Can Hormones Trigger IBS Symptoms?
Sex hormones affect the motor and sensory function of the gastrointestinal tract. Sex hormones, in particular, estrogen, may play a role in triggering IBS symptoms based on the female predominance in IBS.
The prevalence of IBS in women is at least two times as much as in men. IBS occurs mostly in women in their late teens to mid-40s. In contrast, the prevalence of IBS in men is typically constant within the age range of 20 to 70 years.1
Estrogen has been shown to change the contraction of muscles throughout the gastrointestinal tract. Hormones may have an impact on the nervous system, which may change the way the brain responds to pain felt in the abdomen. Women with IBS typically report constipation, bloating, severe abdominal pain, and feelings of incomplete evacuation.1
One study showed a correlation between estrogen and abdominal pain severity in IBS. Estrogen is associated with increased abdominal pain in people with IBS compared with healthy people. Specifically, people with diarrhea-predominant IBS (IBS-D) had more abdominal pain than people with constipation-predominant IBS (IBS-C).2
Sex hormones may affect a women’s gastrointestinal function during the following situations:1
- Hormone replacement therapy
Menstruation, pre-menopausal, and post-menopausal
Hormonal fluctuations during the menstrual cycle can modulate gastrointestinal contractions and movement through the tract. Symptoms of abdominal pain or discomfort, changes in bowel habits and bloating may change during the menstrual cycle. Low levels of ovarian hormones in women may lead to or exacerbate IBS symptoms. Similarly, the decline in ovarian hormones during pre-menopause and post-menopause may cause or worsen symptoms.1
Changes in hormone levels during pregnancy may lead to constipation, which is one of the most common complaints of pregnant women.1
Hormone Replacement Therapy
There is an increase in prevalence of IBS among women taking hormone replacement therapy. Hormone replacement therapy may induce changes in gastrointestinal function. In fact, IBS symptoms may continue for a longer period of time for women taking hormone replacement therapy. 1