Open Access Open Badges Research article

Gastrointestinal symptoms before and during menses in healthy women

Matthew T Bernstein1, Lesley A Graff2*, Lisa Avery3, Carrie Palatnick3, Katie Parnerowski3 and Laura E Targownik1

Author Affiliations

1 Department of Internal Medicine, University of Manitoba, Winnipeg, Canada

2 Department of Clinical Health Psychology, Faculty of Medicine, University of Manitoba, PZ350 - 771 Bannatyne Avenue, Winnipeg, MB R3E 3N4, Canada

3 Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, Canada

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BMC Women's Health 2014, 14:14  doi:10.1186/1472-6874-14-14

Published: 22 January 2014



Little is known as to the extent gastrointestinal (GI) complaints are reported by women around menses. We aimed to describe GI symptoms that occurred premenstrually and during menses in healthy women, and to specifically assess the relationship of emotional symptoms to GI symptoms around menses.


We recruited healthy, premenopausal adult women with no indication of GI, gynecologic, or psychiatric disease who were attending an outpatient gynecology clinic for well-woman care. They completed a survey that queried menstrual histories and the presence of GI and emotional symptoms. We compared the prevalence of primary GI symptoms (abdominal pain, diarrhea, constipation, nausea, vomiting), as well as pelvic pain and bloating, in the 5 days preceding menses and during menses, and assessed whether emotional symptoms or other factors were associated with the occurrence of GI symptoms.


Of 156 respondents, 73% experienced at least one of the primary GI symptoms either pre- or during menses, with abdominal pain (58% pre; 55% during) and diarrhea (24% pre; 28% during) being the most common. Those experiencing any emotional symptoms versus those without were more likely to report multiple (2 or more) primary GI symptoms, both premenstrually (depressed p = 0.006; anxiety p = 0.014) and during menses (depressed p < 0.001; anxiety p = 0.008). Fatigue was also very common (53% pre; 49% during), and was significantly associated with multiple GI symptoms in both menstrual cycle phases (pre p < 0.001; during p = 0.01).


Emotional symptoms occurring in conjunction with GI symptoms are common perimenstrually, and as such may reflect shared underlying processes that intersect brain, gut, and hormonal pathways.