EP.398/ Cyclical Influences on the Endo Belly
Today’s episode is a super short one, because I ran a free masterclass last night and so ended up getting to bed very late, and my body feels quite wrecked! I have a client later, so I am preserving my energy for our session.
So, today’s episode is a brief introduction to the mystery of the endo belly in the luteal phase, and some pointers to get you started.
Now, recent research suggests that the endo belly is cyclical.(1) This was discussed in a narrative review, but the researchers didn’t actually run any studies to validate this claim. In my experience, I do not see this to be the case. Most of my clients have endo belly daily, and for some, it worsens in the luteal phase, but it’s present most of the time. Last night in our masterclass, I actually asked the group, and all of them said they had endo belly nearly every day. Everyone is different of course, and for you, the endo belly may show up only in your luteal phase, but for a number of us, it’s a regular occurrence.
Having said that, there is valid science behind why your endo belly or IBS issues may worsen in the luteal phase, and today, I want to talk about the three key issues.
Number one is the effects of progesterone.
In the luteal phase, we may experience more sluggish bowel movements due to the relaxing effects that progesterone has on smooth muscle,(2) so you may need extra motility support. This is especially true for those of us with conditions like hypermobility (who already struggle with motility disorders), and IBS, IBD, and Crohn’s, with research showing a worsening of these conditions in the luteal and menstrual phases.(3)
Motility support would be anything that has laxative effects, like kiwis or magnesium citrate. So, in the show notes, I am giving you links to where I have done episodes on these laxatives, that will give you doses, time frames, etc.
Number two is water retention.
Some of us may experience more water retention (which for many, manifests as bloating) in our luteal phase due to hormonal shifts,(4) and so healthy progesterone production and oestrogen metabolism will need support here.
One of the best ways to support oestrogen clearance is with flax seed, which also doubles up as a laxative, so this could be a great one to aid with both of these issues. So, again, in the show notes, I’ve added episodes to learn more about this. I’ve also added one or two episodes on evidence-based strategies to improve your progesterone levels.
Number 3 is inflammation.
Elevated inflammatory prostaglandins both in endo and in people with period pain, can ‘spill’ over and cause diarrhea and rectal pain, especially during menstruation,(5) so it’s important to incorporate an anti-inflammatory approach overall as you manage endo and endo belly.
Ideally, the best way we can deal with this issue is via prevention rather than treatment in the moment, and that’s with strategies that lower inflammation and prostaglandin production overall, so that they don’t get excessively high at this time of your cycle. Now, this is a longer area of work, and normally, dietary changes like balancing blood sugar and eating an anti-inflammatory diet are key strategies, but two great ways to lower inflammation and ease IBS symptoms ahead of time is with the use of peppermint oil capsules and ginger. Ginger significantly lowers prostaglandins, period pain and actually eases bloating, and peppermint oil lowers period pain too, but it also eases all symptoms of IBS, including pain, bloating and diarrhoea. Again, prevention is the best strategy, so ideally you would use these supplements all month long to gain the best benefits, or at least in the week leading up to your period. Again, in the show notes, I’ve put episodes on these two supplements.
Now - a quick word, if you’re trying to use these supplements in the moment to stop diarhhoea in its tracks, they may not help - in fact, if you take high doses of ginger, it might even speed things up, so you may find you need some anti-diarrhoea medication to deal with acute episodes, but it’s really the prostaglandins in the long term we want to target, to prevent this from happening.
Okay, so - there are lots more strategies to aid with all of these issues, these are just some simple starting places to begin with. For example, you may want to add into your routine magnesium citrate in your luteal phase for constipation, flax seeds into your daily diet to support balanced hormones and healthy bowel movements, and peppermint and/or ginger in the week leading up to your period.
Now, if you’d like help with your endo belly, I am looking for 5-10 people who would like help with their endo belly and suspect SIBO (there are about four spaces left).
After the success of using probiotics for SIBO in endo clients these past nine months, and the recent practitioner training I ran on endo and SIBO, where I presented the latest research and my experience with endo+SIBO clients over the past several years, I would LOVE to now take this further to a larger group of endo peeps to begin gathering more data on the impact of SIBO on endo, and how addressing it affects IBS symptoms, endo symptoms and endo belly.
I am particularly keen to work with anyone interested in trying the probiotic protocols I’ve been testing, as this is where we have the least data and yet are seeing good success rates, BUT I’m also happy to work with anyone who would like to explore other avenues i.e. elemental diet, herbs, etc.
To keep this affordable and also to help manage my caseload, the programme will consist of three one to one sessions, delivered over six months (nine months if needed, some cases require longer), with email support in between (in contrast to my usual coaching, which is 12 sessions). SIBO is tough to treat, so there will of course be room for extension if required.
Prior to starting, we’ll order you a SIBO test and go over your symptom history to help me identify any SIBO co-conditions or root causes we need to address.
Then we will meet for two initial sessions to get started, covering:
Test results
Protocol options and creating a plan (including retesting)
Dietary options
Die off preparation and management
Symptom management
You’ll then be able to move forward with the protocol, with email check ins and support from me.
The third session will cover prevention of relapse and microbiome rebuilding, or chronic SIBO management if you have a root cause that causes continual relapse i.e. hEDS. It’ll be booked in based on when you’re near completion of the protocol.
In return for the discounted price (which I’ll share in just a moment), I’d love to use your experience to gather information on which protocols were most helpful, which management strategies you responded best to, SIBO success rates, impact on endo, etc. I won’t be sharing any personal information like names, etc. It’ll simply be quantitative data (maybe some qualitative if there’s any quotes that you’re happy to share).
My hope is that I can use this info to learn more about the endo + SIBO connection, develop better and more effective protocols and eventually present all of this in an accessible course or book, that’s budget friendly for everyone.
Because this is a condensed version of my usual work, we won’t be directly targeting/discussing endo, but I will take into account your endo history and symptoms, and this will all be considered in the SIBO protocols, and they will be tailored to support your endo symptoms i.e. certain prokinetics for SIBO can also treat endo pain, certain SIBO dietary changes have also been shown to help endo symptoms, etc. If you’d like one or more targeted endo sessions, they can be booked in, in addition.
Whilst I would love this to be free, I can’t work with that many people on two such tough conditions for no fee - it would simply take up so much time, I wouldn’t have enough spare time to earn a living! But the programme is significantly cheaper than my typical year long 1:1 coaching programme, at £600, with the option of 3-6 month payment plans if needed in £100 or £200 instalments.
If you’d like to learn more, email me on hello@thisendolife.com
1) https://www.mdpi.com/2077-0383/12/22/7176#B44-jcm-12-07176
2) https://pmc.ncbi.nlm.nih.gov/articles/PMC9150547/
3) Irritable Bowel Syndrome and the Menstrual Cycle - PubMed, Change in bowel habits during menstruation: are IBD patients different? - PubMed
4) https://www.ahajournals.org/doi/10.1161/hypertensionaha.107.107136,
https://pmc.ncbi.nlm.nih.gov/articles/PMC3154522/, https://pmc.ncbi.nlm.nih.gov/articles/PMC3984489/
5) https://pmc.ncbi.nlm.nih.gov/articles/PMC4527267/, https://pmc.ncbi.nlm.nih.gov/articles/PMC7883586/, https://pmc.ncbi.nlm.nih.gov/articles/PMC3901893/
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