A GI tract is show with aggravated bursts of color around a tube of lipstick, a pair of reading glasses, and a pregnancy test.

Can Hormones Trigger IBS Symptoms?

Reviewed by: HU Medical Review Board | Last reviewed December 2022 | Last updated: January 2023

Many things can trigger irritable bowel syndrome (IBS) symptoms, including hormones. Recent evidence shows that hormones – particularly estrogen and progesterone – may trigger IBS symptoms or make IBS symptoms worse.1-3

Hormones and women

IBS is 2 times more common in women than in men.3 The reason women have IBS more than men may come down to hormonal changes in women throughout their lives.1,2

The sex hormones estrogen and progesterone – which are responsible for reproduction – may affect a woman’s gastrointestinal (GI) function during the following:1-3

  • Menstruation, or menstrual cycle
  • Pregnancy
  • Before menopause
  • After menopause
  • Hormone replacement therapy

This change in GI function can lead to IBS symptoms such as:1-3

The decline in ovarian hormones during pre- and post-menopause may cause or worsen IBS symptoms as well. A 2021 study found that post-menopausal women who were on hormone replacement therapy had an increased risk of IBS compared with women who were not on such therapy.1,3

IBS and the menstrual cycle

As noted above, IBS is linked to a woman’s menstrual cycle, or period. People with existing IBS may also notice that their period makes IBS symptoms worse.1,2

During the menstrual cycle, estrogen levels rise and fall twice. These hormonal changes make the gut more sensitive. This is known as gut sensitivity.3,4

Hormonal changes due to menstruation may also affect the speed at which food moves through the digestive tract. This can lead to:1,2

  • Stomach pain and/or discomfort
  • Changes in bowel habits (constipation or diarrhea)
  • Bloating

According to a 2019 study, IBS symptoms – including bloating, diarrhea, and stomach cramping – worsened during the days leading up to and during a woman’s period.1,2

The overlap of IBS and PMS

Premenstrual syndrome (PMS) affects 20 to 48 percent of women in their reproductive years. PMS occurs about a week before a woman’s period and continues until about 2 to 4 days after the menstrual cycle has ended.1,2

PMS symptoms include:1,2

  • Stomach cramping
  • Fatigue
  • Mood changes
  • Irritability

Research shows that women who have stomach cramping during their periods are more likely to have IBS symptoms as well.2

The link between diet and hormones

Inside the gut, there are cells called endocrine cells that produce at least 14 different gut hormones. These gut hormones are very important to the overall digestive system. They aid in the digestion, absorption, and movement of waste through the GI tract.5

It turns out that people with IBS have a low amount of these gut endocrine cells. Our diets and the foods we eat can help restore these gut endocrine cells, bringing balance back to the gut environment.5

One specific diet that has been shown to improve IBS symptoms and restore balance to the gut is the low-FODMAP diet. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are different types of sugars found in certain foods that the small intestine has trouble digesting.6

The low-FODMAP diet is an elimination diet that you follow for a set amount of time. It is very restrictive in the foods you can eat. If you are curious about the low-FODMAP diet, work with a dietitian to ensure you are getting the right amount of nutrients in your diet.6

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