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Menstrual Cycle & GI Issues

Generally, women are more likely to experience bloating and GI issues than men. This is all the more true in different phases of our lives, particularly during the perimenopause and menopause phases, as well as in different phases of our menstrual cycles. 

Menstrual Cycle

You may notice that every month right before your period your clothes fit a bit tighter and you feel bloated. This is because high estrogen and progesterone affect the hormones that regulate fluid in the body. 

Estrogen increases a hormone called vasopressin, which is responsible for retaining water and constricting blood vessels. The increase in this hormone causes your body to retain water and constrict blood vessels a bit, which results in increasing blood pressure enough to cause a reduction in plasma volume. 

While progesterone competes for the same receptor site as another fluid regulatory hormone called aldosterone (responsible for retaining sodium), resulting in less aldosterone released. Ultimately, leading to a reduction in blood volume and a reduction in cardiac output and blood pressure. 

What does that mean in terms of training and competing? 

Plasma volume is the volume of fluid in your blood. When it is low, our blood is thicker, and less blood is pumped out with every heartbeat, which results in exercise feeling harder overall. Progesterone elevates our core temperature, so you will feel hotter, plus lower blood volume during a high hormone day makes it harder for your body to sweat and cool itself. More sodium in your system, which increases the risk for heat stress as well as hyponatremia. 

Perimenopause & Menopause Years

Fluctuating hormones during these years can cause digestive fluctuations, leading to diarrhea, vomiting, constipation, and abdominal cramps or pain.

However, high levels of cortisol (sometimes the result of chronic stress and also common during menopause) can slow down digestion and make matters worse for anyone. 

When estrogen levels are high, water is reabsorbed at a higher rate resulting in urinating more frequently. When estrogen levels are low, more water is retained leading to bloating. 

But it’s more than just salt and water. We have to consider overall diet and nutrition to reduce overall inflammation. Peri and postmenopausal women often say that when they start a “clean diet”, they lose 6 to 8 pounds in the first week. It isn’t fat loss, but excess water loss because they have increased the amount of anti-inflammatory foods and most likely decreased inflammatory foods in their diet, resulting in less overall inflammation and water redistribution to the blood. 

Other significant contributors to bloating are sugar substitutes and sugar alcohols, including xylitol, mannitol, and sorbitol. 

What Can You Do?

  • Begin hydrating before you begin your workout - especially if you are working out in the heat.

  • The night before - preload on some sodium with high sodium chicken broth or chicken soup. 

  • Drink a large bottle of low carbohydrate (no more than 9 grams of carbohydrate per 8 ounces) hydration drink every hour you’re out exercising. 

  • Find a special preload hydration product, or make your own! Nuun has a new line of products specifically for endurance athletes, found here, that were created with the help of  Dr. Stacy Sims, an exercise physiologist and nutrition scientist who specliazes in in sex differences of environmental and nutritional considerations for recovery and performance.

  • Taking ibuprofen before a race to head off any possibility of pain is a bad idea for a number of reasons. The common use of anti-inflammatory drugs such as NSAIDs can aggravate gastrointestinal (GI) bleeding, and potentially cause leaky gut. This can allow for bacteria to enter your system and interfere with fluid balance at the level of your kidneys, making it easier to get dehydrated. It has also been shown to interfere with recovery. Instead try to eat a few peppermint Tums (calcium carbonate) about 20 minutes before heading out the door. Keep peppermint Tums handy during higher intensity workouts and long runs to help slow down any GI issues.

  • Other products such as Alive and Goodgut have been shown to maintain the lining of the gut and they work especially well when the gut is stressed from increased body heat and low oxygen/low blood circulation during exercise. Dr. Stacy Sims recommends using this each morning of taper week to help improve gut integrity.

  • Check out the book ROAR by Dr. Stacy Sims for a more in depth look at how you can match your food and fitness to your female physiology for optimum performance, great health, and a strong, lead body for life.

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