Do Your Hormones Affect IBS?

During menopause, your hormone levels change, IBS symptoms can worsen and perimenopause can trigger the onset of IBS.


No one knows the exact reason for irritable bowel syndrome (IBS), a digestive disorder that is more common in women, affecting us from 1.5 to 3 times more than men.

It causes stomach pain, cramps, and bloating, as well as diarrhoea and constipation.

Sex hormones and IBS

Both ostrogen and progesterone affect IBS symptoms in a few ways, from how your intestines work to how much pain you feel.

A growing body of research shows that sex hormones, like oestrogen and progesterone, may be the reason. They can trigger IBS symptoms, which may explain why you have more flare-ups at different points of your menstrual cycle and during menopause hormonal fluctuations.

Cells in your gut have receptors that let these hormones latch on to them. This suggests that your digestive system is designed to sense and react to them.

Here are the main ways they affect IBS:

Digestion: They control the smooth muscle in your intestines, which dictates how quickly food travels through your system.

A woman’s overall gastrointestinal tract moves slower than that of a man and it is contractions of the muscles in the intestinal system that help move food along.

If those contractions are too slow, the person likely has the constipation-dominant variety of IBS, whereas faster contractions lead to the diarrhoea-dominant type.

The stress hormone cortisol is also thought to have some influence on IBS and other GI disorders and often high levels of it accompany constipation. Spikes in cortisol levels often are known to slow blood flow to digestive organs, causing stomach cramping.

Pain level: These hormones affect how much stomach cramps bother you. A dip lowers your pain threshold, in part because oestrogen boosts the production of serotonin, a feel-good chemical in your brain.

A jump in oestrogen can reduce it some so your stomach pain or cramps don’t hurt as much.

Inflammation: Sex hormones can raise levels of inflammation throughout your body. That makes your IBS symptoms worse but bioidentical progesterone also has the function of helping reduce inflammation in the body.

Peri/Menopause and IBS

IBS worsens as hormone levels fall at the start of this cycle of life. But it’s unclear how this affects IBS as in some women it improves after menopause, when these hormonal changes stop.

On the other hand, more than a third of menopausal women in one recent study reported IBS-type symptoms, like wind and heartburn.

 Symptoms of IBS

IBS is diagnosed by recurrent abdominal pain for at least 6 months, combined with weekly pain for 3 months as well as some combination of pain relieved by bowel movements and changes in frequency or form of bowel movements.

Your doctor may refer you to a gastroenterologist, a specialist in digestive diseases, who can help you identify triggers and discuss ways to control your symptoms.

If you are not sure these are the most common symptoms:

1. Pain and cramping The most common symptom of IBS is lower abdominal pain that is less severe after a bowel movement. Dietary modifications, stress-reducing therapies and certain medications can help reduce pain.

2. Diarrhoea This is one of the three main types of the disorder. It affects roughly one-third of patients with IBS. Frequent, loose stools are common and are a symptom of the diarrhoea-predominant type. Stools may also contain mucus.

3. Constipation Although it seems counterintuitive, IBS can cause constipation as well as diarrhoea and is the most common type, affecting nearly 50% of people with IBS.

Constipation is very common. However, abdominal pain that improves after a bowel movement and a sensation of incomplete bowel movements after passing stool are signs of IBS.

4. Alternating constipation and diarrhoea Mixed or alternating constipation and diarrhea affects about 20% of patients with IBS. Throughout each phase, they continue to experience pain relieved by bowel movements.

5. Changes in bowel movements Slow-moving stool in the intestine often becomes dehydrated as the intestine absorbs water.

IBS changes the time stool remains in your intestines and this changes the amount of water in stool, giving it a range from loose and watery to hard and dry.

6. Gas and bloating Altered digestion in IBS leads to more gas production in the gut. This can cause bloating, which is uncomfortable.

In a study of 337 IBS patients, 83% reported bloating and cramping. Both symptoms were more common in women and in constipation-predominant IBS or mixed types of IBS

Following a low-FODMAPs diet can help reduce bloating. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols, which are short chain carbohydrates and sugar alcohols that are poorly absorbed by the body, resulting in abdominal pain and bloating.

Studies have shown that up to 86% of people with IBS had improved symptoms after following the diet.

But a diet low in FODMAPs is not easy to follow. It’s very restrictive, especially at the start when you cut out all foods high in FODMAPs. After eliminating these foods, the goal is to slowly reintroduce them one at a time.

Best done under the guidance of your doctor, Nutritionist, or dietician but as a guide these are what to avoid:

Fructose – fruit, honey, high-fructose corn syrup, agave
Lactose – dairy
Fructans – wheat, onions, garlic
Galactans – legumes, such as beans, lentils, and soybeans
Polyols – sugar alcohols and fruit that have pits or seeds, such as apples, avocados, cherries, figs, peaches, or plums

7. Food Intolerance Up to 70% of individuals with IBS report that particular foods trigger symptoms but why these foods trigger symptoms is unclear. These food intolerances are not allergies, and trigger foods don’t cause measurable differences in digestion.

While trigger foods are different for everyone, some common ones include gas-producing foods, such as FODMAPs as well as lactose, gluten and stimulants such as caffeine.

8. Fatigue and difficulty sleeping Over half of people with IBS report fatigue and IBS is also related to insomnia. Interestingly, poor sleep predicts more severe gastrointestinal symptoms the following day.

9. Anxiety and depression IBS is linked to anxiety and depression, as well but it’s unclear whether IBS symptoms are an expression of mental stress or whether the stress of living with IBS makes us more prone to psychological difficulties.

Other experts say the line of connection between the gut and brain may be more sensitive in some women and we are also more affected psychologically by GI symptoms, according to doctors at Weill Cornell Medicine.

Women also report more depression and anxiety and a decreased quality of life. Whichever comes first, anxiety and digestive IBS symptoms reinforce one another in a vicious cycle.

Dealing with anxiety and stress was found in a study to reduce IBS symptoms.

How to help yourself

Clearly hormone balance is an important factor and stress, poor sleep and changes in gut bacteria may all trigger symptoms.

Lifestyle changes, such as a low-FODMAPs diet, stress relief, exercise and drinking plenty of water can also help. Additionally, avoiding digestive stimulants such as caffeine, alcohol and sugary beverages can reduce symptoms in some people

If your symptoms don’t respond to lifestyle changes or over-the-counter treatments, there are several medications proven to help in difficult cases.

What is very clear is how important a healthy gut is to your overall well-being. If you want to know more about that connection, this article will help.