In all the years I’ve been working as a hormonal health expert, I’ve met very few people who haven’t dealt with one major problem: bloating. Just about every menstruating person I’ve talked to has skipped a party, canceled a date, or missed out on another out-of-the-house event because their stomach felt like a full-blown balloon. And this isn’t just a superficial issue—bloating can hurt, and it is almost always accompanied by a constellation of other upsetting symptoms like intense PMS, acne, migraines, mood swings, and sleep disruptions.
Many menstruating people don’t connect the dots when these issues all crop up at the same time, and I understand why. Based on the images we see in magazines and social media, and the diet and exercise advice that’s offered everywhere (which is based largely on research done on cis males), we’re led to believe a flat tummy is the result of deprivation diets and torturous workouts. But from working with people in my clinic, I can tell you that bloating typically has less to do with how committed you are to your diet and exercise plan and much more to do with the bacteria in your gut and how efficiently you’re metabolizing estrogen.
The key to beating the bloat is to understand what’s causing it. There are three main culprits that cause water retention, and once you can identify which is your main root cause, you can start eating to treat it. Let’s face it: How many more times can we hear “Eat less salt and drink more water”? By the time we’re bloated, it’s too late—we’re deep in our cravings for more salt and all the other foods that add to the physical discomfort we feel.
PMS has many symptoms. If bloating is one that you see regularly, there’s a good chance you have a constellation of other annoying symptoms, including migraines, acne, and mood swings.
What kind of period bloat do you have?
I want you to be able to treat your bloating with laser focus, so let’s first identify which type of bloating you have during your luteal phase—the 10 days before your period starts. These are patterns I have found through more than a decade of counseling women and menstruating people:
1. Estrogen-overload water weight.
Estrogen can cause salt and water to be retained in the tissues. Many women have too much estrogen relative to deficient levels of progesterone. This is likely your bloating type if you have pre-existing hormonal imbalances like fibroids, endometriosis, PCOS, ovarian cysts, PMS, or difficult perimenopause. You have what is referred to as “estrogen dominance,” and during the luteal phase (PMS week), especially high levels of estrogen are associated with bloating.
How to solve it: Help your body during your luteal phase metabolize excess estrogen—make an estrogen-flushing juice from carrot, beet, celery, and lemon; eat dark leafy greens, legumes, flax; reduce animal protein and dairy; and supplement to support liver function with the mother of all antioxidants, glutathione, and vitamin C.
2. Cortisol-stress puffiness.
A few stress-filled days and sleepless nights, and magically you seem to weigh 5 pounds more than you did the day before. That’s the effect of cortisol: It puffs you up by forcing the body to retain sodium. If you’re feeling chronically stressed, overwhelmed, stretched too thin, have low-grade fatigue all day, or rely on caffeine, then this is very likely your bloating type.
How to solve it: Low- to medium-intensity exercise is a great way to beat stress and decrease levels of the stress hormone cortisol. (I get on my trampoline at least once a day!) Stress makes all physical symptoms worse, including bloat. Also: self-pleasure! Masturbating is one of the fastest and most fun ways to flush massive amounts of cortisol. And if you haven’t already, reduce or say goodbye to caffeine, which causes the body to produce extra cortisol.
3. Magnesium-deficiency swelling.
The human body runs on electricity derived from four key electrolytes: calcium, sodium, potassium, and, of course, magnesium. If you work out hard, have stress, and drink caffeine, then it’s very easy for your body to become magnesium-deficient. Signs of deficiency aside from the bloating include depression, migraines, insomnia, leg cramps, facial twitches, and/or insomnia. Menstrual cramps are also a sign of low magnesium.
How to solve it: There are natural strategies for boosting magnesium, including eating key magnesium-rich foods, like sunflower seeds, low-mercury fish, leafy greens, and my personal favorite, dark chocolate!
I love recommending dark chocolate as medicine. Just make sure that you choose chocolate that contains 70 percent cacao or more. A 100-gram serving has 176 milligrams of magnesium, which is just over half of the recommended daily intake for adult women. Enjoy!
4. Gut microbiome low-belly bloat.
Scientists are just beginning to understand the profound effect the millions of microbes in your digestive tract have on your overall health—including bloating. When your microbiome—a fancy word for the flora populating your gut—becomes imbalanced, your gut can start to react to certain foods and have problems absorbing nutrients, both of which fuel a wide range of health problems from acne and weight-loss resistance to brain fog, depression, and bloating.
But here’s where things get really interesting: Digesting food isn’t your gut flora’s only job. A specific set of your bacteria known as the estrobolome is responsible for helping metabolize estrogen. When these bacteria are out of balance, your body doesn’t process and eliminate excess estrogen efficiently. This can lead to estrogen dominance, which contributes to bad PMS, among other health problems—and that includes more bloating. So microbiome imbalances are a double whammy when it comes to bloating, contributing to both food reactivity and estrogen overload. That’s why the first step in putting a stop to bloat is addressing gut health.
How to solve it: Healing your gut is the single best thing you can do to help with bloat—and the process starts with food. Reduce or eliminate sugar, dairy, and gluten, and keep inflammatory processed foods to a minimum. Then stock up on hormone-healthy whole foodslike organic greens, avocados, pastured eggs, ground flaxseed, and berries. Make probiotics part of your diet. Taking a high-quality probiotic helps nudge your gut flora back into balance. And of course a great magnesium glycinate supplement is great this week.
General bloating advice for every menstruating person.
What if we changed the “PMS” acronym from “premenstrual syndrome” to “prioritizing my self”? Most of us put other people and priorities first as a default and leave inadequate time for our own self-care. Neurochemical changes that occur during the luteal phase prime us to focus on our own needs, and not attending to them creates more stress. So PMS, including bloating, could be a sign that your body is trying to get your attention to put yourself first for a week.