Can progesterone cause diarrhea? Understanding the complex link between hormones and gut health

October 8, 2025 •

4 min read

According to research, while progesterone's primary effect on the gut is relaxing smooth muscles and slowing motility, its effects are dose-dependent and complex. The question, can progesterone cause diarrhea?, is therefore more nuanced than a simple yes or no, with hormonal fluctuations playing a key role in digestive changes.

Quick Summary

Progesterone's impact on digestion varies. High levels typically cause constipation, but a sudden drop, with other hormonal shifts, can trigger diarrhea.

Key Points

Dual Effect: Progesterone has a dual effect on the gut; high levels relax muscles and cause constipation, while its withdrawal can lead to diarrhea.
Menstrual Cycle Connection: A drop in progesterone just before menstruation triggers the release of prostaglandins, which stimulate intestinal contractions and cause loose stools or diarrhea.
Form and Dosage: The form and dosage of progesterone supplementation can influence side effects, with oral capsules sometimes causing more noticeable digestive upset.
Perimenopausal Fluctuations: Erratic hormone levels during perimenopause can cause unpredictable digestive changes, including alternating bouts of constipation and diarrhea.
Prostaglandin-Induced Contractions: The same prostaglandins that cause uterine cramps also affect the intestines, explaining why many women experience diarrhea during their period.
Symptom Management: Managing progesterone-related digestive symptoms can involve dietary changes, staying hydrated, and stress management, in addition to medical consultation if necessary.

The relationship between progesterone and digestive health is an intricate one, often leading to confusion and discomfort for those experiencing symptoms. While many associate high progesterone levels with constipation due to its muscle-relaxing properties, diarrhea can also be an unexpected side effect, particularly during periods of hormonal change. This article explores the mechanisms behind progesterone's influence on the gut, distinguishes its effects from other hormonal factors, and provides guidance for managing related symptoms.

The Dual Effect of Progesterone on Gut Motility

Progesterone exerts a powerful influence on the gastrointestinal (GI) system by acting on the smooth muscle lining the digestive tract. Its well-documented primary effect is relaxation, which serves a vital purpose during pregnancy by relaxing uterine muscles to prevent premature contractions. This same relaxing action extends to the gut, slowing down the movement of food and waste, a condition known as reduced gut motility.

High Progesterone: During the luteal phase of the menstrual cycle (after ovulation) and throughout pregnancy, progesterone levels are elevated. The sustained relaxing effect on the gut's smooth muscles slows down peristalsis, the wave-like muscle contractions that propel content through the intestines. This can lead to constipation, bloating, and gas.
Progesterone Withdrawal: In contrast, a sudden drop in progesterone levels, such as before the start of a menstrual period, can trigger a different set of events. This withdrawal can lead to increased gut motility and, combined with other factors, can result in diarrhea or loose stools.

How Hormonal Shifts Lead to Diarrhea

Diarrhea related to hormonal cycles is less about the direct effect of progesterone and more about the body's reaction to its decline. This is particularly relevant in the context of the menstrual cycle and perimenopause.

The Menstrual Cycle and Prostaglandins

For many, menstrual-related diarrhea, often referred to as "period poops," is a familiar experience. The mechanism is driven by chemical messengers called prostaglandins.

Hormone Drop: As the body prepares for menstruation, the unfertilized egg is not implanted, causing a rapid decline in progesterone and estrogen.
Prostaglandin Release: This hormonal drop triggers the release of prostaglandins, which cause the uterus to contract and shed its lining.
Cross-Contraction: These prostaglandins can affect the smooth muscles of the intestines as well, causing them to contract more forcefully and frequently than usual.
Resulting Diarrhea: The increased intestinal motility and sometimes higher fluid content in the intestines lead to diarrhea or loose stools.

Perimenopause and Menopause Fluctuations

During the transition to menopause, or perimenopause, a woman's hormone levels fluctuate unpredictably. Erratic levels of progesterone can lead to alternating periods of constipation and diarrhea as the body tries to adjust to these changes. Lower levels of progesterone and estrogen during menopause may also influence the gut microbiome and cause increased gut permeability, further contributing to digestive upset.

Forms of Progesterone and Their Impact

Progesterone can be administered in several forms, and the method of delivery can influence the severity of potential gastrointestinal side effects. Oral progesterone supplements, for instance, are metabolized by the liver, which can lead to more intense systemic effects compared to other forms.

