Gastrointestinal (GI) symptoms like heartburn and gas are common among people. It can occur due to several factors ranging from infections, dietary choices to stress and medical conditions like Gastroesophageal Reflux Disease (GERD) and bacterial gastroenteritis. However, studies have revealed that indigestion and heartburn can also result from menstruation. Speaking with the OnlyMyHealth team, Dr Sudeshna Ray, Consultant Obstetrician and Gynaecologist, Jaslok Hospital and Research Centre, Mumbai, shares some insight.
The Link Between GI Symptoms And Menstruation
GI symptoms during menstrual periods is a well known association, says Dr Ray, acknowledging that this association does not have robust evidence to back it up.
Also Read: Take Control of Your Menstrual Cycle: Doctor Shares Truth About Period Delaying Pills in Detail
According to him, the most common GI symptoms seen include abdominal pain, diarrhoea and bloating, which can lead to significant digestive discomforts at times. "This is seen in women even without known GI conditions such as inflammatory bowel disease," the doctor adds.
While evidence is lacking, Dr Ray shares that the common causes are the influences of the inflammatory substances, such as prostaglandins, premenstrual spike in the hormone progesterone and increased secretion of the neurotransmitter called serotonin.
Progesterone is a hormone that increases in concentration during the second half of the menstrual cycle, especially if pregnancy occurs. This hormone can relax the Lower Esophageal Sphincter (LES), which is a muscular ring that separates the stomach from the oesophagus. A relaxed LES can allow stomach acid to flow back into the oesophagus, leading to heartburn.
A study published in the Journal BMC Women's Health found that 73% of 156 healthy women experienced at least one of the primary GI symptoms either pre- or during menses, with abdominal pain and diarrhoea being the most common.
Dr Ray adds, “Women with emotional Premenstrual syndrome (PMS) are more prone to develop GI symptoms,” adding that studies have shown that women with depression, anxiety, and fatigue premenstrually experience more pronounced GI symptoms than women who do not have emotional symptoms premenstrually.
The above-mentioned study noted, "Those experiencing any emotional symptoms versus those without were more likely to report multiple primary GI symptoms, both premenstrually and during menses."
It is important to address prominent and persistent GI symptoms with severe period pain, as it could indicate endometriosis, according to Dr Ray.
Do’s And Don’ts When You Have Heartburn And Indigestion During Periods
If you're experiencing heartburn during your menstrual cycle, there are several do's and don'ts that you can consider to help manage your symptoms.
Do's
Pay attention to your diet: Opt for lighter meals that are easier to digest. Choose low-acid foods such as whole grains, lean proteins, vegetables, and non-citrus fruits. Incorporate foods that are rich in fibre, as fibre can aid digestion.
Eat smaller, more frequent meals: Instead of having large meals, try eating smaller portions throughout the day to prevent overloading your digestive system.
Stay upright after eating: Avoid lying down immediately after eating. Remaining upright for at least a couple of hours can help prevent stomach acid from flowing back into your oesophagus.
Stay hydrated: Drinking water can help with digestion and prevent dehydration, which could exacerbate heartburn.
Chew thoroughly: Chew your food thoroughly and take your time while eating to aid the digestion process.
Consider Over-The-Counter (OTC) medications: Antacids, like calcium carbonate or magnesium hydroxide, can provide temporary relief from heartburn symptoms. Consult a pharmacist or healthcare provider before using any medication.
Practice stress management: Stress can contribute to digestive issues. Engaging in relaxation techniques, such as deep breathing, meditation, or yoga, might help manage both stress and heartburn.
Also Read: Embracing Menopause: Experts Explain Impact On Women's Lives And Need To Break Silence
Don'ts
Avoid trigger foods: Steer clear of foods that can trigger heartburn, such as spicy, fatty, fried, and acidic foods.
Limit caffeine and alcohol: Both caffeine and alcohol can relax the lower esophageal sphincter (LES) and contribute to heartburn. Consider reducing or avoiding these during your menstrual cycle.
Cut back on carbonated beverages: Carbonated drinks can lead to bloating and put pressure on the LES, potentially causing heartburn.
Avoid smoking: Smoking can weaken the LES and worsen heartburn symptoms.
Don't lie down right after eating: Lying down immediately after eating can increase the risk of stomach acid flowing back into the oesophagus. Stay upright for a while after meals.
Limit chocolates and mint: Both chocolate and mint can relax the LES and contribute to heartburn. Consider reducing your intake during your menstrual cycle.
Avoid tight clothing: Tight clothing, especially around the waist, can put pressure on the stomach and worsen heartburn symptoms.
Conclusion
Know that everyone's body is different, and what works for one person may not work for another. If you find that your heartburn or other digestive issues during your menstrual cycle is persistent, severe, or interfering with your daily life, it's a good idea to consult with a healthcare provider. They can recommend appropriate treatments or lifestyle modifications based on your individual needs.