The Link Between Gut Health and PMS: How Gut Health can Impact Hormone Balance

Feb 22

Have you ever been hit with a wave of anxiety, brain fog, cravings for all 👏 of 👏 the 👏 carbs, bloating, and other not-cool symptoms in the week leading up to your period?

If you’re nodding a big “YES 👋 that’s me” — you’re not alone, friend.

If you struggle with PMS, you’re one of many menstruators who experience these very common (but NOT normal!) symptoms associated with their cycles.

We unfortunately live in a society where PMS symptoms are normalized, and often disregarded or dismissed by doctors. It’s something that the birth control pill is often thrown at to help "mitigate" symptoms.

While there is absolutely a time and place for the birth control pill (for those of us who have access to it — we are EXTREMELY privileged), it’s a disservice to menstruators, as it doesn’t necessarily investigate the reason WHY they’re experiencing PMS in the first place.

In the type of work that I do (you can learn more here) — investigating the “why,” and uncovering potential root causes behind PMS and other imbalances, is key 🔑

In this article, you’re going to learn how your gut health might actually be playing a role in your PMS!

Let’s dive deep ⤵️

Common Symptoms Associated with Estrogen Dominance

PMS leading up to menstruation is typically a result of what is called “estrogen dominance” — meaning when estrogen levels are too high in their relation to our other sex hormone that plays a major role in our cycle: progesterone.

This could be due to “true” estrogen dominance, where progesterone levels are adequate, but estrogen levels are too high in relation to it. Or it could be that estrogen levels are normal, but progesterone levels are too low, which again results in estrogen levels being too high in relation to progesterone.

Here are some common (but not normal!) symptoms associated with estrogen dominance:

bloating and fluid retention
breast tenderness
anxiety, depression, mood instability
fatigue
cravings (like carbohydrates, sugars)
sleep disturbances
painful periods (cramping, back pain, radiating pain)
nausea and vomiting
heavy periods

While there are many contributing factors that can lead to estrogen dominance (sluggish liver clearance, constipation, poor bile production, stress, inflammation, and nutrient deficiencies to name a few), here we’re focusing on how the gut microbiome can play a role!

Let’s explore how.

Your Liver: the Estrogen Metabolizer

We can’t talk about estrogen and estrogen dominance (or gut health, for that matter), without featuring this powerhouse organ: your liver.

Our liver has some 500+ jobs in the body to perform on a daily basis — some of which play a role in our digestive function, and hormone metabolism.

As it relates to estrogen specifically, the liver’s role is to “metabolize” estrogen (break it down), so that it can be excreted from the body, after it’s been used!

In phase one, the liver takes estrogen and breaks it down into a few intermediates (2-OH-E1, 2-OH-E2, 4-OH-E1, 4-OH-E2, and 16-OH-E1), via a process called hydroxylation. After this first phase, they move onto phase 2, where these intermediates are then “conjugated” — or packaged up in a way that allows them to be excreted from our body.

These estrogen metabolites are then sent to the gut, to be rid of from the body, by our poop! 💩

Meet the Estrobolome

Let’s move over from our liver, to our gut for a second. There is a grouping of microbes that live in our intestinal microbiome, which are collectively referred to as the "estrobolome."

The estrobolome consists of specific microbes that actually have the capabilities to metabolize estrogen (break it down), and can influence estrogen homeostasis (or balance) in the body.

These specific microbes produce an enzyme called "b-glucuronidase.” Enzymes are proteins that enable different chemical processes to occur in the body (in this case, breaking down estrogen).

This enzyme deconjugates estrogen in the gut, turning it back into its active form. This means it can be reabsorbed, and uptaken by estrogen receptors! This enzyme basically reverses phase 2 liver detoxification (where the liver packages up estrogen to be excreted), and allows it to recirculate in your body.

When estrogen is allowed to recirculate in the body this way, it can lead to excess estrogen levels. It’s when there’s this excess estrogen in the body that we can start to experience hormone-related symptoms — PMS being one of the major ones!

Support your Gut Health for Hormone Balance

So now you know that your gut may in fact be playing a role in the dreaded PMS that you experience like clockwork each month.

You might be wondering then, what can you do about it?

Here are a few ways to support your gut health, for better hormone balance:

Make sure that you’re having a bowel movement every day (this is really important to ensure that you’re those estrogen metabolites that the liver sends to the gut, out of your body!). If you’re struggling with constipation (if you aren’t having 1-3 bowel movements a day), thenhttps://www.wiseandwonder.com/blog/constipation check out this in-depth guide for everything you need to know about how to get your bowels moving.
Support a healthy microbiome by eating a diversity of plant foods, prebiotic fibers, and fermented foods. To learn more about how to “feed” your microbiome, check out this post.
Keep your liver happy by being mindful of caffeine and alcohol intake, and consuming liver-supportive foods often (things like beets, arugula, radicchio, beet greens, dandelion greens, citrus, garlic, etc.)
Live a gut-healthy lifestyle — that means managing stress as much as you can, moving your body in some way every day, getting access to sunlight, and getting good quality sleep 😴

What if you still experience PMS

If you’re struggling with PMS symptoms, and are wondering whether your gut (and microbes 🦠) may be contributing to it, I’ve got you covered! We can actually test for b-glucaronidase on the GI MAP (the stool test I run in my practice for my clients), to gain a better understanding of how the gut may be playing a role in your PMS, and other estrogen-dominant related symptoms.

The DUTCH is another favourite of mine for learning more about what your hormones look like 🤓

If you'd like to chat about how to navigate your gut health, and rebalance your hormones — check out my program, the Gut Restore Method.

The Gut Restore Method is a comprehensive 1:1 program, where I help folks restore their gut, recharge their energy, and nourish their nervous system via a root-cause, functional approach ✨

You can learn more about it here.