Oral Progesterone: Pills or capsules often cause more noticeable side effects like abdominal pain, bloating, and diarrhea or constipation. Dosages can also influence the outcome, with some studies suggesting a dose-dependent effect on gut motility.
Topical or Vaginal Progesterone: Creams, suppositories, and vaginal inserts generally have fewer systemic side effects as they are absorbed locally. While local irritation is possible, the impact on general gut motility is typically less pronounced compared to oral intake.
Injections: Progesterone injections can cause localized reactions at the injection site but generally carry a lower risk of systemic digestive issues compared to oral capsules.

Managing Progesterone-Related Digestive Issues

For those who experience digestive upset linked to hormonal changes or progesterone supplementation, several strategies can provide relief:

Dietary Adjustments: Consider a food diary to identify any specific foods that worsen your symptoms, especially around periods of hormonal shifts. Increasing soluble fiber from sources like oats, beans, and apples can help regulate bowel movements.
Hydration: Stay well-hydrated, especially when experiencing diarrhea, to prevent dehydration.
Stress Management: Stress hormones can worsen gut issues. Practicing relaxation techniques, meditation, or light exercise can be beneficial.
Probiotics: Some women find that probiotics, which support a healthy gut microbiome, can help manage digestive symptoms linked to hormonal changes.
Consult Your Doctor: If symptoms are severe, persistent, or interfere with your daily life, it is important to discuss them with a healthcare provider. They can help determine if the progesterone dosage or form needs adjustment or if there is an underlying issue.

Comparison: Progesterone vs. Prostaglandin Effects

To better understand the hormonal influence on digestion, the following table compares the primary effects of high progesterone versus the prostaglandins triggered by its drop.


Feature	High Progesterone (Luteal Phase/Pregnancy)	Prostaglandins (Menstruation)
Effect on Smooth Muscle	Relaxes smooth muscle	Stimulates contractions
Impact on Gut Motility	Slows down peristalsis	Increases gut motility
Common Digestive Symptom	Constipation, bloating	Diarrhea, cramping
Hormonal Driver	High levels of progesterone	Drop in progesterone, release of prostaglandins

Conclusion

The question, can progesterone cause diarrhea?, requires a two-part answer. High levels of progesterone generally slow down intestinal motility, which can lead to constipation. However, it is the drop in progesterone and the subsequent release of prostaglandins, particularly before and during menstruation, that commonly triggers diarrhea. For some, especially those using oral supplements, the medication itself can list diarrhea as a side effect. Understanding these distinct hormonal mechanisms is key to recognizing and effectively managing digestive issues related to progesterone. If you have severe or persistent symptoms, a conversation with a healthcare professional is recommended to rule out other conditions and find the best course of action.

Frequently Asked Questions

The diarrhea you experience before your period is often caused by a drop in progesterone levels, which triggers the body to release prostaglandins. These compounds cause the uterus to contract but can also affect the intestines, leading to increased motility and diarrhea.

Typically, high levels of progesterone, such as during pregnancy or the luteal phase of the menstrual cycle, relax the smooth muscles of the digestive tract and slow down motility. This is more likely to cause constipation and bloating than diarrhea.

Yes, diarrhea is a known side effect of progesterone supplementation, especially with oral capsules. The mechanism can be complex, involving systemic effects influenced by dosage and individual sensitivity.

Hormonal diarrhea is cyclical and tied to specific, predictable hormone level changes, such as before and during a menstrual period. Other types of diarrhea are often caused by infections, food intolerance, or other illnesses.

Yes, the fluctuating levels of progesterone and estrogen during perimenopause can disrupt normal gut motility and microbiome balance, potentially leading to episodes of diarrhea.

To manage symptoms, focus on hydration, especially during a flare-up. Increasing your intake of soluble fiber and incorporating probiotics may also help. For persistent issues, consult your doctor about adjusting your medication.

Yes, hormonal changes, including those involving progesterone, can influence the composition and diversity of your gut microbiome, which in turn affects digestive function.

Diet plays a significant role. Consuming a balanced diet rich in fiber and staying hydrated are key to supporting gut health influenced by hormones. Avoiding trigger foods can also be beneficial.