Why do I have diarrhea and severe pain during menstruation?

Author of the article: Tironova Inna Igorevna

Gastroenterologist, therapist

15 years of experience

Professional skills: Colon hydrotherapy, treatment of gastrointestinal diseases

Due to physiology, women often suffer from intestinal disorders, so diarrhea during menstruation is not surprising during this period. Discomfort and soreness, which causes malaise, significantly worsens well-being and negatively affects mood. Often, diarrhea does not require special treatment and goes away very quickly. How to relieve an unpleasant symptom, and what causes it?

Main reasons

Experts have long figured out why diarrhea appears in the first days of menstruation, and have conducted many clinical studies aimed at measuring the concentration of female hormones and studying their direct effect on the digestive system. As a result, it has been proven that changes in hormonal levels contribute to an increase in the level of lipid physiologically active substances - pain mediators (prostaglandins). They cause frequent contractions of the muscle fibers of the intestinal walls, which leads to liquefied stools.

On the first day of menstruation, the body weakens and reacts violently to external and internal irritant factors. Most women/girls of reproductive age experience lethargy, nervousness, cephalalgia (headache), attacks of dizziness, increased or decreased appetite before menstruation and during bleeding. Only a third of them experience increased gas formation, a feeling preceding vomiting, retching, frequent bowel movements, and intestinal spasms.

The causes of diarrhea during menstruation may be the following:

• Contraction of the walls of the uterus, affecting intestinal motility.
• Hypertonicity of the vagal nerve, manifested by low blood pressure, hyperhidrosis, freezing of the extremities, and gastrointestinal disorders.
• A surge in the level of gestagens, which are responsible for the reproductive functions of the genital organs.
• Changes in taste, increased appetite, leading to overeating and consumption of large amounts of laxative foods (for example, pumpkin, beets, fresh fermented milk drinks).
• Stressful situations. Any minor upset can cause tears and serious worries these days. The body immediately responds to emotional instability with diarrhea, even in the middle of the cycle.
• Increased blood circulation in the pelvis, which causes slight swelling of the uterus. It compresses the intestines and provokes the appearance of liquid stool.

Even when your period is just approaching, diarrhea can appear, disrupting all plans. This is due to hormonal fluctuations and signs of premenstrual syndrome (PMS).

Important! There are cases when loose stools during menstruation coincide with the development of pathological conditions. Therefore, you need to pay attention to the accompanying signs so as not to miss the onset of the disease and take all necessary measures to eliminate it in a timely manner.

How to relieve the condition

It is impossible to eliminate the symptom without changing the menu. To stabilize a woman’s stool during menstruation, it is recommended:

• Adhere to proper nutrition, removing fried, spicy, fatty foods from your diet.
• Eat fresh vegetables and fruits. Eat small and often.
• Drink more liquid in the form of water, rosehip decoction, compotes.
• Perform light exercise daily.
• Avoid stressful situations and heavy physical activity.

The girl’s digestive system is sensitive during this period; you should not eat food with irritating ingredients in its composition. To avoid dehydration, you should drink at least 2 liters of fluid per day.

If diarrhea occurs regularly, it is recommended to include foods in the diet that can strengthen the stool. Recommended:

• Strong black tea, in the absence of contraindications.
• White bread crackers.
• Buckwheat, fig.

It is not recommended to take loperamide anti-diarrhea tablets. If your stomach hurts, take No-shpa, which eliminates cramps.

During this period, you should not make responsible decisions or overcome difficulties. Emotional disorders affect the functioning of digestion.

You will not be able to get rid of diarrhea with diet if the disorder is caused by poisoning or an intestinal infection. In this case, it is recommended to take sorbents and seek help from a doctor.

If following a diet and regimen does not help eliminate the symptom, or signs of other pathologies develop, you should consult a doctor. The cause of loose stools is not menstruation. The doctor will help identify the true cause of the symptom by prescribing an examination.

Diarrhea during menstruation causes discomfort, so to eliminate it and reduce symptoms, experts recommend following a diet:

• exclude fatty, spicy, fried foods from the diet;
• eat more vegetables and fruits;
• change the amount of food consumed - reduce portions, but increase their quantity;
• drink more fluids, you can take herbal decoctions;
• increase the amount of moderate physical activity;
• get rid of irritating factors such as stress, heavy physical activity, and nervous disorders.

