Period Pain & Gut Health

How Our Gut Health Can Drive Period Pain

Period pain is your body communicating that something is out of balance. There can be a number of different root causes to period pain, a major one being poor gut health. According to Dr. Katharina Dalton, a British gynecologist and expert on PMS, there are two types of period pain:

  1. spasmodic period pain
  2. congestive period pain

We find women that fall in-between these categories. You may not fit perfectly, but just understanding the underlying causes of both and assessing your nutrition and lifestyle will be helpful.

Spasmodic Period Pain–more related to inflammation

  • Onset: first day of period
  • Site of pain: lower abdomen, back, inner thighs
  • Type of pain: comes in spasms
  • Often accompanied by period poops
  • Usual age: 15-25 years
  • Ovulation: must be present
  • PMS Symptoms: not always present
  • What Helps: reducing prostaglandins and inflammation in the body


Congestive Period Pain–more related to a lack of progesterone

  • Onset: Up to 14 days prior to period
    • Often accompanied by changes in mood, difficulty falling or staying asleep, feeling hangry, etc.
  • Site of pain: lower abdomen, back, head, breasts, joints, and limbs
  • Type of pain: heavy, dragging, and continuous increasing as menstruation starts
  • Usual age: 13-53 years
  • Ovulation: may be present or not
    • Lack of ovulation or not having a strong ovulation is what contributes to low progesterone
  • PMS Symptoms: Always present
  • What Helps: increasing progesterone and balanced, consistent meals throughout the day

Where Gut Health Comes In

Poor gut health and impaired digestion can lead to an elevation in estrogen and inflammatory prostaglandins. This impacts are periods in two ways:

  1. Elevation in inflammatory prostaglandins can lead to period pain, diarrhea/loose stools, and overall not feeling great during your period. Progesterone protects our bodies from inflammation, which means the presence of inflammatory prostaglandins can negatively impact progesterone levels.
  2. Excess estrogen means that our progesterone levels will be trying to match our estrogen levels, which will also negatively impact progesterone.

What We Can Do About It

If you think that your gut health could be impacting your hormones and period pain, there are some simple actions that are appropriate for most people. Everyone will be unique in what they need and it’s always best to talk with your provider to figure out what’s best for you.

  1. Support digestion: using 1-2 tsp of apple cider vinegar or digestive bitters prior to meals to help support digestive juices. This will help you break your food down better, which means better nutrient absorption and less stress in the gut. Learn more about supporting digestion in this podcast episode. 
  2. Include supportive herbs: slippery elm, aloe vera, and ginger are all great options you can use as teas or tinctures. Ginger is especially helpful for period pain at doses of about 2,000mg.
  3. Prioritize calcium rich foods: these can help reduce cramps. Foods like dairy, cooked greens, beans, and seafood are all great sources of dairy.
  4. Increase magnesium via topical sources like epsom salt baths or magnesium oil spray or oral sources like magnesium glycinate. Glycinate also supports gut health.
  5. Castor oil packs: can help support the liver and reduce inflammation.

If we have a long history of gut health issues and the suggestions above aren’t enough to improve your period pain, it can be helpful to get support from a practitioner and do further testing. We use the GI map stool test and hair mineral testing with all of our clients. If you need support improving your gut health and hormones, you can learn more about working with our team here.

I hope this is helpful for those that are struggling with period pain and think there gut could be part of the root!

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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