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Expert answers to your most intimate health questions

Is my period making my IBS worse?

Q:

Four months ago my doctor diagnosed the intestinal cramps, diarrhea and nausea I was having as IBS. Since then, I’ve been avoiding spicy, fried and acidic foods as she advised. It’s helped, but once my period starts, my symptoms return. What’s going on?

A: Research shows that up to 50 percent of women who have irritable bowel syndrome (IBS) report an increase in painful gut spasms and other symptoms during their period. Experts believe this uptick is due to prostaglandins, the hormone-like substances that also cause menstrual cramps. These compounds help the uterus contract and expel its lining, but they can also make the cramping and diarrhea associated with IBS worse.

Fortunately, there are a few things you can do to ease your symptoms. In addition to the dietary adjustments you’ve already made, I advise limiting caffeine and alcohol since both can irritate the intestinal lining, triggering or worsening symptoms. And for relief during your period, try sipping 1 to 2 cups of peppermint tea (like Alvita Organic Peppermint Tea, $5 for 24 tea bags, LuckyVitamin.com) daily. Peppermint contains antispasmodic compounds like menthol and methyl salicylate, and has been shown to alleviate cramping, nausea and diarrhea. You may also want to avoid artificial sweeteners, which many women with IBS find problematic, and instead opt for stevia to sweeten your tea and other beverages and foods.

These steps should significantly reduce your IBS symptoms during your next period, but if they don’t, I suggest seeing your doctor. She can recommend other treatments, such as antispasmodic medications or oral contraceptives, which prevent the uterine lining from releasing pain-producing prostaglandins.

What’s causing these headaches?

Q: My husband and I have always had a great love life, but lately I haven’t wanted to be intimate because I’ve been getting intense headaches during intercourse. Should I be worried about this?

A: It sounds like you’re experiencing coital cephalalgia, headaches brought on by sexual activity. We doctors don’t know exactly why these headaches occur, but it’s possible that they’re caused by the excessive contractions of neck and jaw muscles and rapid increases in heart rate and blood pressure in the brain’s blood vessels during the physical act of sex. Women prone to migraines seem to be at higher risk.

I suggest talking with your doctor, who can rule out other causes or underlying factors. If she agrees that you’re dealing with coital cephalalgia, avoiding positions that put a strain on your neck and switching to one that minimizes muscle tension, like lying on your back, may prevent these headaches. Also smart: taking 400 to 600 mg of ibuprofen 15 to 60 minutes before sex to prevent the pain. A I suspect you’re dealing with contact dermatitis, an allergy-like reaction to substances that come in contact with the skin. It can be triggered by perfumes and other ingredients in panty liners and pads and it’s common in perimenopause, as waning estrogen causes vulval skin to thin and become more sensitive.

Applying coconut oil to the area twice a day can ease the soreness. And to ward off future irritation, try switching to natural cotton pads (like the reusable Organic Day Pad, $19, GladRags.com). Finally, since harsh soaps can worsen irritation, consider cleansing this area with water only and using unscented detergent to wash pads and undergarments. If symptoms don’t resolve within a week of trying these strategies, or if the discharge changes in color or odor, see your gynecologist, who can offer other remedies.