IBS symptoms in females

IBS symptoms in females are similar to those that males experience. However, some women report specific differences in the symptoms they experience. 

Women are 1.5-3 times more likely to have IBS than males and women seek IBS health services twice as often as males (1, 2). 

This post will discuss why IBS is more prevalent in females, risk factors and symptoms women may experience. 

Common IBS symptoms

You may be aware of the range of symptoms that are associated with IBS. The following symptoms are common for both males and females with IBS:

• Constipation 
• Diarrhoea
• Bloating
• Stomach pain
• Fatigue

Uncommon IBS symptoms in females

In addition to the common IBS symptoms mentioned above, there are also some uncommon IBS symptoms that females may experience. 

It is important to note that not all females will experience these uncommon IBS symptoms and you may not experience any at all. Everyone is unique and will experience different symptoms.

Please note that these are all uncommon symptoms and if you are experiencing them, you should still see your doctor.

Chronic pelvic pain

In one study, 40% of women who reported having chronic pelvic pain, also reported having IBS (3). This is around 4 times the normal rate of IBS, suggesting a link. 

Pelvic organ prolapse

Pelvic organ prolapse is when one or more of either the vaginal walls, the uterus or top of the vagina slips down from their regular position. There is no cause for concern if a prolapse occurs, but you could be in pain or discomfort (4). 

Pelvic organ prolapse is caused by many reasons; however, chronic constipation is often a common culprit. Continued constipation increases the pressure inside the abdominal wall (5).

Worse premenstrual syndrome (PMS)

Premenstrual syndrome is a series of symptoms caused by hormone changes before a period, which usually disappear within a few days.

Different stages of the menstrual cycle have been associated with worsening IBS symptoms due to fluctuations in hormones (6).

IBS may not cause worse premenstrual symptoms rather, it’s the premenstrual symptoms that exacerbates the IBS symptoms at this time of the month (7).

You can read more about why IBS is worse during your period here.

Back pain

One study has shown that women with gastrointestinal issues such as bloating and abdominal pain may be linked to back pain (8). However, this research is limited and the cause of back pain is unknown. 

Back pain can be caused by numerous different problems and not necessarily IBS-specific.

Causes of IBS in women

The cause of IBS is still unknown, but there are some factors that appear to be linked with the onset;

• Gender – Women are 1.5-3 times more likely to have IBS than males (2). 
• Age – Individuals under 50 years old are more likely to get IBS than those over 50 (2). 
• Poor mental health – IBS has been linked to higher rates of generalised anxiety disorders, depression and stress (9). Click here to read more about how stress affects IBS. 
• Family history – Genes may play a role, as the relatives of someone with IBS are 2-3 times more likely to have IBS themselves (10).

How to get IBS symptoms in females diagnosed

Getting an IBS diagnosis does not differ between males and females.

Receiving an accurate IBS diagnosis is essential to be able to rule out other gut conditions such as inflammatory bowel disease, coeliac disease or bowel cancer. Click here to see how to get an accurate IBS diagnosis. 

Are women’s digestive systems different to mens?

Yes! Women’s digestive systems are different to men. 

Did you know that the female digestive system is actually longer than males? This can contribute to gastric emptying and colonic transit times being slower in females than males (11, 12). 

How do women’s hormones impact IBS symptoms?

The two female hormones oestrogen and progesterone play a role in IBS and the menstrual cycle. 

Surprisingly, receptors for these hormones are found in the gastrointestinal tract (13). When your hormones change over the course of your menstrual cycle, gastrointestinal function can change (7, 14). 

Periods and IBS

For many women who have IBS, their symptoms may be worse during menstruation.

Click here to see why your IBS can be worse during menstruation.

Here are some things you can try to help manage your IBS symptoms during your period: 

• Know your IBS trigger foods – If your gut is more sensitive during your period, it may be worth avoiding high FODMAP foods to minimise symptoms. Working with a Registered Dietitian can help you to identify these trigger foods.
• Heat packs or hot water bottles – These may provide relief to both menstrual pain and IBS symptoms to relax the gastrointestinal system. 
• Get adequate calcium – One study found that higher calcium intakes were associated with lower premenstrual symptoms and fewer IBS symptoms (15). 
• Light exercise – Energy levels change throughout the menstrual cycle but it is important to still include some light exercise into your daily routine. Click here to see how exercise benefits gut health. 
• Adequate sleep
• Stay hydrated – click here to find out the best teas for IBS. 

Is there a link between heavier periods and IBS?

Research into whether IBS causes heavy periods is non-existent or very outdated (16). 

Other known causes of heavy periods include stress, genetics, endometriosis and certain medications (17). Therefore, exploring other reasons for your heavy periods is important. 

The link between endometriosis and IBS

Endometriosis affects 1 in 10 women and is often misdiagnosed as IBS due to the similarity in symptoms (18). 

Many of those with IBS are also found to have an endometriosis diagnosis. This can be due to endometriosis being present on the bowel, contributing to IBS symptoms. However, further research is needed on the link between both (19). 

Read more about endometriosis and the low FODMAP diet. 

Pregnancy and IBS

During pregnancy, some women may find their IBS symptoms change. Sometimes symptoms worsen and sometimes they improve.

Pregnancy causes a number of hormonal and physical changes to a woman’s body that have a knock on impact to the gut. Each trimester of pregnancy will likely have a different impact as the baby grows.

Read this post for more about IBS and pregnancy.

IBS symptoms in women causing weight gain

However, IBS and weight gain are not linked (20). 

You may be less active due to IBS symptoms or find that typical ‘healthy’ foods cause your symptoms to worsen. These are normal and valid concerns for someone with IBS. 

Your hormones play a small role. Five hormones that are related to controlling appetite were found to be abnormal in those with IBS (21). Read this blog post to find out more about losing weight and IBS, and these appetite controlling hormones.

Summary

IBS is more commonly diagnosed in females than in males. However, the symptoms, treatment and diagnosis of IBS is similar.

For females, sex hormones; oestrogen and progesterone play a role in the severity of certain symptoms. As female hormones naturally fluctuate throughout the month, so can IBS symptoms. Pregnancy can also affect IBS. 

Other female only conditions such as endometriosis can contribute towards IBS symptoms, so it is important to seek medical help and to receive an accurate diagnosis.

 Written by Camilla Donaldson BSc Hons Nutrition reviewed by Serena Bansal Registered Dietitian BSc Hons