5 Ways I Manage Pre-Period Constipation

I’m very familiar with the Bristol stool scale. That’s a chart you might have seen in your doctor’s office, at least if you go to a gastroenterologist (GI) as much as I do. It describes the seven most common kinds of poop.

Thanks to my plant-based diet and giving up dairy, I typically have type three or four. Those are the typical stools that are “sausage or snake-like” and easy to pass.

But my poops aren’t always so perfect.

Managing pre-menstrual constipation

If you’re someone who menstruates, it’s common to poop less than usual before your period. I’ve asked my GI doctor why this happens to me. His answer was hormonal fluctuations can “slow everything down.”

On top of that, he told me some people with endometriosis tend to have very sensitive bowels to these changes. Why? It appears the jury is still out on that one.

Always talk to your doctor if your bowel habits change. Here are the things that I do to get things moving.

Eat breakfast

Wave-like contractions carry poop through your intestines. Like sleep, most of us have a daily pooping rhythm. I usually poop once or twice in the morning.

During my period, I often have diarrhea. But that’s for another story.

Putting food in my stomach first thing triggers my gastrocolic reflex. That signal from the brain tells the bowels to make room for more food.

Sometimes a cup of coffee does the trick. But often, I need something more substantial. My pre-period breakfast isn’t big: a small piece of sourdough toast or a bowl of gluten-free oatmeal.

Get moving

Running often gives me diarrhea. The urge will be so strong I’ll have to stop my workout and find a toilet or a spot in the woods where no one can see me.

This commonly happens to my husband, so it doesn't just happen to those with endometriosis.

But running before my period causes pelvic pain and sometimes bleeding. I opt for long walks instead.

I must get in at least 4-8 miles daily to boost my bowels. That’s about 9,000 to 17,000 steps.

I don’t make this trek all at once. Here’s how I make my mileage:

• Walk to and from my local coffee shop instead of driving. (2 miles round trip)
• Go for a walk around my block several times daily. (1 mile each loop)
• Park in the farthest spot away from whatever store I’m going to.
• Use the treadmill I bought during the pandemic.

I’m able-bodied and work from home. I also live in a neighborhood with sidewalks and have access to exercise equipment. These privileges make it a lot easier for me to stay active.

If you’re having trouble finding ways to exercise, especially if you live somewhere unsafe or can’t walk very well, bring it up with your doctor. They should be able to refer you to a physical or occupational therapist who’ll brainstorm ideas for how to keep you moving.

Stay hydrated

It’s rare for me to drink a full eight glasses of water a day. Usually, that doesn’t cause any digestive issues. But stool dries out if your bowels are sluggish. Drinking more fluid usually softens things, so I don't have to strain when I poop.

I don’t feel thirsty a lot. And plain water is kind of boring, tbh. To stay hydrated, I do the following:

• Exercise, which makes me feel thirsty and gets my bowels moving at the same time
• Drink Vitamin Water Zero or some kind of sparkling water
• Eat more fruits and vegetables (this kind of water counts!)

Manage my fiber

Dietary fiber is one of the best things you can do for your bowel health. But my constipation gets worse when I load up on insoluble fiber, like the kind found in high-FODMAP foods.

For example, I get very bloated and backed up if I eat cruciferous vegetables like Brussels sprouts or broccoli. Cauliflower is a definite no-go for me.

Before my period, I opt for only low-fodmap fiber sources, including:

• Oats
• Carrots
• Zucchini
• Leafy greens
• Brown rice
• Almonds (only 10 at a time)

I also skip raw fruits and veggies. It’s much easier for me to digest plant-based foods if they’ve already been cooked. Think zucchini bread, stir-fry, or low-sugar blueberry muffins.

Use stool softeners or osmotic laxatives

When diet and lifestyle changes aren't enough, I’ll try non-stimulant, over-the-counter laxatives. These meds increase bowel movements by pulling water into poop. The ones I take include:

• Docusate sodium softgels
• Polyethylene glycol (Miralax)

My GI doctor told me it’s safe to take stool softeners or osmotic laxatives for the week before my period. You should ask your doctor if they’re right for you.

Occasionally, I may drink senna tea no more than two days a month. That’s an herb that stimulates colon contractions. However, I don’t use OTC stimulant laxatives like ex-lax.

Always talk to a healthcare professional about your pooping problems. They’ll want to rule out other health issues, such as bowel endometriosis, inflammatory bowel disease, or other medical conditions.

Avoid using laxatives regularly, stimulant or otherwise, without talking to your doctor first. They’ll let you know the best way to manage your constipation concerns.