You can eliminate loose stools using fixing products:

• Black tea;
• rich meat broths;
• cottage cheese;
• white bread croutons;
• buckwheat, rice, oatmeal.

In cases where diarrhea is accompanied by attacks of nausea and vomiting, you should consult a specialist. This condition may be a sign of serious poisoning. After identifying the cause of this condition, the specialist will recommend the girl the correct, adequate therapy.

If you have diarrhea, you need to focus your energy on restoring the condition. To alleviate the condition you need:

• minimize the impact of stress;
• refuse to consume any unhealthy food, for example, fatty, fried, overly salty, spicy;
• stop smoking and consuming alcoholic beverages;
• give preference to light physical activity.

Any medications are taken only in consultation with the doctor and if absolutely necessary. Include fresh fruits and vegetables in your diet. Products must be fresh and of high quality. In addition, there must be a drinking regime. Limit the amount of caffeine.

You can eat cottage cheese and crackers. Instead of coffee, drink strong tea. Confectionery products should be excluded. If the symptom is accompanied by abdominal pain, then you need to rest as much as possible and take a horizontal position. During menstruation, you should give preference only to positive emotions.

Reduce the amount of salt. The drink should be warm. Cold or excessively hot is prohibited. Unconventional methods can be used to alleviate the condition. However, you should consult your doctor first. The doctor will select effective prescriptions.

When loose stools can be considered a pathology

There is an opinion that diarrhea that occurs during menstruation is only beneficial for the body: this way it is cleansed of toxins and waste, rejuvenated, and healthier. But sometimes repeated loose stools are not caused by changes in hormonal balance, but are associated with an aggravated illness. A woman needs to monitor the possible appearance of unpleasant symptoms, as well as evaluate the characteristics of bowel movements.

Loose pathological stools during menstruation are characterized by:

• Repulsive putrid odor.
• The presence of mucus and bloody discharge in the stool.
• Watery consistency.

These symptoms indicate damage to the gastrointestinal tract by an intestinal infection. The patient has to go to the toilet frequently, her body temperature rises, she starts vomiting, has a headache, and feels very weak.

An experienced specialist will tell you why you still diarrhea during menstruation. The reason may be hidden in a serious illness:

• Endometriosis . It can also cause bloody diarrhea.
• Cystitis . This is an inflammatory process in the urinary canals. Menstruation is often a factor that provokes the exacerbation of many ailments, including cystitis.
• Enteritis and colitis . Chronic pathologies that occur without severe symptoms. A weakened body becomes more susceptible to irritation, which contributes to the appearance of new signs of the disease.
• Algodismenorrhea . This is a gynecological disease accompanied by diarrhea during menstruation, vomiting, and acute pain.
• Dysbacteriosis . During menstruation, diarrhea occurs if the balance of the intestinal environment is disturbed, and the number of pathogens far exceeds the number of beneficial bacteria. Probiotics will help get rid of the unpleasant syndrome.

In some cases, the causes of the disorder are gastritis, ulcers, pancreatitis and other stomach diseases that have similar symptoms. The main factor in the development of gastric ulcers is the activation of spiral-shaped bacteria, which infects various parts of the stomach.

Diarrhea during menstruation is sometimes observed in women with a tilted uterus. This is not the worst pathology, but with it, periods are often painful (especially for girls). There is no need to treat this condition. As a rule, it normalizes after childbirth, or remains until the end of life, without causing any problems associated with conception or other ailments of the genitourinary system.

When is diarrhea a reason to see a doctor?

Sometimes diarrhea is caused by serious pathologies that require medical attention. In this case, intestinal upset can occur at any time, and menstruation is just a coincidence.

If a girl knows the cause of bowel irregularities, she can promptly respond to changes in her body. There are factors that cannot be ignored:

• frequent bowel movements that do not stop after the first 2-3 days;
• feces have blood streaks, foam, green fragments;
• going to the toilet is accompanied by severe pain;
• menstruation is accompanied by fever, general weakness, and vomiting.

A good reason to see a doctor is the presence of diarrhea even after the end of menstruation. Consultation with a therapist or gastroenterologist is required.

Warning symptoms include:

• uncharacteristic unpleasant odor from feces;
• the presence of mucous inclusions in feces;
• significant change in stool color;

Bad smelling stool can be a bad sign

• the presence of green or bloody streaks;
• the presence of a foamy consistency.

