Bloating

15 March 2017.

Note: Some people refer to constipation as ‘bloating’, but we deal with that as a separate symptom here

When it comes to menstrual cycle, or hormonal medication-related health, this term can actually be used to refer to a couple of different symptoms:

1. Water retention- the medical term is oedema- a build up of fluid in the body which causes the affected tissue to become swollen. The swelling can occur in one particular part of the body or may be more general. Hormone-related water retention tends to accumulate under the skin – most commonly causing swelling of the lower legs and ankles [1]. In menstrual cycle-related bloating, the excess fluid is usually excreted (through wee) once menstruation (the period) has started.

Main symptoms: As well as swelling or puffiness of the skin, oedema can also cause; skin discolouration; areas of skin that temporarily hold the imprint of your finger when pressed (known as pitting oedema); aching, tender limbs; stiff joints; or weight gain.

2. Trapped gas/ wind in the gut- Most people experience this symptom from time to time; the tummy becomes stretched, tight and uncomfortable and you may feel the need to pass wind, but not be able to do so in full. It can be a distressing symptom, causing embarrassment and affecting quality of life if it happens on a regular basis [2]. It is known to correspond to the menstrual cycle, and some people experience it as a side effect of hormonal medications [3].

Main symptoms: Distended (fully expanded) stomach; discomfort or pain; or increased flatulence (passing wind).


1. Water retention

Conditions to rule out first, under medical supervision [1];

Medical treatments that can sometimes cause water retention, include:

TOP TIP! An often overlooked cause of fluid retention is due to binge eating alternating with strict dieting. This can cause intermittent fluid retention. Make sure you eat regular meals and avoid ‘dieting’- eating fresh food and exercising is the best way to maintain a healthy body weight.


Note: If your symptoms are caused by your hormonal medication, we suggest that you discuss your options with a doctor. These steps may reduce symptom severity, but are unlikely to be able to stop them completely whilst you remain on the same medication.

Managing hormone-related water retention:

Oedema/ water retention is often temporary and clears up by itself. For example, you may notice retention at some point in the 14 days leading up to menstruation, then excrete the excess fluid (through urination) once menstruation starts. However, it is possible to improve your symptoms, through a hormone-balancing diet and lifestyle changes;

Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms, as well as help reduce weight, or maintain a healthy weight. We highlight a few of the key steps that are especially relevant for those suffering from water retention, below;

Reduce salt intake– Salt is made of sodium and chloride. Sodium binds to water in the body and helps maintain the balance of fluids both inside and outside of cells. If you often eat meals that are high in salt, such as processed foods, your body may retain water [4].

Try nutritional supplements– Vitamin B6 [5] (RDA 1.3 mg), magnesium [6] (RDA 300-400 mg),  and potassium [7] (RDA 3700 mg) can all help reduce hormone-related water retention. Try taking a supplement if you are not getting enough of these elements in your diet- However, DO NOT take supplements if you are also using diuretic medication, unless specifically advised to by a doctor.

  • Vitamin B6 is found in potatoes, walnuts, meat, and bananas
  • Magnesium is found in grains, nuts, leafy greens, and dark chocolate
  • Potassium is found in avocado, bananas, and tomatoes

TOP TIP! If suffering from water retention, it can be tempting to reduce the amount of water that you drink- however, this will make the problem worse, rather than better. Make sure you drink at least 6 glasses of water per day.


You can help reduce water retention by taking regular exercise, such as walking, swimming or cycling. Also try raising your legs three to four times a day to improve your circulation, avoid standing for long periods of time, or wear compression stockings.

Note: Compression stockings are not always the most ‘fashionable’ of items, but they really can make a difference. If you don’t fancy the idea of wearing the ‘flesh coloured’ type of stocking, you might want to try more modern sports, travel, or even ‘fashion’ compression socks?


2. Trapped gas/ wind in the gut

Conditions to rule out first, under medical supervision [2];

If your stomach or tummy often feels bloated, it could also be due to:


Note: If your symptoms are caused by your hormonal medication, we suggest that you discuss your options with a doctor. These steps may reduce symptom severity, but are unlikely to be able to stop them completely whilst you remain on the same medication.

Managing hormone-related trapped gas/ wind;

Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms. We highlight a few of the key steps that are especially relevant for those suffering from trapped gas/ wind, below;

Cut down on foods known to cause wind– beans; onions; broccoli; cabbage; sprouts; and cauliflower [2]. But make sure you still eat five portions of fruit and vegetables a day!

Watch how and when you eat– Try not to swallow too much air- Don’t talk and eat at the same time, sit down to eat (sitting upright and not slumped over), reduce the amount of fizzy drinks you consume, stop chewing gum and chew with your mouth closed so that you’re not taking in excess air. Eat little and often. Small, regular meals are less taxing on the gut, minimising the chance of indigestion-related bloating. Avoid missing meals, or leaving long gaps between them [2].

Get minted!– Peppermint is renowned for its soothing effects on the digestive system, try sipping peppermint tea for natural relief from trapped wind. Minty antacids are also very useful for treating the effects of trapped wind…

Get your oats!–  It may help to eat oats (such as oat-based breakfast cereal or porridge) and linseeds (up to one tablespoon a day) to reduce bloating and flatulence…


Go for a walk or do some stretches:

– Twisting exercises help push air out of digestive system, this can be done in a chair or on the ground. Sit feet facing forward then rotate torso to the right and reach around to hold back of the chair, then repeat other direction.

– A yoga pose called ‘child’s pose’ is a great way to compress your intestinal tract and can help push gases through the digestive system. Kneel on all fours, then lower your hips back and down until they are resting on your feet bend forward to rest torso on legs as you reach arms forward on the ground.


If you have tried the suggested tips and tricks for at least 3 months, and your symptoms do not improve, please consult your doctor.

If you have any suggestions, or tips, for managing bloating- please let us know– we can share them with others!


Further information:


Page last reviewed and updated: June 2018


References:

  1. NHS. 2016. Oedema. [ONLINE] Available at: http://www.nhs.uk/conditions/oedema/Pages/Introduction.aspx. [Accessed 31 March 2017].
  2. NHS. 2016. Beat the bloat. [ONLINE] Available at: http://www.nhs.uk/Livewell/digestive-health/Pages/beat-the-bloat.aspx. [Accessed 31 March 2017].
  3.  Gas and contraceptives
  4. Public Health England (2003) Scientific Advisory Committee on Nutrition advice on salt and recommended Dietary Reference Values (DRVs) [ONLINE] Available at: https://www.gov.uk/government/publications/sacn-salt-and-health-report
  5. Ebrahimi E, Khayati Motlagh S, Nemati S, Tavakoli Z. (2012) Effects of magnesium and vitamin b6 on the severity of premenstrual syndrome symptoms. J Caring Sci. Nov 22;1(4):183-9. doi: 10.5681/jcs.2012.026. eCollection 2012 Dec. PubMed PMID:
    25276694; PubMed Central PMCID: PMC4161081.
  6. Walker AF, De Souza MC, Vickers MF, Abeyasekera S, Collins ML, Trinca LA.(1998) ‘Magnesium supplementation alleviates premenstrual symptoms of fluid retention’. J Womens Health Nov;7(9):1157-65. PubMed PMID: 9861593
  7. Gallen IW, Rosa RM, Esparaz DY, Young JB, Robertson GL, Batlle D, Epstein FH, Landsberg L. (1998) ‘On the mechanism of the effects of potassium restriction on blood pressure and renal sodium retention’. Am J Kidney Dis. Jan;31(1):19-27. PubMed PMID: 9428447

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