Constipation in Women: Why It Happens and What Actually Works

By Tina Chagoury, Clinical Dietitian · 6 min read · 2026-09-27

Constipation is common in women and often accepted for years. Here is why it happens, why it matters for your hormones, what actually relieves it, and when to see a doctor.

Constipation is something women rarely mention unless I ask directly. Then the details come out: every two or three days, straining, hard stools, the feeling that something is still there afterwards. Often for years. Often accepted as simply the way their body works.

It is common, and it is worth fixing. A bowel that empties properly is part of how your body clears used hormones as well as waste, so this is a hormonal question too.

What counts as constipation

There is no single normal number. Anywhere from three times a day to three times a week can be within the usual range. How it feels matters more than the count. You may be constipated if:

• You go fewer than three times a week
• Stools are hard, dry or in small pellets
• You strain, or need a long time on the toilet
• You feel you have not emptied completely
• You regularly need something to make it happen

Many women go daily and are still constipated, because the emptying is incomplete.

Why women are more prone to it

Progesterone. In the second half of the cycle, progesterone slows gut motility. Constipation in the week before a period, and during pregnancy, is a direct hormonal effect.

The pelvic floor. Pregnancy, childbirth and age can change how the pelvic floor muscles coordinate. Some women strain because these muscles tighten when they should relax. This is treatable, and a pelvic floor physiotherapist can help.

Undereating and dieting. Less food means less bulk. Very low carbohydrate diets often cut fibre along with the carbohydrate.

Holding it in. Busy mornings, school runs, unfamiliar bathrooms, travel. Ignoring the urge again and again teaches the bowel to stop sending it.

The hormone link most women never hear about

Once your body has finished with oestrogen, the liver packages it and sends it into the gut to be eliminated. When stool sits in the bowel for longer, more of that oestrogen can be reactivated and reabsorbed into circulation. This is why chronic constipation is a hormonal issue as well as a digestive one, and why I always ask about bowel habits when hormones are part of the conversation. I explain the whole loop in your gut and your hormones.

Other causes worth checking

An underactive thyroid. Thyroid hormone sets the pace of many systems, including the gut. New constipation together with tiredness, feeling cold, dry skin or hair loss is worth a thyroid test, and a full thyroid panel tells you more than TSH alone.

Iron supplements. Iron is one of the most common causes. If your bowels slowed after you started iron, tell your doctor. The form, the dose and how often you take it can often be adjusted, so you keep treating the deficiency without the side effect.

Other medicines. Some painkillers, antacids containing aluminium or calcium, certain antidepressants and some blood pressure medicines can slow the bowel. Never stop a prescribed medicine on your own. Ask the doctor who prescribed it.

Not enough fluid. In a hot climate you lose more water than you think, and when you are short of it, the bowel takes water back from the stool.

Stress. The gut has its own nervous system and it is in constant conversation with the brain. Chronic stress slows some women down and speeds others up.

What actually helps

Fibre, increased slowly

Most women eat far less fibre than they need. Get it from a variety of plants: vegetables, lentils and chickpeas, oats, chia and ground flaxseed, fruit eaten with its skin. Kiwi and prunes are two foods many women find particularly helpful.

Increase fibre gradually over two or three weeks. A sudden jump causes gas and bloating, which is why so many women give up on fibre too early. I explain why fibre may matter even more than protein.

Fluid, alongside the fibre

Fibre works by holding water in the stool. More fibre without more water can make constipation worse. Drink steadily through the day, and more in the heat or when you exercise.

Magnesium

Some forms of magnesium draw water into the bowel. Magnesium citrate has a mild laxative effect, and magnesium oxide acts mainly as a laxative. Glycinate is gentle on the bowel and less useful for this purpose. I explain the forms in magnesium for women. Check with your doctor first if you have kidney disease or take regular medication.

Movement

Walking stimulates the bowel directly. A daily walk, particularly after meals, is one of the simplest and most effective things you can do.

A routine your bowel can learn

The gut is most active after waking and after eating. Give yourself unhurried time after breakfast, and go when you feel the urge instead of postponing it.

Your position on the toilet

Rest your feet on a small stool so your knees sit higher than your hips, lean forward slightly and relax your belly. This straightens the angle of the rectum and makes emptying easier.

Severe constipation in adults

Laxatives have a place, and a short course can be very helpful. If you find you need them regularly, involve your doctor, so the cause is found and the right type is chosen. Detox teas are usually stimulant laxatives in disguise and are best avoided.

If you have not opened your bowels for several days and have severe pain, a swollen abdomen, vomiting, or cannot pass wind, that is urgent. Seek medical care the same day.

Red flags: see a doctor

Please see a doctor if constipation comes with any of these:

• Blood in your stool, or black stool
• Weight loss you cannot explain
• A new and persistent change in your bowel habit, especially if you are over 45
• New constipation that alternates with diarrhoea
• Severe or persistent abdominal pain
• Anaemia
• A family history of bowel cancer or inflammatory bowel disease
• No improvement after several weeks of getting the basics right

Most constipation responds to the basics. The point of the list is to make sure nothing more serious is missed.

This article is nutrition education, not medical advice. A sudden or persistent change in bowel habit should always be assessed by a doctor.

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About the author. Tina Chagoury is a licensed clinical dietitian specialising in women's hormonal health, inflammation and gut health, and the creator of the Hormone Reset Method™. Learn more about the Hormone Reset Method.

Frequently asked questions

What is the fastest way to relieve constipation?

A warm drink, a walk, and unhurried time on the toilet with your feet raised often help within the day. Fibre, water and magnesium work over days. If you need laxatives often, speak to your doctor.

Why am I constipated before my period?

Progesterone rises after ovulation and slows gut motility. Things usually start moving again once your period begins.

Can iron tablets cause constipation?

Yes, it is one of their most common side effects. Ask your doctor about adjusting the form, dose or timing instead of stopping them on your own.

Does constipation affect hormones?

It can. The gut is one of the main exit routes for used oestrogen, and when stool moves slowly, more of it can be reabsorbed.

Is blood in the stool always serious?

It is often caused by haemorrhoids or a small tear from straining, but it always needs checking by a doctor, especially if it is new, dark, or comes with weight loss or a change in bowel habit.

Related reading

• Why Am I Bloated? The Real Causes and What Actually Helps
• Iron Deficiency That Never Improves Is Telling You Something
• IBS in Women: Why Your Gut Flares With Your Cycle and Your Stress