In the first part of our interview, we talk with nutritional therapist in functional and therapeutic nutrition Jana Zahradníková, DiS., guide to functional and interactive nutrition Eliška Hosnedlová, IHP (Integrative Health Practitioner), and physician and nutrition consultant MUDR. Kateřina Fialová about the importance of a healthy gut microbiome.
In the interview, you will learn how to care for your gut microbiome, what causes increased bloating, digestive problems, and a distended belly before and during menstruation.
What causes increased bloating and changes in bowel movements in women before and during menstruation?
Jana: From my practice, I see two synergistic variables:
Firstly, it is due to hormonal changes (especially estrogen and progesterone levels) accompanied by the shedding of the uterine lining. It could therefore be said that small changes in bowel movements and mild intestinal discomfort can be a natural part. However, more pronounced bloating and diarrhea or unpleasant pain are often a consequence of hormonal imbalance. So, when we restore the natural balance of hormones, these discomforts will likely subside or disappear completely.
Secondly, the information above, in my opinion, intertwines with the fact that many women experience a decline in mental stability before menstruation and find themselves in an emotional current. In this state, it is easy to fall out of one's eating routine and reach for sweets, coffee, or a glass of wine more often. This is further complicated by the effect of stress and the sympathetic nervous system, leading to a burden on the gut microbiome, which can contribute to weakened digestive quality and feelings of bloating or even diarrhea.
Eliška: I can only agree. The menstrual cycle hormones estrogen and progesterone are, among other things, involved in controlling gut motility, i.e., the movement of food through the gut. Hormonal fluctuations or certain imbalances can affect motility, especially in the second half of the cycle (the period before menstruation). Sudden and significant changes in estrogen and progesterone levels can cause symptoms such as bloating, constipation, or diarrhea.
In this case, chemical substances called prostaglandins and their increased production in the body also play a significant role. In addition to other functions, they also contribute to the contraction of uterine muscles, thereby helping to shed the uterine lining if fertilization has not occurred. However, due to an unsuitable lifestyle, their excessive production often occurs, and prostaglandins can also begin to cause muscle contractions in the intestines, resulting in an increased need and diarrhea before menstruation.
Kateřina: There are indeed many reasons why digestion is not optimal. I would also add that there are, of course, various combinations of these.
Among the most common, without a direct connection to female hormones, I would include low-calorie diet and a disturbed microbiome, or gut dysbiosis.
What is the most common cause of bloating and digestive problems in women?
Kateřina: There are really many reasons why digestion is not optimal, and then of course there are their various combinations. Among the most common, without a direct connection to female hormones, I would include low-calorie diet and disturbed microbiome, i.e., gut dysbiosis. And if we were talking about problems with a direct link to female hormones and the cycle, then it would be bloating and slower peristalsis (movement of the digestive tract) in the period from ovulation to menstruation, when there is a physiologically lower level of estrogen and thus also serotonin (known as the happiness hormone), which also affect gut motility, and therefore during this period women may suffer from constipation and bloating. Conversely, with menstruation, the level of so-called prostaglandins increases, which (if there are too many in the body, which is often associated with a pro-inflammatory diet) affect gut motility in the opposite direction - meaning they accelerate it, and women may then suffer from diarrhea.
Jana: I would add that long-term chronic stress and improperly managed priorities in life can also be a factor.
An example is a woman with priorities: work or school first, then friends and family, last but not least saving the whole world, and only when there is time left, it's her turn. However, in the long term, this cannot be practiced with mental stability, and it leads to chronic stress.
Chronic stress and neglected time for oneself will affect a whole cascade of mechanisms, starting with an imbalance between the sympathetic and parasympathetic nervous systems. These are parts of the autonomic nervous system that need to be in balance, thanks to which we can then handle acute stress or, conversely, good regeneration of the body, including the regulation of digestion and immunity. Chronic stress denies this balance and disrupts digestion and the synergy of the stomach, intestines, and liver. For proper digestion without bloating, it is therefore necessary to choose not only the right foods but also to ensure that there are suitable conditions for digestion.
