Healthy Woman: Bloat Got Your Goat?

N E W   Y O R K -- There's nothing like bloating to make you feel sluggish and uncomfortable. Who feels like working or going out when you're convinced you're lugging around extra water or gas?

Although many women have had days where the skirt they wore yesterday can't be zipped today, the precise cause of this feeling of fullness and tightness is sometimes unclear. That's because both gynecological and gastrointestinal troubles can lead to bloating, and sometimes it's due to a combination of these problems.

Hormonal Bloating

If bloating in a premenopausal woman follows a pattern, it's likely to be related to the menstrual cycle. During the last two weeks of the menstrual cycle, known as the luteal phase, women can retain water, which causes swelling in not only the abdomen but sometimes in the hands, feet and breasts.

The rising levels of hormones also have a direct effect on the gastointenstinal tract. "This hormonal effect causes the GI tract not to empty as quickly and to produce gas," explains Dr. Grace Janik, director of reproductive endocrinology at St. Mary's Hospital in Milwaukee.

Because stool and gas are moving more slowly through the intestines, women often have constipation and bloating in the two weeks before their periods. When women get their periods, their hormone levels drop and they sometimes get diarrhea.

Although it's less common, women can also have hormone-related bloating from changing or going on or off birth control pills or from the contraceptive Depo-Provera. Bloating due to these contraceptives, however, usually subsides after about three months.

Abdominal distension may be a sign of early pregnancy, particularly in women who aren't using birth control. And older women who are taking hormone therapy for menopausal symptoms such as hot flashes may also have discomfort from abdominal bloating.

Gynecologist Dr. Linda Bradley, director of hysteroscopic services at the Cleveland Clinic Foundation, says after she takes a medical history, she often suggests that younger women keep a diary of their symptoms to determine if the bloating is cyclical. If it appears to be related to the menstrual cycle, she may prescribe a mild diuretic or birth control pills.