How IBS impacts female health

Irritable bowel syndrome, or IBS, is a common disorder that causes gastrointestinal pain and discomfort. IBS impacts women and menstruating people more frequently than males, and it can have significant implications on our gut, hormone, and overall health. 

In this article we will be taking a closer look at IBS and how it impacts our health. Read on to learn: 

• What is IBS? 
• What are common symptoms of IBS for menstruating people? 
• How is IBS diagnosed? 
• What causes IBS?
• How does IBS impact our overall health? 
• What should I do if I have or suspect I have IBS? 

What is IBS? 

IBS is a chronic gut condition that affects the large intestine. It is estimated that at least 10-15% of adults in the United States have IBS, with up to two-thirds of these individuals being females. In fact, some studies report that nearly 25% of women have this condition (1). 

IBS can cause a range of symptoms, including:

• Abdominal pain
• Bloating
• Constipation (medically defined as less than 3 bowel movements per week)
• Diarrhea (more than 3 bowel movements per day) 
• Mucus in stool 

The Rome II diagnostic criteria for IBS include at least 12 weeks (which do not need to be consecutive) in the prior 12 months of abdominal discomfort that has 2 of the following 3 factors: 

• Relieved with a bowel movement
• Onset associated with a change in frequency of passing bowel movements 
• Onset associated with a change in the appearance of bowel movements 

There are 4 subtypes of IBS, each with equal incidence:

• IBS-D: Presents as mostly diarrhea with abdominal discomfort
• IBS-C: Presents as mostly constipation with abdominal discomfort
• IBS-mixed: Presents as alternating diarrhea and constipation with abdominal discomfort
• IBS-U: Undefined subtype in which symptoms vary

What causes IBS? 

The cause of IBS is not well understood, and a diagnosis is typically made based on symptoms alone. 

At Pollie, we believe that IBS is an umbrella diagnosis that can occur due to many root causes. Several of these causes include: 

• Gut-brain axis dysfunction: The communication between the brain and the gut is known as the gut-brain axis. Disruptions in this communication can lead to alterations in gut motility, sensitivity, and secretion, contributing to IBS symptoms. Factors such as stress, anxiety, and a history of psychological trauma can influence the gut-brain axis and trigger or worsen IBS symptoms.
• Altered gut microbiota: The gut is home to a complex community of microorganisms known as the gut microbiota. Imbalances in the composition and diversity of the microbiota, called dysbiosis, have been associated with IBS. Changes in the microbiota can affect gut function, immune responses, and the production of certain substances that can influence symptoms.
• Visceral hypersensitivity: Some individuals with IBS have increased sensitivity or heightened perception of sensations in the gastrointestinal tract, known as visceral hypersensitivity. Even normal intestinal contractions may be perceived as painful or uncomfortable, leading to abdominal pain and discomfort characteristic of IBS.
• Abnormal gut motility: Alterations in the movement of the intestines can contribute to IBS symptoms. In some cases, the contractions of the intestines may be stronger and more prolonged, leading to diarrhea. In others, the contractions may be weaker, causing constipation.
• Post-infectious IBS (PI-IBS): Some people develop IBS symptoms after experiencing a gastrointestinal infection, such as gastroenteritis. This is known as post-infectious IBS (PI-IBS). It is believed that the infection triggers an inflammatory response or leads to long-term changes in the gut, resulting in persistent symptoms.

It's important to note that these factors are not comprehensive or mutually exclusive, and multiple factors may contribute to the development of IBS symptoms. Each individual may have a unique combination of factors that contribute to their specific symptoms. It is recommended to consult a healthcare professional for an accurate diagnosis and personalized management plan.

Looking to get to the bottom of your IBS or gut symptoms? Sign up for a Pollie membership today on your Apple or Android device! 

How does IBS impact female health? 

Although IBS most obviously impacts the gut and gastrointestinal comfort, it can actually have much broader implications for our overall health as menstruating people. 

Below are a few ways IBS can impact female health: 

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• Chronic gynecological conditions and symptoms: Individuals with IBS may experience more menstrual pain, heavier menstrual bleeding, and more severe premenstrual syndrome (PMS) symptoms than women without IBS. Additionally, women with IBS may be more likely to have conditions such as endometriosis, polycystic ovary syndrome (PCOS), and pelvic floor dysfunction (2, 3, 4, 5).
• Impaired fertility: There is some evidence to suggest that women with IBS may have a slightly increased risk of infertility, although more research is needed in this area (6).
• Mental health conditions: IBS can be a very stressful and frustrating condition to live with, and this can take a toll on a person's mental health. People with IBS may be more likely to experience anxiety, depression, and other mental health concerns than women without IBS (7, 8).
• Quality of life: Because IBS can cause a range of uncomfortable and disruptive symptoms, it can have a significant impact on a woman's overall quality of life. People with IBS may need to plan their activities around their symptoms, avoid certain foods or situations that trigger symptoms, and may even need to take time off work or school if their symptoms are particularly severe (8).

What next?

If you suspect you have IBS, be sure to visit your primary care doctor or gastroenterologist to explain your symptoms. Any symptoms such as blood in the stool, rapid weight loss, fevers, or extreme pain should be treated with urgency as these may be signs of a more serious condition. 

Fortunately, IBS can be largely managed and improved through lifestyle and medication. Below are some options that have helped many people with improving their gut: 

• Diet and lifestyle changes: IBS is typically responsive to lifestyle and dietary modifications like the ones we help members with at Pollie. This may involved identifying and avoiding trigger foods (e.g., dairy, alcohol, gluten), increasing dietary fiber intake, maintaining regular meal times, staying hydrated, moving regularly, and managing stress. 
• Alternative therapies: Some people even find relief from IBS symptoms through complementary and alternative therapies, such as acupuncture, herbal remedies (e.g., peppermint oil), or dietary supplements (e.g., peppermint, fennel, or ginger). 
• Probiotics: Probiotics, which are beneficial bacteria, can help regulate the gut microbiota and alleviate IBS symptoms in some individuals. Specific strains of probiotics, such as Bifidobacterium and Lactobacillus species, have shown promise in certain cases of IBS. Note: Probiotics (sadly) won’t be a cure-all. Make sure you have the building blocks in place first of proper rest, stress management, frequent movement, and a nutrient-dense diet! 
• Medications: Medications such as antispasmodic medications, laxatives and fiber supplements, and even low-dose selective serotonin reuptake inhibitors (SSRIs) are sometimes leveraged for pain reduction and gut regulation with more severe cases of IBS. If you decide to pursue these options, be sure to discuss whether they are right for you and potential side effects with your doctor. Note: Long-term laxative use can be harmful for your health and also cause disordered eating. Use laxatives with extreme caution and under the guidance of a medical professional. 

As with most health conditions, taking a personalized and root cause approach can help you learn how to manage your symptoms in a sustainable way that works for the long-term. If you would like to learn more about how Pollie can help you with managing your IBS symptoms, book a discovery call with our team today! 

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Sources 

1. https://www.med.unc.edu/ibs/wp-content/uploads/sites/450/2017/10/IBS-in-Women.pdf 
2. Kałużna M, Kompf P, Wachowiak-Ochmańska K, Moczko J, Królczyk A, Janicki A, Szapel K, Grzymisławski M, Ruchała M, Ziemnicka K. Are patients with polycystic ovary syndrome more prone to irritable bowel syndrome? Endocr Connect. 2022 Apr 26;11(4):e210309. doi: 10.1530/EC-21-0309. PMID: 35275093; PMCID: PMC9066599. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9066599/. 
3. Nabi MY, Nauhria S, Reel M, Londono S, Vasireddi A, Elmiry M, Ramdass PVAK. Endometriosis and irritable bowel syndrome: A systematic review and meta-analyses. Front Med (Lausanne). 2022 Jul 25;9:914356. doi: 10.3389/fmed.2022.914356. PMID: 35957857; PMCID: PMC9357916. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357916/. 
4. Pati GK, Kar C, Narayan J, Uthansingh K, Behera M, Sahu MK, Mishra D, Singh A. Irritable Bowel Syndrome and the Menstrual Cycle. Cureus. 2021 Jan 14;13(1):e12692. doi: 10.7759/cureus.12692. PMID: 33614302; PMCID: PMC7883586. https://pubmed.ncbi.nlm.nih.gov/33614302/. 
5. Singh P, Seo Y, Ballou S, Ludwig A, Hirsch W, Rangan V, Iturrino J, Lembo A, Nee JW. Pelvic Floor Symptom Related Distress in Chronic Constipation Correlates With a Diagnosis of Irritable Bowel Syndrome With Constipation and Constipation Severity but Not Pelvic Floor Dyssynergia. J Neurogastroenterol Motil. 2019 Jan 31;25(1):129-136. doi: 10.5056/jnm17139. PMID: 30646484; PMCID: PMC6326213. https://pubmed.ncbi.nlm.nih.gov/30646484/. 
6. Anton C, Ciobica A, Doroftei B, Maftei R, Ilea C, Darii Plopa N, Bolota M, Anton E. A Review of the Complex Relationship between Irritable Bowel Syndrome and Infertility. Medicina (Kaunas). 2020 Nov 6;56(11):592. doi: 10.3390/medicina56110592. PMID: 33172048; PMCID: PMC7694637. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694637/ .
7. Fadgyas-Stanculete M, Buga AM, Popa-Wagner A, Dumitrascu DL. The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations. J Mol Psychiatry. 2014 Jun 27;2(1):4. doi: 10.1186/2049-9256-2-4. PMID: 25408914; PMCID: PMC4223878. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4223878/. 

Kopczyńska M, Mokros Ł, Pietras T, Małecka-Panas E. Quality of life and depression in patients with irritable bowel syndrome. Prz Gastroenterol. 2018;13(2):102-108. doi: 10.5114/pg.2018.75819. Epub 2018 May 16. PMID: 30002768; PMCID: PMC6040097. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040097/.