What is Constipation and how does it affect your hormones?

When your digestion is working well and things are moving along smoothly (you’re opening your bowels each day) excess hormones like oestrogen, cortisol and insulin can be excreted out of the body in your stool instead of being reabsorbed.  When your digestion has been comprised (dysbiosis) you may suffer from constipation. Constipation affects women more than men so there is definitely a hormonal component to this condition.

What is constipation?

Infrequent, irregular or difficult evacuation of the bowels that persists for several weeks or longer.

• Infrequent bowels – opening less than three times a week.
• Stools that are hard to pass – looking like pebbles or like a lumpy sausage.
• Feeling as though there's a blockage in your rectum that prevents bowel movements.
• Feeling as though you can't completely empty the stool from your rectum.
• Needing help to empty your rectum, such as using your hands to press on your abdomen and using a finger to remove stool from your rectum.

Common causes of constipation

Constipation is not always related to an underlying health condition. It may be caused by:

• Insufficient quantities of fibre and water in meals.
• Changes to your diet.
• Physical inactivity.
• Holding your stool for long periods even with the urge to open your bowels. This can happen to people at work (you don’t want to sit on the toilet for too long) or people who have a fear of using public toilets.
• Pharmaceuticals such as painkillers, antidepressants, oral contraceptives, antacids and thyroid medications.

Constipation is not always related to an underlying condition as it can be caused by one of more of these:-

• Insufficient quantities of fibre and water in meals (highly processed diet).

• Food poisoning.
• Changes in diet.
• Physical inactivity.
• Holding your stool for long periods of time, even when you have the urge (especially at work or when travelling as some people don’t like to use public toilets).
• Taking pharmaceuticals such as painkillers, antidepressants, antacids, thyroid medications or oral contraceptives.
• Abdominal surgery.

 What health conditions contribute to you being constipated?

Constipation is covered under the irritable bowel syndrome (IBS) umbrella which includes symptoms such as bloating and abdominal pain. Other conditions are as follows:-

• Small Intestinal Bacterial Overgrowth (SIBO).
• Large Intestinal Bacterial Overgrowth (LIBO).
• Haemorrhoids (internal and/or external).
• Bowel Obstruction.
• Anal Fissure.
• Diabetes -Type 1 and Type 2.
• Hypothyroid and Hashimoto’s Disease.
• Parkinsons Disease.
• Multiple Sclerosis.

How are hormonal imbalances connected to the digestive system?

The microbiome (bacteria in your gut) plays a big role in our hormones, whether they are ‘healthy’ hormones (balanced) or ‘unhealthy’ hormones (imbalances).  Good bacteria can metabolize and recycle hormones in your body.  For example, oestrogen circulates throughout the body and when it reaches the liver it is then inactivated.  In a normal functioning digestive system, this inactivated oestrogen is then sent to the intestines where it can be excreted in your stool. 

If you have a history of chronic constipation then you aren’t able to excrete your inactivated oestrogen and this will then recirculate back into your body and this will cause oestrogen dominance. The body then senses that free circulating hormones are elevated and then will shut down the ability to make new hormones. 

Sex hormones themselves can influence the digestive system.  Imbalances of estrogen and progesterone can influence the movement of food through the intestines.  They can either speed up the process (causing diarrhea, nausea and abdominal pain) or they can slow things down (causing bloating or constipation).  Altered oestrogen levels can cause hyper-responsiveness to stress, which may promote an immune response and contribute to leaky gut.

Constipation can contribute to hormone imbalances but on the flip side, hormone imbalances can also contribute to constipation, making for a vicious cycle. 

Supporting the Glucuronidation detoxification pathway as it is one of the major phase 2 detoxification pathways in the liver which helps us eliminate hormones from the body.  An enzyme called beta glucuronidase can block this detoxification process, which can cause your hormones (including oestrogen) to get reabsorbed, reactivated, and put back into circulation.  Beta glucuronidase is produced by imbalanced intestinal bacteria.

Whether you have metabolic syndrome (pre-diabetes) or Diabetes Type 1 (Autoimmune) or Type 2 (lifestyle) you are susceptible to constipation. This is due to poor blood sugar control (insulin levels) over a long period of time and this can affect our fluid levels in our body. A lot of people who are in the pre-diabetes stage can be like this for many years before being tested for Diabetes. High insulin levels can cause damage to the nervous system which is a known long-term complication of diabetes. High blood sugar levels from type 1 and type 2 diabetes can lead to diabetic neuropathy (or nerve damage) causing the nerves controlling the digestive tract can lead to constipation, diarrhoea and incontinence.

Perimenopause can also cause your insulin levels to increase and some women can experience more symptoms of constipation if their blood sugar levels are out of whack. Insulin levels affect our weight especially around the middle and it can be difficult to shift, but not impossible.

Stress and our cortisol levels affect our digestion by affecting our transit time, with our busy lifestyles, long term stress is a common cause of constipation in some and diarrhoea in others. Cortisol raises our blood sugar levels causing extra weight gain around our middle and also leads to slowing our migrating motor complex (MMC) which causes constipation. This is another common occurrence for perimenopausal women as most women have been in a state of long term stress for many years.

Certain bad bacteria such as methanobrevibacter smithii (M. smithii) which is present in Methane dominant SIBO (constipation) can slow transit time and methane-producers have reduced postprandial (after your meal) serotonin levels, which can also affect intestinal transit along with glucose levels.

“Specifically, methane slows down small intestine transit time by 59%!”

As you can see, the digestive system and our hormones are very closely linked.

In my own clinic I have observed the connection between hormones and digestive health for many years. I work with both women and men to achieve digestive and hormonal freedom.

My clients typically are dealing with both digestive issues and hormonal imbalances as most of my clients are perimenopausal and post menopausal. We work together on balancing their hormones and supporting their digestive systems through dietary changes, herbal formulas made in clinic that support their needs along with supplements which support their liver and the bodies natural detox mechanisms. Getting a good night’s sleep, reducing and supporting their stress levels and getting their energy levels back again is an essential part of healing.

Are you ready to invest time, energy and money into getting to the root cause of your hormone and digestive system imbalances? 

Please reach out to me via my booking link ‘Work With Me’ on my website. I work with clients both in clinic and online. 

Yours in health and wellness,

Katrina xx