Digestive Health Irritable Bowel Syndrome Symptoms IBS Symptoms in Women: What to Know Women often present different IBS signs and symptoms from men By Brittany Poulson, MDA, RDN, CD, CDCES Updated on January 20, 2024 Medically reviewed by Robert Burakoff, MD Print Table of Contents View All Table of Contents Why More Common in Women? Symptoms Subtype Symptoms During Periods Effect on Sexual Function In Pregnancy Treatment Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) condition that can cause abdominal pain as well as changes in bowel habits. Signs and symptoms of IBS can vary in women versus men. Women are up to two times more likely than men to develop IBS. Experts have long known that IBS manifests differently in women. Symptoms can range from mild to disabling. This article covers everything women with IBS need to know. bernie_photo / Getty Images A Note on Gender and Sex Terminology Verywell Health acknowledges that sex and gender are related concepts, but they are not the same: Sex refers to biology—chromosomal makeup, hormones, and anatomy. People are most often assigned male or female at birth based on their external anatomy; some people do not fit into that sex binary and are intersex. Gender describes a person's internal sense of self as a woman, man, nonbinary person, or another gender, and the associated social and cultural ideas about roles, behaviors, expressions, and characteristics. Research studies sometimes don't use the terminology in this way. For example, terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate. To reflect our sources accurately, this article uses terms like "female," "male," "woman," and "man" as the sources use them. Why Is IBS More Common in Women? Experts aren’t exactly sure why IBS is more common in women than men. However, researchers think that hormones may play a role, particularly hormonal variations during the menstrual cycle. A 2020 study compared symptoms in IBS patients, including men and postmenopausal women 45 years or older, as well as men and premenopausal women under the age of 45. The researchers found that postmenopausal women with IBS had more severe IBS symptoms than premenopausal women, while men had no comparable age-related changes in symptoms. The study concluded that this had to do with the way sex hormones in females regulate the brain-gut connection, which affects both GI function as well as how symptoms are felt. A 2014 review of studies also suggests that sex hormones influence the brain-gut connection involved in the pathophysiology of IBS. The researchers concluded that these hormones and the brain-gut axis contribute to the alterations seen in IBS, including visceral sensitivity (the threshold for pain in the internal organs), motility (movement of digestive muscles), intestinal barrier function (the tissues that allow nutrient absorption and protect the intestines from outside influences), and immune activation of the intestinal mucosa (lining of the intestines). Although experts are still trying to figure out exactly how, it is clear that hormones influence IBS. How Do IBS Symptoms Differ in Women From Men? People of all sexes can experience IBS, though some symptoms may be more common in or exclusive to women. Common IBS symptoms in people of all sexes include: Pain in the abdomen Abdominal bloating Diarrhea Constipation Gas A feeling of incomplete bowel movements Whitish mucus in the stool A 2021 study found that IBS symptoms in women may vary depending on their menstrual cycle. When looking at over 100 women with IBS, patients experienced more severe symptoms during their period compared to other stages of their cycles. In addition to symptoms being worse during their periods, women with IBS are more likely to experience other symptoms more frequently, including: Fatigue Backache Insomnia Food sensitivities Painful menstruation Abdominal cramping Premenstrual syndrome (PMS) Depression Anxiety You Can’t Cure IBS Permanently, But You Can Learn to Enjoy Life Again Which IBS Subtype Do Women Tend to Experience? Among the different IBS subtypes, IBS with constipation (IBS-C) is significantly more common in women than men. Women with IBS also tend to experience more symptoms related to constipation, including abdominal pain, discomfort, and bloating. Why Do Women Experience More IBS Symptoms During Their Periods? Research suggests that women with IBS experienced more severe symptoms during their period compared to other stages of their cycles. Hormonal fluctuations throughout the menstrual cycle can increase symptom severity, particularly during menstruation. Worsening symptoms in women with IBS may include PMS, cramping during menses, and heavier and more painful periods. Endometriosis and IBS Research suggests that