What conditions are important for digestion?
Jana: For example, having the correct pH in the stomach and enough hydrochloric acid. This environment has a major impact on gut health, as whatever passes, whether in a better or worse digested form, through the mouth and stomach, goes directly into the intestines. And precisely, as I mentioned, the parasympathetic nervous system is one of the systems we need to have "switched on" to create good conditions for proper digestion. The parasympathetic nervous system is the part of the autonomic nervous system that is associated with feelings of well-being, rest, calm, and slowness.
Imagine a woman hastily devouring a bun while looking at her phone. And then another woman, consciously and slowly eating her morning porridge, broth, pancakes, or eggs, chewing each bite thoroughly, sipping herbal tea, all without a phone, computer, or significant time pressure. Such a seemingly small change in approach can have an incredible impact on our digestion.
What role does the gut microbiome play in achieving healthy hormones in women?
Jana: A very significant one, everything is interconnected. I can mention one specific term, the estrobolome. The estrobolome is a set of gut bacteria that regulates estrogen metabolism. Estrogen, along with progesterone, is our key hormone in the female reproductive system. And it is the estrobolome bacteria that modulate (filter) the activity and amount of estrogen produced in our body. Its necessary amount remains in the body, and the excess leaves the organism.
In an optimal situation, there is a balanced ratio between active estrogen and estrogen that is excreted with stool. However, the opposite often happens. Many women have a disturbed microbiome balance due to an improper lifestyle and chronic stress, which also affects the estrobolome and an excess of active estrogen in the body. This whole imbalance then leads to estrogen dominance, which many women recognize by worsened skin, PMS, mood swings, painful menstruation, and cravings for sweets.
Eliška: As mentioned, the gut microbiome is important for healthy hormone production and function for many reasons. The intestines ensure the absorption and utilization of essential nutrients, thanks to which hormones can function properly and maintain their balance. Furthermore, it contributes to the proper function of the thyroid gland and the conversion of its hormones, which is also an indispensable part of women's hormonal health.
How can women care for their gut microbiome to feel good?
Jana: I'll tell you something, women don't want to hear it, but often solid fundamentals are enough.
First and foremost, I would recommend setting priorities straight and starting to investigate the cause/causes. Many women start from the opposite end and focus on symptoms. They buy a pile of supplements because they read that they need all sorts of probiotics and other supplements in the form of fiber and the like, but often their health does not change. It doesn't change because they helped a little in one area, but they didn't eliminate the cause/causes.
By the way, with those supplements, I'm not saying it's bad, I applaud all women who take extra care of themselves. I love working with functional nutraceuticals/supplements myself, but in the case of optimizing digestion and the menstrual cycle, I would start from the beginning, and the rest would only "complement and support" the entire cascade of changes for restoring women's health.
Eliška: The basis is natural foods without refined sugar, various food additives, and industrially processed foods. The best support comes from broths made from bones and meat, fermented dairy products such as kefir or yogurt, or fermented vegetables. In addition to diet, our microbiome is also influenced by how we take care of ourselves, how we manage stress, and whether we exercise enough.
In summary, for a healthy microbiome, it is important to:
- Build a life attitude and style that minimizes the intake of medicines, antibiotics, and hormonal contraception.
- Minimize industrially processed foods and refined sugars, including alcohol.
- Eat mindfully, without your phone, and don't gulp down food.
- Regularly include fermented foods – fermented dairy products, fermented vegetables and various types of fiber (from fruits, vegetables and nuts or seeds, cereals, pseudocereals and legumes).
- Give your intestines room to rest, don't keep "nibbling".
- Build your mental stability, as the sympathetic nervous system has a huge influence on the entire synergy of digestion.
- Support overall bowel function and peristalsis with quality movement, breathing, and sleep.
- Don't overdo it with cleanliness. Healthy dirt is beneficial. Cuddle with animals, dig in garden beds; it has been proven that belonging to nature modulates our immunity and microbiome in the right direction.
- Probiotics, fiber products and other supplements are a wise choice if wisely selected and used.
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