No one knows the exact reason for IBS, but one thing experts are sure about is that gender does play a role. According to the International Foundation for Functional Gastrointestinal Disorders, 35 to 40 percent of people with IBS are male, compared to 60 to 65 percent female.
However, this could be because men and women handle the condition differently — “toughing it out” versus getting it checked out by seeking medical care. Regarding symptoms, women more often report abdominal pain and constipation-related symptoms, while men more commonly report diarrhoea-related symptoms.
It is still unclear whether these differences have to do with physiologic differences or simply differing medical care-seeking behaviours between men and women. Despite limited comprehensive data, sex hormones are believed to contribute to these gender differences, cultural factors, and gender roles.
It has been proposed that hormones may affect these sex differences in patients, the connotation between IBS symptoms, and the varying hormonal phases that women are subjected to, such as menstrual cycle phases, pregnancy, and menopause.
Both oestrogen and progesterone are known to obstruct ‘smooth muscle contraction.’ Smooth muscle cells line the walls of your stomach and intestines and contract automatically to help you digest your food. When high rates of oestrogen and progesterone interfere, it can slow down gut motility.
This is why women tend to suffer more from IBS-C than men do. Women also have expressed more persistent and intense IBS symptoms during menstruation, such as soft bowel movements, severe bloating, and increased abdominal pain during their menstrual cycle.
Stress and gender roles also may affect IBS symptoms in women more than similar situations for men. Stress has a more significant effect on decreasing upper GI motility and increasing lower GI motility in females versus males. In general, men have shorter colonic transit times than women. These differences can lead to more significant discomfort, bloating, or constipation in women versus men.
Additional research is needed to guide treatment strategies for women’s unique needs.