endometriosis (a condition in which tissue similar to the lining of the uterus grows outside the uterus and includes symptoms of chronic pelvic pain) may overlap with IBS.Several studies have shown that women with endometriosis have more GI-related symptoms consistent with a diagnosis of IBS. Because they share some common symptoms, distinguishing between the two conditions is important to get accurate diagnoses and treatment plans. Does IBS Affect a Woman’s Sexual Functioning? Concerns related to sexual functioning are reported in around 32% of women with IBS. Sexual dysfunction in women with IBS most commonly includes decreased sexual drive but can include other symptoms, such as painful intercourse. One reason may be visceral (relating to internal organs) hypersensitivity. This heightened sensitivity to pain in IBS may be specific to some organs, including the vagina, compared with an overall increase in pain sensitivity. How Does Pregnancy Affect IBS Symptoms? There is not a lot of research on IBS during pregnancy. However, surveys of pregnant people indicate that there is an increase in GI-related symptoms during pregnancy, ranging from heartburn and nausea to increased stool frequency and/or constipation. In addition, people with IBS may experience an increase in anxiety and depression during pregnancy. Changes in hormone levels, increased pressure on the GI tract from the growing fetus, and increased stress may all play a role in the worsening of IBS symptoms during pregnancy. More research is needed in this area to more fully understand how pregnancy affects IBS. Does IBS Treatment Differ for Women? The overall approach for IBS treatment is the same for people of all sexes. Treatment will vary depending on the individual's specific symptoms and may include: Medication Diet modifications Increased physical activity Dietary supplements Stress management Mental health treatment Prioritizing sleep There are several pharmacotherapy studies that have suggested that women may respond better to some medications for IBS compared to men, and some medications for IBS are only approved for use in women. However, many studies on people with IBS include a majority of women, so more research is needed on men with IBS to verify these conclusions. Summary IBS is a condition that affects the GI tract and leads to symptoms such as abdominal pain and changes in bowel habits. Women are more likely to develop IBS than men. Women with IBS may also experience additional or more severe symptoms than men with IBS, including fatigue, insomnia, backache, food sensitivities, PMS, cramping, and depression and anxiety. Symptoms or symptom severity may increase during menstruation and pregnancy. IBS-C is more common in women than men. IBS can also affect sexual function, leading to symptoms such as decreased sexual drive and painful intercourse. The overall treatment approach for IBS is similar in people of all sexes, though some medications may be more effective in women compared to men. Treatment for IBS should always be individualized to the person, regardless of sex. 10 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute of Diabetes and Digestive and Kidney Diseases. Definition & facts for irritable bowel syndrome. Lenhart A, Naliboff B, Shih W, et al. Postmenopausal women with irritable bowel syndrome (IBS) have more severe symptoms than premenopausal women with IBS. Neurogastroenterol Motil. 2020;32(10):e13913. doi:10.1111/nmo.13913 Mulak A, Taché Y, Larauche M. Sex hormones in the modulation of irritable bowel syndrome. World J Gastroenterol. 2014;20(10):2433-2448. doi:10.3748/wjg.v20.i10.2433 National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of irritable bowel syndrome. Pati GK, Kar C, Narayan J, et al. Irritable bowel syndrome and the menstrual cycle. Cureus. 2021;13(1):e12692. doi:10.7759/cureus.12692 International Foundation for Gastrointestinal Disorders. IBS in women. Kim YS, Kim N. Sex-gender differences in irritable bowel syndrome. J Neurogastroenterol Motil. 2018;24(4):544-558. doi:10.5056/jnm18082 Ayadilord M, Mahmoudzadeh S, Hoseini ZS, et al. Neuropsychological function is related to irritable bowel syndrome in women with premenstrual syndrome and dysmenorrhea. Arch Gynecol Obstet. 2020;302(4):915-923. doi:10.1007/s00404-020-05659-3 Nabi MY, Nauhria S, Reel M, et al. Endometriosis and irritable bowel syndrome: A systematic review and meta-analyses. Frontiers in Medicine. 2022;9. doi:10.3389/fmed.2022.914356 International Foundation for Gastrointestinal Disorders. Medications for IBS. By Brittany Poulson, MDA, RDN, CD, CDCES Brittany Poulson, MDA, RDN, CDCES, is a registered dietitian and certified diabetes care and education specialist. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit