IBS In Women

Irritable bowel syndrome (IBS) can affect people of all different ages and backgrounds. However, women in the United States are twice as likely as men to be diagnosed.1-4

There are many theories about why this difference exists. Some of these are related to hormones, stress levels, and sensitivity of the gut.1-4

Diagnosing IBS in women

IBS is diagnosed based on the type of symptoms present, how often they occur, and for how long. The same criteria apply to both women and men. Common symptoms include:1

  • Abdominal pain
  • Pain with bowel movements
  • Changes in the frequency or consistency of stool

It can be difficult to talk about IBS symptoms with doctors. Discussing bowel movements, abdominal pain, and gas can be sensitive or embarrassing. Because of this, people with IBS may not talk openly about their symptoms. This can lead to delays in diagnosis or being diagnosed with the wrong condition.2

However, some experts have suggested women in the United States might be more likely to see a doctor and talk about these issues than men. This may be a reason why women are diagnosed more often.2

IBS symptoms can also be different in women. Women are more likely to have:2-4

  • Constipation
  • Fatigue
  • Mental health issues like anxiety or depression

All of these factors may lead women to seek care sooner or receive a diagnosis of IBS earlier.2-4

Types of IBS in women

The same 4 types of IBS exist for both men and women:1

  • IBS with constipation (IBS-C)
  • IBS with diarrhea (IBS-D)
  • IBS with mixed bowel habits (IBS-M)
  • IBS unspecified type (IBS-U)

Overall, IBS-C seems to be more common in women. Men are more likely to have IBS-D.1,2

The relationship between women and IBS

Women tend to be more willing to talk about sensitive symptoms than men. They may also be more willing to go to the doctor. Both of these reasons can play a role in the differences in diagnosing men and women. However, there are other theories as well, including those relating to sex hormones.2

Female sex hormones like estrogen may affect gut movement and sensitivity. Some women have reported that IBS symptoms tend to fluctuate with their menstrual cycle. IBS may be more common in those with painful periods or endometriosis. In contrast, male sex hormones such as testosterone may protect against pain sensitivity in the gut.2,3,5

IBS is commonly diagnosed during early to mid-adulthood. This is when sex hormones are at their peak for women. The differences in IBS diagnoses between men and women tend to become more equal later in life. This may be related to decreases in sex hormones and their impact on the gut.2

Stress may also play a role in IBS, inflammation, and gut sensitivity. Women are more likely to report increasing levels of stress. They are also more likely to feel physical symptoms of stress, such as:2,6

  • Fatigue
  • Headache
  • Anxiety
  • Upset stomach

Other stress-related conditions like fibromyalgia or chronic pelvic pain are also more common among women who have IBS.2,5,6

In recent years, experts have been looking at the role of genetics in IBS. A 2018 study found a specific gene that seemed to be impacted among many women with IBS. The same gene also played a role in sex hormone production and age of first menstrual cycle.7

More studies like these may help determine the role genetics have in why women are more likely than men to have IBS. They may also help link other risk factors together, like sex hormone production.7

Treating IBS in women

Treating IBS is similar across all groups. These include:1,3,4

We know more about how certain IBS drugs impact women, as more women participate in clinical trials than men. Some studies have even shown that certain drugs may be more effective at treating IBS in women than in men.1,3,4

However, much more research is needed to determine the true differences in effects.

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Written by: Casey Hribar | Last reviewed: September 2021