Gender differences in gastrointestinal, psychological, and somatic symptoms in irritable bowel syndrome
Open accessAbstract
In the United States, more women than men seek health-care services for symptoms of irritable bowel syndrome (IBS). A number of explanations are given for this gender difference including the higher rates of somatic non-gastrointestinal symptoms and increased psychological distress reported by women with IBS. However, these gender differences are found in studies that rely on retrospective recall with little attention to age or reproductive status. The purpose of the current analysis was to prospectively compare the frequency (days/month of moderate to severe based on a daily diary) of somatic, gastrointestinal (GI), and psychological distress symptoms, in menstruating women (N = 89) and postmenopausal women (N = 66) to men (N = 32) with IBS. In addition, the correlation between daily symptoms and daily report of overall health was evaluated. Postmenopausal women reported significantly more GI pain/discomfort symptoms, especially bloating and abdominal distension, than men, however these differences are greatly attenuated when age is controlled for. Both postmenopausal and menstruating women reported significantly more somatic symptoms (especially joint pain and muscle pain) than men with IBS. The effect was stronger in postmenopausal women, whose somatic symptoms were also higher than menstruating women (P = 0.014). Fatigue and stress were higher in women than men but anxiety and depression were not. All three types of symptoms were strongly correlated with self-rating of health, both across and within-person. Gender-related differences in GI and somatic symptoms are apparent in persons with IBS, more strongly in postmenopausal women. The presence of somatic symptoms in postmenopausal women with IBS may challenge clinicians to find suitable therapeutic options.
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Differences in irritable bowel syndrome symptom severity between men and women are reported, with women having increased constipation compared to men, likely due to higher levels of progesterone and oestradiol.
“Differences in IBS symptom severity between men and women is also reported, with women having increased constipation compared to men, likely due to higher levels of progesterone and oestradiol.(44, 45)”
From Association Between Sex Hormone Levels and Gut Microbiota Composition and Diversity—A Systematic Review (2022) · cites this paper as [44]
Flores et al. demonstrated a relatively weak correlation between faecal β-glucuronidase activity and levels of urinary estrogens.
“Flores et al.(44) demonstrated that there was a relatively weak correlation between faecal β-glucuronidase activity and levels of urinary estrogens.”
From Association Between Sex Hormone Levels and Gut Microbiota Composition and Diversity—A Systematic Review (2022) · cites this paper as [44]
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“Women with IBS are more likely to have other coexisting health problems (fatigue, sleep disturbances; Cain et al., 2009) as well as psychological distress (depression) and poorer QoL than men (L. Chang, Toner, et al., 2006).”
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- Authors
- Cain, K. C., Jarrett, M. E., Burr, R. L., Rosen, S., Hertig, V. L., & Heitkemper, M. M.
- Affiliations
- University of Washington (US)
- Group Health Cooperative (US)
- Corresponding author
- Heitkemper, Margaret M.
- Venue
- Digestive Diseases and Sciences
- Published
- 2008-11-01
- Volume
- 54
- Issue
- 7
- Pages
- 1542-1549
- ISSN
- 0163-2116 (ISSN-L)
- 1573-2568
- PMC
- PMC3569485
- OpenAlex
- W2061252565
- Cited by
- 126
- References
- 35
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 5 · 2023: 4 · 2022: 12 · 2021: 5 · 2020: 6 · 2019: 3 · 2018: 8 · 2017: 7 · 2016: 9 · 2015: 7 · 2014: 10 · 2013: 3 · 2012: 13
- FWCI
- 6.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Digestive Diseases and Sciences (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Nursing Research (P30NR004001, P30-NR04001, R01NR001094, NR01094)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- irritable bowel syndrome, gender differences, postmenopausal women, menstruating women, somatic symptoms, gastrointestinal symptoms, psychological distress, bloating, abdominal distension, joint pain, myalgia, fatigue, stress, self-rated health, daily symptom diary
- MeSH terms
- Adolescent, Adult, Aged, Female, Health Status, Humans, Male, Middle Aged, Pain, Prospective Studies, Sex Factors, Stress, Psychological, Irritable Bowel Syndrome, Young Adult
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