About 80% of people with periods experience premenstrual symptoms (PMS), and about 50% of those people seek medical care for them. One of those symptoms is bloating, which isn’t always caused by fluid retention, but could be due to inflammation.
Bloating before and during your period may be the result of changes in levels of sex hormones progesterone and estrogen. About a week before your period starts, your progesterone levels fall—this reduction of progesterone causes the uterus to shed its lining, which is what causes menstrual bleeding.
How these changes affect bloating
There are two ways your sex hormone levels, and menstruation can cause you to bloat.
- They directly cause you to hold on to slightly more water. Along with causing your period to start, research suggests the changes in progesterone and estrogen levels cause the body to retain more water and salt. The cells in your body become swollen with water which causes the feeling of bloating.
- Increased inflammation also causes your body to swell some and hold on to water. If you’ve ever worked out intensely after you’ve taken a few months off, you’ll know this feeling. After exercising really hard, your body is inflamed, and all of the muscles you worked don’t just hurt, but they’re actually puffy and swollen. When your body—or parts of your body—are inflamed, they hold on to extra water. This is what happens in your pelvis during your period.
A bit of inflammation is required to break down the uterine lining so you can start bleeding, but when it gets carried away the inflammation itself causes significant bloating. It can also be frustrating because it may feel impossible to get comfortable or find comfy clothes to wear that don’t remind you that you’re menstruating, you’re bloated.
Another cause of inflammation
Studies have proven that prostaglandins are associated with inflammation and are produced during menstruation. Equally important to scientists’ research is the impact of prostaglandins on menstrual pain. Excuse us while we get technical here. Prostaglandin F2α (PGF2α) and Prostaglandin E2 (PGE2) have specific roles in the inflammatory process. PGF2α causes constriction of the acruate vessels—arteries and veins—of the uterus which causes local hypoxia—lack of sufficient oxygen—of endometrial tissue. Another job of PGF2α is to stimulate smooth muscles to contract—the uterus is a smooth muscle—which supports menstrual bleeding. Think of squeezing toothpaste out of the tube.
PGE2’s actions, however, depend on the type of receptors, but it can include the relaxation of endometrial blood vessels and may work to increase swelling and recruit leukotrienes—inflammatory chemicals the body releases after coming in contact with an allergen or allergy trigger.
Prostaglandins may also be involved in the formation of other chemokines—an extended family of small size chemoattractant cytokines that facilitate leukocyte migration—and growth factors involved in the inflammatory response or in the repair process post menstruation. Prostaglandins may also increase the migration of neutrophils and leukocytes—white blood cells—into the endometrium.
Phew! That was a lot, thanks for sticking with us.
A quick note about endo
Endometriosis is a chronic, hormone-dependent, inflammatory condition, characterized by the presence and growth of endometrial tissue outside the uterine cavity. It affects 5-10% of the menstruating population of reproductive age and is often associated with moderate to severe pain, subfertility, and a marked reduction in health-related quality of life. Especially common in people with endo is what’s referred to as endo-belly which is extreme bloating during your period. This is believed to be linked to the significantly higher pelvic inflammation in people with endometriosis. If you’re severely bloated during your periods and suspect it may be due to endo, talk to your doctor about a treatment plan that’s right for you.
What you can do to combat the bloat
Some lifestyle changes may be enough to help you decrease your bloating around your period. Check out the tips below!
- Limit/avoid salty foods. Sodium can increase the amount of water your body retains. Avoiding overly salty foods may help decrease water retention and therefore bloating on your period. The AHA recommends limiting salt intake to 1500mg per day. Most processed foods and frozen meals contain loads of salt, so cooking your own meals is advised to limit salt as you can control how much goes into each meal.
- Eat some potassium. Foods rich in potassium may help reduce period bloating due to it decreasing sodium levels and increasing urine production. How’s that for a 2-in-1? Some foods to keep in stock:
- dark leafy greens—spinach, kale, swiss chard
- sweet potatoes
- coconut water
- Drink more water. Staying hydrated allows your body to use it where it needs it. Trying to consume less water, so you don’t retain any can actually make bloating worse. Getting dehydrated is stressful on your body which can make the inflammation worse, and your body will still find ways to hold on to water. Plus, it’s never a bad idea to improve your hydration, so we’re all for drinking more water!
- Stay away from refined carbohydrates. We totally get it; this one is hard! But hear us out. Foods like white flour and processed sugar cause spikes in your blood sugar which increases insulin levels in the blood and causes your kidneys to retain more sodium. (And we’re trying to lower sodium levels here.) This leads to more water retention, which can cause bloating, you know this, you just read it. So yes, cookies and cake and muffins should be limited or avoided altogether.
- Get some regular exercise. Studies have shown that exercise may help improve PMS symptoms and bloating is a symptom of PMS. Aim for about 2.5 hours per week of moderate exercise.
- PMS & Period Support. If you’re looking for help with PMS symptoms and period pain, we’ve got you covered! Our supplement is packed with 9 powerhouse plant extracts and minerals to help your body when you need it most! Pssst! It’s also the only clinically tested PMS supplement on the market!
Although menstruation is considered by some to be a proinflammatory event, that doesn’t mean massive amounts of bloating and/or inflammation are normal. If you feel like Regina George—“These sweatpants are all that fit me right now!”—before and during your cycle, know that you’re not alone, but also that you can do something about it! Chat with your doctor and see if you can get to the root cause of your symptoms and make sure to communicate that while you understand it’s common, you don’t believe it’s normal and know that there’s a solution out there for you. You don’t have to settle for feeling bloated and uncomfortable! Let’s change the language around bloating from normal to common.