Dear Doctor, I always develop diarrhea during my menstruation periods. At first, I would think it was the food I used to eat during my periods but for the last three years, each month I get diarrhea whenever I’m in my periods. What could be causing this?

Pamela, Gacuriro

Dear Pamela,

Menstruation is a period of change in balance of hormones of a woman’s body. The purpose of these changes is to prepare the uterus for receiving a baby. If conception does not occur, the thickened, highly vascular inner lining of womb is shed, which manifests as menstrual blood flow. The interval between blood flow and number of days of flow is highly variable from woman to woman depending on level of hormones and the equilibrium in the body.

Due to these changes women experience different symptoms in variable amounts like abdominal pain, cramps in legs, nausea, vomiting, weakness, e.t.c. One may have one or more of these symptoms in variable amount. Diarrhea though rare is also one of the problems women can have during their menstrual cycles and this has been proven by studies. 

The exact underlying mechanism of diarrhea occurring during pregnancy is not clear. But the hormone progesterone is implicated in causing it. This diarrhea may be in form of increased number of liquid or semi liquid stools. There may be associated abdominal colicky cramp like pain. But rarely, it may be severe enough to cause dehydration or make one really sick and take to the bed.

Mental stress or anxiety is another factor which may contribute to the diarrhea. This is called irritable bowel syndrome. Here one has chronic or recurrent diarrhea and tests for all possible causes show negative results, i.e no causative organisms are identified for causing the diarrhea. There is nothing to worry about the diarrhea. Accept it as part of your reproductive life. Along with menopause, this problem will also stop. 

Eat a healthy balanced diet which will supply all necessary nutrients. This shall prevent anemia and or osteoporosis occurring later in life. Drinking adequate amount of fluids during periods of diarrhea will prevent dehydration. Fruits like bananas are useful in reducing frequency of diarrhea and preventing electrolyte imbalance which is a risk with greater frequency of stools being passed.

Dr. Rachna Pande is a specialist in Internal Medicine at Ruhengeri Hospital