If you experience digestive discomfort or IBS, and you are a woman, then fluctuations in your estrogen or progesterone may be a contributing factor to your IBS symptoms! While these hormones do not directly regulate digestion, some doctors in the functional medicine community believe they have an impact on the digestive system. To understand why this is (and if you may be affected), you must first understand the relationship between hormones and the gut.
What are Hormones?
Hormones are chemical signalers produced by different glands such as the thyroid, ovaries, and pancreas. They are messengers that travel throughout the body to signal action on other cells. They are tiny in size, but tremendous in effect.
There are lots of hormones that are made by the digestive tract or other parts of the body that regulate the gastrointestinal tract. Some of the main players are gastrin, cholecystokinin (CCK), secretin, somatostatin, and motilin. However, reproductive hormones like estrogen, progesterone, and testosterone may impact digestion. Women biologically have a higher concentration of estrogen and progesterone because of the female body’s reproduction system and function; women also have a higher incidence of IBS. Inevitably, changes in the body cause a shift in hormone production. These changes can include ovulation, PMS, pregnancy, and menopause.
The impact of hormones on digestion does not have a clear scientific definition and is still undergoing study. There is a convincing reason to believe the two have a significant relationship, but the evidence is mostly observational.
Which Hormones Play a Role in Digestion?
The gut has something called the migrating motor complex (MMC). The MMC is a muscle and works to move food from mouth to rectum. Interestingly, progesterone has a relaxing effect on ligaments and muscles in the body. This relaxation can slow muscle contractions. We know that the female body experiences a progesterone surge in the second two weeks of her cycle. Therefore, the secretion of progesterone could have a slowing effect on the MMC. Slow MMC function will decrease digestive motility and may cause constipation.
Progesterone also affects prostaglandins, which are small inflammatory molecules made from fats in our body. Progesterone may increase prostaglandins. Depending on the type of prostaglandin produced in the body, they can be very irritating and disruptive. Irritation as a result of this inflammation would look like cramping, water retention, and bloating in the GI and pelvic area. Prostaglandins composed of good fats, like omega-three fatty acids, are less inflammatory. However, when the molecule is made from less beneficial fats like arachidonic acid or fats from animals, it tends to be more irritating. We know that the types of foods we eat influence inflammation levels, so diet can significantly decrease the chance of inflammatory prostaglandins.
There are estrogen receptors found all over the body, and many concentrated in the colon. There is evidence that estrogen communicates with the MMC. Some studies suggest estrogen slows stomach emptying and others that suggest it speeds up colonic emptying. This all depends on the location of the estrogen. We also know that estrogen helps increase the tight junctions on intestinal cells. These tight junctions promote a healthy and strong barrier for the gut. An unhealthy barrier often leads to leaky gut. The key is to have a healthy balance of progesterone and estrogen to promote optimal digestion.
Overall, there are not many studies on the effect of testosterone on digestion and GI movement. We do know that healthy levels of testosterone work alongside prostaglandins to regulate inflammation levels.
Healthy Hormone Removal
The liver is essential in the process of digestion relating to hormones. A healthy liver tends to remove old hormones. However, a liver under stress or busy removing lots of toxins from the body may have a harder time eliminating the body of these old hormones, which may result in unpleasant symptoms. These symptoms include acne, abdominal pain, PMS, and mood fluctuation.
Hormones and the digestive system have a significant relationship. There are three ways the body works to help remove hormones. Phase one and phase two detoxification of the liver are the first two. The third is a healthy gut with the regularity of stool. These three functions keep the body clear of used-up or excess hormones and promote a healthy digestive system.
Jiang Y, Greenwood-Van Meerveld B, Johnson AC, Travagli RA. Role of estrogen and stress on the brain-gut axis. Am J Physiol Gastrointest Liver Physiol. 2019 Aug 1;317(2):G203-G209. doi: 10.1152/ajpgi.00144.2019. Epub 2019 Jun 26. PMID: 31241977; PMCID: PMC6734369.
Zhou Z, Bian C, Luo Z, Guille C, Ogunrinde E, Wu J, Zhao M, Fitting S, Kamen DL, Oates JC, Gilkeson G, Jiang W. Progesterone decreases gut permeability through upregulating occludin expression in primary human gut tissues and Caco-2 cells. Sci Rep. 2019 Jun 10;9(1):8367. doi: 10.1038/s41598-019-44448-0. PMID: 31182728; PMCID: PMC6558054.
Barcikowska Z, Rajkowska-Labon E, Grzybowska ME, Hansdorfer-Korzon R, Zorena K. Inflammatory Markers in Dysmenorrhea and Therapeutic Options. Int J Environ Res Public Health. 2020 Feb 13;17(4):1191. doi: 10.3390/ijerph17041191. PMID: 32069859; PMCID: PMC7068519.
Everson GT. Gastrointestinal motility in pregnancy. Gastroenterol Clin North Am. 1992 Dec;21(4):751-76. PMID: 1478733.