6 g of fiber in just 1 ounce (28.4 g). They mainly contain insoluble fiber, but about 7–15% of the total fiber content is soluble fiber.
  • Berries: Most varieties of berries are also high in fiber, containing both soluble and insoluble types. For example, blueberries provide 3.6 g of fiber per cup (150 g).
  • Legumes: These include beans, chickpeas, lentils, peas, and peanuts, which are high in fiber. For example, 1 cup (180 g) of boiled lentils contains 14.2 g of fiber. Legumes can also help increase your body's production of butyric acid, which may act as a natural laxative.
  • Flaxseeds: These have natural laxative properties and contain a good mix of both soluble and insoluble fiber. A 3/4-cup (100 g) serving of flaxseeds provides 27.3 g of dietary fiber.
  • Kefir: This is a fermented milk product that contains probiotics, which can help increase regularity, improve stool consistency, and speed up intestinal transit.
  • Castor oil: When consumed, it releases ricinoleic acid, which has a laxative effect by activating a specific receptor in the digestive tract.
  • Leafy greens: Eating leafy greens such as spinach, kale, and cabbage can help improve regularity and prevent constipation. They are also rich in magnesium, which helps draw water into the intestines to aid in passing stools.
  • Senna: Senna is commonly used as a natural laxative in products like Ex-Lax and Senokot. It contains sennosides, which cause the digestive system to move faster and increase fluid absorption in the colon, providing relief from constipation.
  • Apples: Apples are high in fiber, providing 3 g of fiber per cup (125 g), and pectin, a type of soluble fiber that may act as a laxative.
  • Rhubarb: This contains sennoside, specifically sennoside A, which leads to a laxative effect. It also contains nearly 2.2 g of fiber per cup (122 g).
  • Prunes: Prunes contain 7.7 g of fiber in a 1-cup (248-g) serving. They also contain sorbitol, a type of sugar alcohol that acts as a laxative when consumed in large amounts.
  • Kiwi: One cup (180 g) of kiwi contains 5.4 g of fiber. It also contains pectin, which can help relieve constipation.
  • Magnesium citrate: This increases the amount of water in the intestinal tract, causing a bowel movement. It has been shown to be more bioavailable and better absorbed in the body than other types of magnesium.
  • Coffee: Coffee contains caffeine, which may affect the time it takes for substances to move through your digestive tract. It can also contain small amounts of soluble fiber that help prevent constipation by improving gut bacteria balance.

In addition to incorporating these natural laxatives into your diet, it is important to stay well-hydrated, follow a healthy diet, and make time for regular physical activity. These steps will help prevent constipation and keep your digestive system healthy.

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Frequently asked questions

No, laxatives are used to treat constipation, which can be caused by hormonal changes during a person's period.

Constipation during a period is caused by hormonal changes that affect both the uterus and the gastrointestinal tract. Fluctuations in the hormones progesterone and estrogen are thought to contribute to constipation.

There are several ways to treat constipation during your period. You can try eating more fiber, drinking more water, and exercising more. If these lifestyle changes do not work, you can try taking a laxative for a short time.

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