When you need a doctor

It is not always possible to find out on your own why diarrhea occurs during menstruation. Therefore, if you detect suspicious symptoms, you should consult your doctor. Only he can find the cause of impaired digestion.

It is especially dangerous when:

• Diarrhea is accompanied by fever, vomiting, and a terrible stomach ache.
• Diarrhea lasts longer than two days. Normally, during hormonal changes, loose stools are observed for a maximum of 2 days.
• The appearance of stool with changes in color, mucus and streaks of blood is observed. This is unacceptable during menstruation.

Diarrhea and retention

It happens that a girl waits for the onset of her critical days, but instead an attack of diarrhea begins. This happens at the beginning of pregnancy, when hormonal changes occur. An increased concentration of progesterone in the bloodstream has a laxative effect on the gastrointestinal tract. The absence of menstruation on time and attacks of diarrhea are a good reason to purchase a pregnancy test, especially when you feel weakness, drowsiness, intolerance to certain smells, irritability, sudden mood swings, and decreased performance.

Diarrhea allows the internal organs to cleanse themselves, which is the initial stage of the period of bearing a child. It can last for several weeks and appear periodically in the first months of gestation. In the future, the stool will become harder, and closer to childbirth, constipation may appear.

Important! Stool upset can bother a girl even before her menstruation is delayed. In this case, the lower back often pulls, moderate pain appears, which signals the fixation of the fertilized egg in the uterus.

If pregnancy is ruled out, and instead of menstruation, bowel movements become multiple and liquid, there is no need to panic. Sometimes this happens when:

• Psycho-emotional overload.
• Poor nutrition, hunger strikes, strict diets.
• Hormonal imbalance associated with the formation of the monthly cycle up to menopause.
• Cancellation of hormonal contraception.
• Lactation.

Rarely, such a violation indicates:

• Inflammation or oncopathology in the reproductive organs.
• Hormonal disorders associated with the thyroid gland or pituitary gland.

If the delay lasts longer than five days, but the test does not confirm fertilization of the egg, you should urgently consult a doctor.

Characteristics of diarrhea during menstruation

Diarrhea begins a week before the delay. A slight looseness of stool is noticeable 5–7 days before menstruation. More liquid stools begin two days before the start of the cycle. Acts of defecation occur in the morning.

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Diarrhea before menstruation is accompanied by pain of moderate intensity. After bowel movements, the attacks subside, and the woman ceases to feel discomfort.

It is quite normal if this phenomenon appears a few days before the start of menstruation. A healthy woman should not have more than three urges to go to the toilet per morning during this period. Otherwise, the cause of the problem should be sought not in gynecology, but in gastroenterology. A deviation from the norm should also be considered if the symptoms of diarrhea do not disappear after menstruation.

Diarrhea and ovulation

When the egg leaves the ovary and enters the fallopian tube, a bout of diarrhea may occur, which is usually associated with irritable bowel syndrome.

During ovulation, the intestinal walls contract intensely, which causes the stool to liquefy. It will not be possible to make you feel better with medications. The only acceptable option is to correct the diet and take herbal decoctions. If, after ovulation and before the start of menstruation, diarrhea does not go away, and is accompanied by fever and vomiting, you should seek medical help and look for the true cause of the pathology.

Why does diarrhea occur during menstruation?

Diarrhea during menstruation is a completely safe process, although unpleasant. In most cases, diarrhea goes away on the first day of menstruation, but sometimes it can linger for a couple more days. There is a logical, calming explanation for this - at the beginning of menstruation, the female body produces a lot of progesterone. An increase in this hormone provokes a powerful cleansing of the body and, in addition to diarrhea, brings troubles characteristic of menstruation:

1. Fatigue, lethargy, tearfulness.
2. Slight weight gain.
3. Acne on the face and décolleté.
4. Headache.
5. Changes in appetite, permanent hunger.
6. Pain when touching the mammary glands and the like.

Diarrhea during menstruation occurs in every third woman

In addition, during menstruation, the uterus is enlarged and contracts regularly, expelling blood, thereby stimulating the wall of the rectum. This pressure causes the urge to defecate; on the first day of menstrual bleeding, when the volume of blood coming out is maximum, a woman may constantly want to go to the toilet “in a big way.” Intestinal peristalsis works in the same rhythm with uterine contractions, therefore, as soon as the latter become more frequent, the intestines seem to synchronize and also speed up their work.

