Gut health!

Okay, that’s the short answer…

April is both PMDD and IBS Awareness Month.

Premenstrual dysphoric disorder is largely debilitating, making it extremely difficult or even impossible to get through everyday tasks, affecting work and relationships. It includes acute and intense symptoms in the days to weeks prior to and/or during menstruation:

  • feelings of hopelessness or depression
  • fatigue
  • difficulty concentrating
  • disinterest in regular activities
  • sleep problems
  • anger/rage
  • mood swings
  • anxiety
  • headaches
  • cramps
  • bloating

Some studies show a connection between PMDD, cyclic hormone changes, and low serotonin, a neurotransmitter that in a nutshell helps us feel good, calm, and happy.

So what does that have in common with IBS?

Irritable bowel syndrome is often a diagnosis of exclusion, when other disorders have been ruled out. But the symptoms are real and disruptive for sufferers as well. These include:

  • abdominal pain, bloating, and/or cramping that may subside with bowel movements
  • excess flatulence
  • diarrhea and/or constipation, often alternating but may also be consistently one or the other
  • mucus in stool

Some common triggers of IBS are thought to include food habits, stress, and hormone imbalances, particularly around periods, with women/AFAB people more likely to have IBS. People with IBS are also more likely to develop or have a pre-existing mood disorder that’s also associated with low serotonin, including anxiety or depression.

Here’s the common thread: up to 90% of your body’s supply of serotonin is made in the intestines, mostly by the microorganisms that live there. Thus, in a nutshell, gut health is an important factor to consider for supporting these conditions.

Now this is not to say that there’s a direct link between PMDD and IBS – correlation does not equal causation – and also not to say that solving gut health problems is the final word in solving these disorders. But I do think the overlap is worth considering if you suspect you have one or both of these conditions.

So what are some things you can do to help support your gut health for more stable bowel habits as well as moods and hormones?


In general, working on gut health is a central tenet for hormone balance, because, for example, the body metabolizes hormones like estrogen and excretes what’s no longer needed via the intestines (i.e. bowel movements).

IBS is associated with inflammation in the intestine and altered gut microbiome. Microorganisms present in a healthy gut affect our health in incredible ways: they may help calm inflammation in the tissues where they reside, and produce metabolic byproducts that actually improve our moods. Not to mention they also help us absorb nutrients and eliminate waste!

Lactobacilli and Bifidobacteria are among the most common bacteria families populating a healthy microbiome, so looking for a multi-strain product with a good balance of both types and a variety of colony-forming strains (e.g. L. acidophilus, L. rhamnosus, B. bifidus, etc.) is a great place to start. There are products with more specialized blends to support mood, IBS, women’s health, etc. as well, so talk to your nutritionist, naturopath, or quality supplement provider to help you choose one that best fits your needs!

As well, including cultured foods like dairy-free yogourt or kefir, kombucha, tempeh, and kimchi help provide additional transient strains of probiotics, so they’re great to add into your happy-gut diet.

[Shop probiotics on Fullscript]

Fiber and mucilage

Fiber helps form the bulk of our stool, binds to products of metabolism, and feeds the organisms in our microbiome. Eating enough of the right kinds of fiber is recommended both in hormone balancing protocols and in IBS supportive protocols.

Ground flax, chia seeds, bananas, oats, asparagus, and zucchini are some of the foods that provide a good balance of soluble and insoluble fiber, as well as a substance called mucilage. If you’ve ever made a flax egg, chia pudding, or oatmeal, or cooked a zucchini, mucilage is basically what’s giving them that thickened, gel-like consistency. Mucilage helps coat the digestive tract to aid passage of wastes and may also help calm inflammation.

As an added bonus ground flax contains anti-inflammatory omega-3 fats and a phytoestrogen known as lignan, which helps your body balance the effects of excess estrogen.

Any time you introduce more fiber to your diet, and especially if you struggle with gas or constipation, make sure you drink enough water and pay attention to your intake of healthy fats to reduce inflammation and provide additional lubrication to your digestive tract.

Get your greens

The liver loves cruciferous vegetables. More specifically, cruciferous vegetables – which include the likes of broccoli, cabbage, cauliflower, kale, and bok choy, among others – contain a family of antioxidants called glucosinolates, which include indole-3-carbinol and di-indolyl methane. These sulfurous compounds may also help with the metabolism of excess estrogen, and may even have anti-carcinogenic properties particularly in relation to hormone-sensitive cancers of the breast, ovary, and cervix. Including a variety of them in your diet may also be beneficial for improving premenstrual symptoms.

What about for IBS? This is a little trickier. Because crucifers are sulfurous, they may exacerbate gas and bloating. It may help to cook or ferment them (think sauerkraut and kimchi, both of which are traditionally made with cabbage) rather than eat them raw to help reduce this effect.

Cabbage is also a source of that soothing mucilage, so try incorporating a little briny fermented goodness in the form of 1-2 Tbsp. sauerkraut or kimchi to start.


While there may be no direct clinical connection between PMDD and IBS, it’s interesting to note that low serotonin is among the possible causes or triggers of both. Supporting your overall gut health – particularly making sure you work toward regular bowel movements, smooth digestion, and giving your liver the tools it needs to better process everything – could go a long way to reducing symptoms of PMDD and IBS.



Mayo Clinic:



The information in this post is not meant to replace a diagnosis or the advice of your primary health care practitioner. Please consult with your PHCP prior to making changes to your protocol.

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