The Link Between Hormones and Gastrointestinal Problems

Updated on 2024-03-26 09:50:55 0 0

By Elizabeth Pratt

Medically reviewed by Robert Burakoff, MD

Hormones are chemical messengers created by the endocrine system. Hormones that are released into the bloodstream work to regulate most body systems, including metabolism, emotions, fertility, and heart rate.1

Hormonal balance can also play a role in regulating gut health. Hormonal imbalances or fluctuations may increase some gastrointestinal symptoms, such as symptoms of irritable bowel syndrome (IBS).2

This article explains how hormonal changes influence gastrointestinal symptoms. It also covers treatment options and when to see a healthcare provider.

Hormones and Irritable Bowel Syndrome (IBS)

Research suggests that hormones can influence both symptom severity and pain sensitivity in irritable bowel syndrome (IBS).2

Fluctuations in sex hormones, in particular the fluctuations of estrogen in women, can contribute to symptom severity in IBS.3

The influence of estrogen on gastrointestinal symptoms is thought to play a role in why rates of IBS are two to three times higher among women than among men.3

Sex-related differences in IBS are evident from adolescence with the onset of menstruation, and they last until a person's mid-40s. Researchers have observed that women tend to experience improvements in their IBS symptoms during menopause when hormonal fluctuations stop.3

Both female and male hormones can influence the level of pain sensitivity and inflammation in the intestine, but fluctuations of female hormones seem to have a bigger impact.2 Other hormones like cortisol (the stress hormone) and cholecystokinin (a hunger hormone that regulates the gut) may also play a role.2

Menstruation

There are two main hormones associated with menstruation—estrogen, and progesterone. These hormones do not just affect the sex organs. There are receptor cells for these hormones throughout your gastrointestinal (GI) tract. This's why many women—even those without IBS—experience digestive symptoms related to their menstrual cycle.3

The menstrual cycle can be broken up into two main stages:

Before ovulation, called the follicular phase: During this time (days one to 14 from the start of your period), estrogen levels are increasing from the midpoint in this cycle. As estrogen levels rise, GI symptoms tend to be reduced.
After ovulation, called the luteal phase: Estrogen levels drop significantly after ovulation. This may be accompanied by an increase in GI symptoms.

Possible GI symptoms that may be more severe during the luteal phase and the first few days of your menstrual period include:4

Constipation
Bloating
Diarrhea
Abdominal pain

Pregnancy

The hormonal changes that occur in pregnancy can impact both digestion and other functions of the GI system. This can cause a variety of symptoms.

These symptoms may also be caused by the growth of the baby. As the baby grows, the space in the abdomen becomes limited and this may impact the function of the stomach or intestines.5

Possible symptoms include:5

Heartburn
Constipation
Diarrhea
Nausea
Vomiting

Vomiting may occur in the first 16 weeks of pregnancy when morning sickness is most likely.

In pregnancy, hormonal changes cause the muscles between the stomach and the esophagus to relax. This can cause heartburn. By the third trimester of pregnancy, half of all expectant mothers will experience heartburn.5

Changes in hormones may also impact the lower part of the gastrointestinal tract. This can cause a slowing of bowel movements and can result in constipation.5

Perimenopause

The time before menopause, called perimenopause, can trigger hormonal fluctuations that are different than a standard menstrual cycle.6

The hormonal fluctuations that can occur during perimenopause differ for everyone, but significant fluctuations in estrogen and progesterone may trigger an increase in IBS symptoms, like constipation and diarrhea.7

Menopause

During menopause, the levels of estrogen hormones decrease and the levels of the stress hormone cortisol increase.8

Studies on the relationship between IBS and menopause have yielded mixed results. Research indicates that the prevalence of IBS symptoms decreases for women after the age of 40 or 45—a decrease not seen in men.93

However, the rise in stress hormones and general age-related slowdowns may lead to changes in the function of the GI system. That in turn leads to an increase in IBS symptoms.8

Hormonal Birth Control

Birth control pills use synthetic estrogen and progesterone to reduce the ability to become pregnant. These synthetic hormones can reduce the hormone fluctuations related to the menstrual cycle. However, research on hormonal birth control's effect on IBS symptoms is inconclusive.

Anecdotally, many women have reported that taking birth control pills helped their IBS while others have said that their IBS worsened when they started taking an oral contraceptive.310

Managing Symptoms

Coping with IBS symptoms in addition to hormonal symptoms will vary based on individual experience.9

For managing stomach pain, treatment options may involve:11

Medications
Staying hydrated
Using a hot water bottle
Eating bland foods

For constipation, possible management strategies include:12

Dietary changes
Fiber supplements
Increased fluid intake
Exercise
Laxatives

For diarrhea, treatment options include:13

Medications
Rehydration drinks
Dietary changes

Nausea may be managed by:14

Medication
Drinks like chamomile tea or ginger ale
Eating a bland diet
Eating small meals

Improving Gut Hormones

The endocrine system, which creates hormones, has an important role in the function of the body.

There are a number of ways to keep the endocrine system healthy and functioning well. These include:15

Seeing your healthcare provider regularly for a check-up
Checking with your healthcare provider before taking any kind of herbal treatment or supplement
Exercising regularly
Following a nutritious diet
Advising your healthcare provider if you have a family history of problems that affect the endocrine system, including diabetes or thyroid issues

When to See a Healthcare Provider

If you have IBS and are dealing with more pronounced symptoms due to hormonal fluctuations or if you've taken medication for GI symptoms for two weeks and haven't seen any improvement, you should see your healthcare provider.16

You should also see your healthcare provider straight away if you have any of the following:16

Bleeding from the rectum
Stomach pain that worsens
Indigestion that worsens
Unintended weight loss
Trouble swallowing
Sudden change to your bowel habits that persists
Worsening heartburn
Worsening indigestion

Summary

Hormones can affect a variety of things in the body, including the gut. Some hormonal changes can cause an increase in gastrointestinal symptoms, especially if you have IBS. Hormone changes may occur due to menstruation, pregnancy, menopause, and being on birth control.

Managing symptoms can include medication or self-care remedies like staying hydrated and using a hot water bottle. If symptoms worsen or you have other symptoms like bleeding from the rectum or unintended weight loss, you should speak to your healthcare provider.

Sources

Hormone Health Network. Your health and hormones.

UNC Center For Functional GI and Motility Disorders. Hormones and IBS.

Mulak A, Taché Y, Larauche M. Sex hormones in the modulation of irritable bowel syndrome. World J Gastroenterol. 2014;20(10):2433-2448. doi:10.3748/wjg.v20.i10.2433

International Foundation for Gastrointestinal Disorders. Gynecological aspects of irritable bowel syndrome.

UTSouthwestern Medical Center. 4 common pregnancy-related GI issues, and when to call the doctor.

Jean Hailes. Perimenopause: how to manage the change before ‘The Change’.