In addition, during menstruation, women experience sharp changes in food preferences - some are drawn to sweets, others, on the contrary, prefer salty or spicy foods. The intestines immediately react to unusual nutrition, which irritates its walls and provokes diarrhea. Eating sweet foods during menstruation increases the sugar content in the body, causes fermentation in the stomach, bloating, flatulence, and causes diarrhea. Salty food, on the contrary, provokes severe thirst; a woman often drinks, which is why the feces become liquefied.

During PMS, some women's taste preferences change

There are two more explanations for why menstrual periods in women are accompanied by diarrhea. Firstly, blood circulation increases in the pelvis, which significantly affects the functioning of the gastrointestinal tract. Blood rushes to the intestines, stimulates it, pushes it to increased activity.

Secondly, due to the presence of progesterone in increased quantities, women feel all external problems more acutely, become more susceptible, vulnerable, and irritable. Mild stress can also cause increased peristalsis in the intestines and diarrhea.

Treatment

You should not immediately resort to antidiarrheal drugs if diarrhea during menstruation is caused by hormonal imbalance, which is absolutely normal. Menstruation is not considered a disease, and diarrhea caused by its occurrence also does not require therapeutic measures. Using antidiarrheal drugs in this case is not only inappropriate, but also harmful, as they can cause constipation. Imodium or its analogues will be effective if frequent bowel movements were preceded by a gastrointestinal disorder.

If diarrhea began simultaneously with menstruation, accompanied by painful spasms of the intestines, it is allowed to take No-Shpa, which relaxes smooth muscles and significantly alleviates the condition. Among the folk methods, if there are no restrictions, you can use black peppercorns: swallow a few pieces, without chewing, with water.

Stomach upset during menstruation

Causes of stomach problems before menstruation:

• increased amount of progesterone during the second phase of the cycle;
• increased levels of the hormone prostaglandin, which relaxes the intestinal muscles;
• disrupted hormonal levels;
• increased tone of the vagus nerve (hypotension, profuse or absent sweating, chills);
• diseases of the digestive system, the aggravation of which may occur during menstruation;
• chronic intestinal irritation;
• relaxation of the vaginal muscles;
• change in food preferences;
• reflex disturbance of the digestive process;
• increased intestinal motility due to its close location to the uterus, which is in good shape.

Diarrhea before menstruation can have various causes. In addition to hormonal changes, physiological factors also lead to stool disorders. Possible reasons:

• contraction of the uterine muscles;
• changes in hormonal levels;
• improper diet;
• diseases of the stomach and intestines;
• rush of blood to the pelvic organs;
• bend of the uterus.

Changes in the body due to the menstrual cycle can lead to intestinal disorders. Only after determining the exact cause of diarrhea can adequate therapy be prescribed.

With the arrival of menstruation, a woman’s food preferences may change. Diarrhea during menstruation can occur due to improper, non-standard nutrition for a woman.

Some girls start eating a lot often, while others resort to serious culinary experiments. Hormonal fluctuations force a woman to consume foods that she had not even thought about eating before.

Therefore, the digestive organs are stressed, peristalsis increases, which causes diarrhea.

Uterine contractions

Before menstruation, preparation processes take place in the uterus for the detachment of the functional mucous layer. With the arrival of menstruation, the activity of muscle contractions of the uterus spreads to the intestines, since they are located close to each other. There is no need to treat this condition - diarrhea goes away on its own.

Diseases

Some diseases are asymptomatic for a long time, but after the onset of menstruation they begin to actively manifest themselves. The sensitivity of the female body during this period increases significantly. Common symptoms of a bowel disorder are:

• nausea;
• vomit;
• pain in the abdomen.

If a woman believes that stool disturbances are due to some disease, she needs to undergo diagnostics and therapy prescribed by a specialist.

Another serious pathological condition may also cause bowel dysfunction:

• endometriosis;
• cystitis;
• enteritis and colitis;
• intestinal infections.

During menstruation, the female body faces serious changes in hormonal levels, in particular an increase in the level of prostaglandin, which is responsible for relaxing smooth muscles. First of all, this process should spread to the uterus, but the intestines also relax, so diarrhea during menstruation is a natural process of cleansing the body.

Rush of blood

Menstruation causes serious changes in the body. The rush of blood into the pelvic organs causes an increase in the load on them. As a result, the intestines respond to the increased load by disrupting stool.

Bend of the uterus

A complete diagnosis in a medical facility can give a woman an answer to the question of what caused diarrhea during menstruation. An examination is necessary when a woman does not have any disturbances in the functioning of the gastrointestinal tract, and loose stools are explained by gynecological factors.

A bent uterus is a serious pathological condition that provokes severe pain and diarrhea. Diarrhea may continue even after your period. To date, experts do not know methods for treating this pathology. It is believed that after childbirth the problem may disappear on its own.

Are there any complications?

There is no reason to panic if the loose stools are free of blood or mucus. As a rule, this is a protective reaction of the body (compensatory), due to which the cleansing of harmful and toxic substances occurs. But with diarrhea during menstruation, it is necessary to monitor changes in the color and consistency of stool, as serious changes can be observed here.

The danger of diarrhea during menstruation

passing laboratory tests, performing ultrasound to examine the pelvic organs. Severe diarrhea cannot be ignored, as the consequences can be very serious. In addition, many women, based on the advice of their friends, resort to self-medication using medications, for example, antidiarrheals.

How to reduce pain during menstruation

How to treat

Treatment of diarrhea during pregnancy

Depending on the factor that triggered diarrhea during menstruation, various treatment methods can be used, including taking medications, following a special diet and maintaining a healthy lifestyle. Let's consider the basic recommendations to eliminate this delicate problem:

• therapeutic diet. As noted earlier, an unhealthy or unbalanced diet often leads to diarrhea, so treatment should begin with a change in diet. The daily menu must include weak green tea, rice porridge, low-fat chicken broth, yogurt and oatmeal. It is also necessary to maintain a drinking regime and drink a sufficient amount of liquid every day (the water should be warm); How to eat during your period
• consuming various decoctions prepared with medicinal herbs will help relieve irritation from the intestines. Typically, yarrow, calendula or chamomile are used for diarrhea. If desired, you can add a small amount of sugar or honey to the prepared broth to improve the taste;
• taking medications. It is recommended to resort to drug treatment only in extreme cases. As a rule, doctors prescribe drugs such as No-Shpa, Drotaverine, Imodium and others to combat diarrhea. The dosage and duration of the therapeutic course are prescribed by the attending physician; "No-Shpa"
• Throughout the entire therapeutic course, it is recommended to regularly spend time in the fresh air, engage in moderate physical activity and take vitamin supplements (prescription only);
• Eliminate from your diet foods that provoke intense bile production. We are talking about food containing a large amount of fat;
• Eating proper and healthy food is not everything, as you need to follow a proper diet. Avoid overeating as this can overload your digestive system. Doctors recommend eating often, but in small portions (you need to follow this rule not only during treatment, but throughout your life); Fractional meals
• The best drinks for diarrhea are still mineral water or fruit jelly. For variety, you can drink nettle decoction;
• In order to avoid future bouts of diarrhea during menstruation, experts recommend completely eliminating plums, dried apricots and other foods that have a laxative effect from your diet a few days before the menstrual cycle.

It is not recommended to take anti-diarrhea medications

Often, diarrhea goes away on its own and does not pose a serious danger to a woman’s body during menstruation. But if the symptom bothers you for a long period or is accompanied by other alarming signs, then you should not postpone your visit to the doctor until later. Ignoring the problem will only make the situation worse.

How can the products be used?

Diarrhea before and during menstruation can be a serious problem. Once diagnosed, a specialist may prescribe medication based on the cause and characteristics of the disorder. You can get rid of diarrhea with:

• Imodium - the drug helps to normalize the functioning of the intestines and improves the general condition.
• Probiotics – the drug enters the body along with “friendly bacteria” and helps normalize the intestinal microflora. It should be remembered that probiotics are not a means of quick action - you must complete a course of therapy prescribed by a specialist.
• Esterosorbents (activated carbon, food additives). Such products absorb harmful toxins and leave the body naturally. Most often prescribed for serious poisoning, peptic ulcers, gastritis. It is important to remember that such drugs remove not only harmful, but also beneficial substances from the body. Therefore, it is not recommended to use them for a long time.
• Antibiotics – are necessary to treat diarrhea caused by harmful bacteria. Only a doctor can determine which antibiotic will be effective.

There are many reasons for bowel irregularities during menstruation. When diarrhea appears, there is no need to panic, because it can go away on its own; if this does not happen, it is better to contact a specialist and follow his recommendations.

Treatment of diarrhea during menstruation

If diarrhea was caused solely by hormonal changes, then you do not need to immediately drink Imodium and Loperamide - substances that quickly relieve a person of diarrhea.

But they are used only when diarrhea was preceded by a gastrointestinal disorder.

Due to the fact that a woman’s period is not a disease, such medications will only aggravate the situation and provoke another pathology – chronic constipation.

But there are a number of effective measures that will help cope with diarrhea on the first day of menstruation. They are:

1. A woman should control her appetite and watch what she eats. Food should only be freshly prepared, boiled or stewed. You will have to temporarily give up fried foods so as not to think about why you have diarrhea during your period.
2. Experts recommend eliminating fatty foods, salt and sugar from your diet a day or two before menstruation. This also includes hot spices that can cause diarrhea. It is better to reduce the consumption of fruits and vegetables that cause fermentation in the gastrointestinal tract.
3. Doctors advise eating oatmeal, buckwheat or rice porridge cooked in purified water. Such nutrition will protect the intestinal mucosa and stop loose bowel movements. You can drink tea, jelly, eat white bread crackers, lean meat and low-fat cottage cheese.
4. It is worth remembering that food should be taken often, but in small portions. This is especially true in the evening, before bed.
5. Intestinal upset will quickly subside after menstruation if the girl drinks chamomile teas, which soothe the intestines and have an astringent effect.
6. Drinking water should be neither hot nor cold. It is better to boil it first and cool it.
7. Physical activity and sports are common causes of diarrhea during menstrual periods. Why is this happening? Because active movements improve peristalsis and push feces to exit naturally. The girl is recommended to walk more, breathe fresh air in a calm environment.
8. No-spa will help relieve intestinal spasms. This drug relaxes the body and relieves pain.

Doctors have established a connection between diarrhea and digestive disorders. This suggests that the underlying causes should be addressed to prevent defecation disorder.

A girl should think about why she still has symptoms of diarrhea after menstruation, and try to solve this problem with the help of qualified specialists.

However, in some cases it can cause severe discomfort, for example, at work, where it is not possible to empty the bowels as soon as necessary. In this case, doctors give the following recommendations:

1. Refusal of certain products. Thanks to a well-designed diet, you can easily prevent diarrhea and alleviate the condition. So, you just need to exclude unusual and new foods, fatty, hot, fried and spicy foods from your diet. A few days before the start of menstruation, exclude beets, prunes, dried apricots, and plums from the diet, since these products have a laxative effect.
2. Eat healthy foods. These include any cereals and bread. Rice and oatmeal and baked goods made from wholemeal flour are especially useful for diarrhea. Apples, bananas and cheese improve intestinal function.
3. Diet. Firstly, it is better to eat less, but more often. Secondly, eat only fresh and proven products.
4. Drinking regime. It is simply necessary to restore intestinal function. Pure water, green and black tea, jelly, herbal infusions are the most beneficial drinks for the intestines. By the way, it is better to avoid coffee, since in many people it causes intestinal irritation and, as a result, diarrhea.

In addition, if possible, you should adhere to other recommendations:

1. Maintain bed rest. At rest, it is extremely difficult to cause diarrhea. If it is not possible to lie in bed, you should try to at least eliminate physical activity.
2. Do not take tablets for indigestion. Medicines can have the opposite effect.
3. Lead a passive lifestyle. For a while you need to give up any physical activity, sports, or outdoor activities.
4. Provide the body with rest. You need to spend more time lying down or half-sitting in a relaxed state.
5. Emotional condition. If possible, there is no need to solve serious problems during menstruation, especially if you feel unwell or have diarrhea. Against the background of stress and anxiety, diarrhea can even begin on its own, regardless of the phase of the menstrual cycle.
6. Relaxation. In the first days of your period, it is better to devote time to yourself: do what you love, quietly watch a movie or read a book, wrapped in a blanket - every girl knows best what activity gives her positive emotions.

Prevention of diarrhea also plays an important role, which should be considered long before the onset of menstruation.

Source: https://motiv-tarif.ru/rasstroystvo-zheludka-vremya-mesyachnykh/