Friday, June 5, 2015

A Warning Bowel Movement Before Your "Period"...Who Freakin Knew???!!!

I'm sure this topic may be a bit weird or uncomfortable for many to address, Hoooowever...when it happens to me I'm always concerned about the probability of it happening to another woman, and if she then feels as if she can't express concern or question it because she's the "only one" or its "not proper" to discuss.  If you have been reading my blog AT ALL, you know that my purpose is to discuss and post about such topics because they are natural, normal, they do happen on a daily basis, and we MUST discuss them in order to familiarize ourselves with the anomalies of our body!  And most importantly, not having these discussions enables feelings of isolation, loneliness, insufficiency, and irrelevance that can be harbored as depression and anxiety issues in women, which we ultimately run the risk of passing on to younger women.

I decided to write this post because, over the years I have noticed an obvious relationship between the day I start mensing and horrible crampy bowel movements.  Since I have had a hormone free IUD, I have noticed very difficult, cramping, can't keep still bowel movements the day of mensing (bleeding).  These bowel movements are so painful that I have to use labor breathing techniques, stomach rubbing, and rocking to cope with the pain...afterwards I feel as if my entire bowel tract has been emptied and I'm exhausted and must take a nap.  AND upon waking from my nap... menstrual mensing (bleeding) has begun! Initially, I was thinking that the bowel pain, and discomfort that I was experiencing was related to my Crohn's disease, but in all reality it appears to be related to a non-steroid hormone in our body called prostaglandin!

So What Is Prostaglandin?
Prostaglandins are non-steroid hormones that are very potent and present in very small amounts (Shier, Butler, & Lewis, 2007, p. 495).  They are not stored in cells but are synthesized just before they are released (Shier, Butler, & Lewis, 2007, p. 495).  Different prostaglandins have different functions, but this post is going to focus on one prostaglandin in particular that is named PG4.  This particular prostaglandin has the ability to contract smooth muscle in the walls of the uterus, causing menstrual cramps and labor contractions (Shier, Butler, & Lewis, 2007, p. 495).

Translation to Painful/Urgent BMs at the Start of Menses...
When our endometrium is stimulated by estrogen and progesterone, the production of prostaglandin is increased.  When the endometrium begins to shed or when mensing (bleeding) begins the actual break-down of the endometrium causes the release of prostaglandin (Lewis, Heitkemper, Dirksen, O'Brien, & Bucher, 2007, p. 1386).  The prostaglandin in our reproductive organs causes contractions and constriction of our uterus to expel the complete uterine lining.  In some women, the release and amount of prostaglandin can be very excessive causing the non-steroid hormone to travel to the bowel regions, at which point it causes contractions and constrictions of the bowels...which leads to the urge to have a bowel movement and/or painful, cramping bowel movements within 12-24 hours before the onset of your menses (bleeding).  In addition, this same excessive prostaglandin release is the cause of primary abdominal pain or discomfort (dysmenorrhea) associated with menstrual flow.

Other Symptoms
Other symptoms of excess prostaglandin release can include

  • lower abdominal pain that is sharp, radiating to your lower back and upper thighs
  • abdominal pain can be accompanied with nausea, diarrhea, loose stools, fatigue, headache, and light headedness (Lewis, Heitkemper, Dirksen, O'Brien, & Bucher, 2007, p. 1386).


How to Feel Better
I'm not sure there is much that can be done about the urgent, very painful, cramping bowel movements.  I just thought it would nice for you to know that those "horribly crampy, smelly bowl movements"  that you may experience between 12 hours and 2 days of your period starting...are not in your head and that there is a legit reason for them...NO REASON TO BE ASHAMED ;)  However, with regards to painful menstrual cramping you can use:
  • heat (apply to lower abdomen or back)
  • regular exercise (can reduce prostaglandin production),
  • proper nutritional habits,
  • avoiding constipation,
  • eliminating stress and fatigue, 
  • drug therapy( such as NSAIDs, Naproxen, Ibuprofen, etc..) - remember that these medications should be started at the first signs of bleeding, and continued for every 4-8 hours to maintain a sufficient amount of the drug in your system to minimize prostaglandin release (Lewis, Heitkemper, Dirksen, O'Brien, & Bucher, 2007, p. 1387).
  • lying down for a short period,
  • drinking hot beverages (herbal teas), and
  • taking warm tub baths.

Educate Yourself
Make sure to keep track of your menstrual symptoms and moods through out your cycle, with some sort of application (I've named a few in a previous post).  This way you can better prepare for rough days, and pick up changes or alterations that can be discussed with your health care providers.  The more aware you are of your body and its responses or lack thereof, the better prepared you can be to address the issue.

I hope this post helps with deciphering between bowel issues related to Crohn's and  bowel issues related to menstruation.  I also hope this post resonates with someone...sometimes all it takes is one person to mention an issue for others to relate.  So, I hope this post is relatable ;)  Feel free to share and comment.  Until next time ;)











References:
Lewis, S., Heitkemper, M., Dirksen, S., O'Brien, P., & Bucher, L. (2007). Medical Surgical Nursing Assessment and Management of Clinical Problems (Seventh ed.). St. Louis, Missouri, USA: Mosby Elsevier.


Shier, D., Butler, J., & Lewis, R. (2007). Hole's Human Anatomy & Physiology (11th ed.). Boston: McGraw-Hill.