Getting your period is never fun. All the bloating, cramps, mood swings, and inevitable excess laundry that result from your battle during shark week is pretty miserable. For some people, the symptoms are even worse, more numerous, and possibly more unexpected than you'd imagine. For example, you may also experience painful migraines, terrible constipation or unfortunate diarrhea, and shooting, crippling pains in your body every time you go to the bathroom. But what causes this phenomenon? Why does it hurt to poop when you're on your period?
"Prostaglandins released during menstrual cycles have been shown to increase nerve sensation, potentially also increasing sensitivity to pain and discomfort," Dr. Jessica Shepherd, MD MBA, gynecologist and U by Kotex partner tells Romper. "Rectal pain can be common during menstrual cycles due to the increase in progesterone and estrogen levels. The uterus is in close proximity to the rectum, and during your period there are increased inflammatory changes that occur and can cause some 'butt pain.'"
There are also a lot of nerves in the region surrounding your anus, rectum, and small intestine, and they often become inflamed simultaneously, according to the British Journal of Obstetrics and Gynecology.
However, it could be something more dire. If you suffer from extreme pain with bowel movements during your cycle, it's possible that the pain is caused by scar tissue around your rectum and lower intestine that has formed due to endometriosis, according to The Royal Australian and New Zealand College of Obstetricians and Gynecologists. The scar tissue that builds from the disease can obstruct the narrow passageways or swell with the fluctuation of hormones during your period.
Shepherd agrees that your pain while pooping may be cause of concern, telling Romper, "If you’re experiencing new or excruciating rectal pain or discomfort during your period, it’s important to consult with a trusted medical professional, in case it is a symptom of something potentially more serious like endometriosis or internal hemorrhoids."
That's certainly the case for me. I was diagnosed with endometriosis in my early 20s, and every month I have terrible constipation followed by bouts of terrible diarrhea. When I finally do have to go to the bathroom, it feels like someone is twisting my insides and prodding me in the butt with a fire-hot poker. It has been so bad that I have had to bite down on a washcloth so that my children don't hear me screaming. Mine is actually so extreme that I was diagnosed with ulcerative colitis secondary to endometriosis.
But if you don't have endometriosis, you really can just chalk it up to good ol' hormones. Erin Graham CNM, the Lead Midwife at Baby+Co. in Charlotte, North Carolina, tells Romper, "One of the things that happens pre-period, during PMS, is that you have a rise in progesterone levels, which can lead to constipation. When your period starts, you have a sudden drop in hormones, and your bowels can overcorrect. Pain could be constipation related." Basically, you're pushing too hard, and too long, and it's uncomfortable.
Also, Graham says that it could be due to the shedding of the lining of your uterus. When the blood vessels constrict, it's possible that you could feel it in your rectum, causing significant discomfort.
If you're concerned that the pain you're experiencing is abnormal or even just more than what you think you can deal with comfortably, call your OB-GYN. I know that some of the treatments that I've been put on have helped dramatically, and no one should feel that they need to suffer in silence. "Pain medication that decreases inflammation such as Ibuprofen can help with pain, especially if it is taken the day before you start your cycle or have the symptoms of rectal pain," Shepherd says. "Over-the-counter medication, like Midol, can be used to treat symptoms. For a more serious condition, a doctor might suggest hormonal therapy or similar treatment." Just get evaluated and get the help you need. You have to be your own best advocate.
Dr. Jessica Shepherd, MD MBA, gynecologist
Erin Graham CNM, Lead Midwife at Baby+Co. in Charlotte, North Carolina
This post was originally published on June 21, 2018. It was updated on Sep. 5, 2019. Additional reporting by Samantha Darby.
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