Know the symptoms and know your body.

As women, we know a thing or two about bloating. Whether it’s that time of the month or not, women are far more likely to talk about feeling bloated or uncomfortable than men are, and it’s not just because we’re more in touch with our bodies.

What you might not know is that there are multiple reasons why we might experiencing a bloated belly, and the menstrual cycle is just one of them. Here are the main reasons that women can get bloated and how to tell the difference. Please note, this advice is not to replace the expert advice of your doctor, but hopefully this guide can help you go to your doctor informed about your symptoms and what they could mean.

Food Sensitivity, Intolerance, or Allergy

Bloating can be a primary symptom for Celiac disease or Irritable Bowel Disease (IBD). In both cases, the bloat you’re experiencing is often accompanied by intestinal cramping and pain. Sometimes it occurs in direct response to eating a food (within a few hours), while other times it might not appear till a day or two later. If you already have known food sensitivities or allergies, consider whether you might also have an unknown food issue that could be contributing to your bloated feelings, especially if you can tie it to a specific food category, like gluten or dairy. Work with your general practitioner or nutritionist to get to the bottom of your food issues.

Gut Health or Bacterial Imbalance

Sometimes it’s not an allergy, but a gut issue. Our microbiome lives in our intestines and is an entire universe worth of bacteria that helps to keep us healthy and alive. But mixed in with the good bacteria there are bad strains. Sometimes gut problems are caused by excessive amounts of bad bacteria that outnumber the good, but other times it’s because bacteria have migrated from the large intestine (where they should be) to the small intestine (where they don’t belong) and begin causing bloating and other issues in a condition known as SIBO, or small intestinal bacterial overgrowth. Bloating can be a huge problem with SIBO until the bacterial balance is fixed. Bloating from these issues would be more consistent and less directly tied to specific meals or times of the month.

Poor Digestion

If you don’t have enough stomach acid to break down your food, it will enter the small intestine partially digested and instead of efficiently continuing through the digestive process, it will sit there and start to ferment. This can be associated with SIBO, but it can be more directly tied to a need for digestive enzymes. Overuse of antacids can be related to this, as well as poor chewing habits, constantly eating in a rush and on the go, or eating a lot of processed and prepared foods. So if you think you are bloated for any digestive reasons, slow down when you eat, swap processed foods for more vegetables, fruits, and whole foods. See how your body responds after a few weeks of this change in your diet and eating habits.

PMS

While most women can identify when bloating is related to their cycle, in more extreme cases of PMS, bloating can last for almost two weeks leading up to a period. This can be due to irregular cycles, hormone imbalances, early symptoms of menopause, or side effects from medications like birth control or fertility treatments. Even if this is always how your cycle has been, bloating like this isn’t normal, and you might benefit from exploring digestive associations with hormones, like limiting or avoiding caffeine and alcohol, or junk foods, eating more fiber, or making sure you’re drinking enough water each day.

Ovarian Cancer

While no one likes the C-word, bloating without pain or other digestive associations is one of the primary symptoms of ovarian cancer, a type of cancer that is often not diagnosed until it’s in a later stage because of symptoms that overlap with so many other aspects of womanhood.

Ovarian cancer is most associated with symptoms like bloating, feeling full, having a low appetite, or running low on energy. Of course, this can describe many women, so don’t panic. But if you experience chronic bloating that isn’t associated with digestive or intestinal pain, it never hurts to speak with your OB-GYN to rule it out.

Endometriosis

Another gynecological condition that isn’t easily diagnosed, endometriosis may affect up to 10 percent of women, in many cases, without them knowing it. Because endo requires a somewhat invasive diagnostic process, practitioners often won’t investigate until it becomes a serious problem. Many times it is found during infertility treatments.

In endometriosis, tissue from the uterine lining grows where it shouldn’t, like the ovaries, bladder, intestines, and rectum. This can lead to bloating, discomfort, and pain depending on the severity of the endometrial growths. For some women it can be mild, while others will be in excruciating pain and will require surgical treatment.

When is Bloating More Than a Little Gas?

Knowledge is power, right? Of course, it can also open up a new can of worries. While you might feel more worried the next time your jeans feel a little tight, the best way to address bloating is to listen to your body. If it’s a new problem, it’s always best to run your concerns by your doctor. If it’s something that can be tied to a specific issue, like eating cheese or ice cream, work with a nutrition professional to make dietary adjustments. If that doesn’t help, explore further with your OBGYN. If you have a family history of ovarian cancer, endometriosis, or other gynecological conditions, keep your doctor in the loop about how you’re feeling, even if the updates as seemingly minor as the state of your bloated belly.