One for the ladies: yes we’re talking THAT time of the month…again (Part 2)

managing symptoms during menstruation

Shirley Webber & Lyndal McNamara - Research Dietitians, 27 October 2017

Worsening IBS symptoms or a change in usual bowel habits and symptoms is common for many women leading up to and/or during their period. (1)

Why? This is explained in more detail in one of our previous blogsFor some women, symptoms may be worse for a couple of days prior to menstruation, for others symptoms are worse during menstruation and for a lucky few, symptoms may even improve at this time of the month.

Symptom flare ups - on top of having your period - can leave many women feeling frustrated and wanting to reach for just about any solution. So here are our top tips on keeping your symptoms in check during this time.

1. Know your trigger foods - avoid key symptom triggers around the time of your period if you are one of those women who find that your gut becomes increasingly hypersensitive. Avoiding high FODMAP foods that you generally do not tolerate may help to minimise unpleasant symptoms.

2. Keep a hot pack handy - heat can really help to alleviate symptoms of pain and cramping. Try doing some light stretching with a heat pack on the area where you experience the most pain a few days prior or on the first couple of days of your period. 

3. Take pain relief if needed - over-the-counter medications can assist in managing pain, however always ensure that these are consumed with food (to minimise any GI side effects) and used as recommended by your pharmacist and/or doctor. 

4. Personal remedies - If you have a remedy that you know usually works for you such as peppermint tea or peppermint oil, then carry these with you in the lead up to menstruation to ease off the symptoms.

5. Add in extra fibre - including sources of soluble fibre such as psyllium or linseeds/flaxseeds in your diet for a couple of days prior and during your period may assist with alleviating constipation and diarrhoea symptoms. These types of fibre may help with constipation by forming a thick paste when they come in contact with fluid. This helps to add bulk to stools, making them softer and easier to pass. With management of diarrhoea, they may assist in absorbing extra fluid and forming a more solid stool to pass. Remember to always start with a small dose at first and build up gradually over several days to allow your body time to adjust to this extra fibre. 

6. Keep a food and symptom diary - Keeping a diary throughout your whole menstrual cycle will allow you to see if there are any patterns and identify when your symptoms are at their worst. This way you can be more prepared in managing your symptoms. This may mean avoiding your trigger foods, starting to take a fibre supplement or having personal remedies/medications handy a couple of days before you usually start to show symptoms. 

7. Make sure you are getting enough calcium - studies have shown a strong association between high dietary calcium intake and reduced risk of premenstrual syndrome (PMS).(2) In addition, several high quality trials have demonstrated that calcium supplementation may be of benefit in managing PMS. (3-4) So if you do suffer from PMS, ensuring that you are meeting recommended dietary targets for calcium (~3-4 serves dairy foods every day) may be a good place to start. For those with lactose intolerance or who avoid dairy, make sure that you replace these 3-4 serves each day with appropriate low lactose or calcium fortified dairy alternatives

8. Try evening primrose oil - although we have not tested this for FODMAP levels, evening primrose oil has been suggested to reduce the effects of PMS both anecdotally and in a small number of research studies. (4) Although more randomised controlled trials are needed to establish the true effectiveness, dose and duration of effect, this supplement is generally considered safe. Keeping a symptom diary may assist with knowing when to incorporate evening primrose oil in a daily routine. You may want to start taking this a few days prior to when pain starts and continue until your period is over. 

Find what works for you and remember, a flare up of symptoms is common and you are not alone! Don’t suffer in silence. If symptoms are unbearable to manage seek assistance from your GP or dietitian. 

If you have any go-to remedies, please share them in the comments on our Facebook page!  


  1. Bharadwaj S, Barber MD, Graff LA, Shen B. Symptomatology of irritable bowel syndrome and inflammatory bowel disease during the menstrual cycle. Gastroenterology Report. 2015;3(3):185-93.
  2. Bertone-Johnson ER, Hankinson SE, Bendich A, Johnson SR, Willett WC, Manson JE. Calcium and vitamin D intake and risk of incident premenstrual syndrome. Archives of internal medicine. 2005;165(11):1246-52.
  3. Shobeiri F, Araste FE, Ebrahimi R, Jenabi E, Nazari M. Effect of calcium on premenstrual syndrome: A double-blind randomized clinical trial. Obstetrics & Gynecology Science. 2017;60(1):100-5.
  4. Whelan AM, Jurgens TM, Naylor H. Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review. The Canadian journal of clinical pharmacology. 2009;16(3):e407-29.

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