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Why Is IBS More Common in Women?

1 hour ago
14 min read

By Kat Pachas BSN, RN

Imagine never knowing whether your next meal or a stressful day will throw your gut into chaos. For millions of women with Irritable Bowel Syndrome (IBS), this happens every day. They deal with unpredictable waves of cramping, bloating, abdominal pain, constipation, and diarrhea (6, 9, 17). For them, these symptoms can feel like they have a mind of their own.


IBS is very common, affecting 10–20% of the global population. Women are up to three times more likely than men to develop IBS, and they also experience more bloating and constipation (22). They report higher rates of fatigue, anxiety, and depression, and say it lowers their quality of life (16).


Since there are no visible signs of damage to the gut (9), IBS is often taken less seriously than other conditions. But the absence of visible damage doesn't make IBS any less miserable or frustrating. It can interrupt social activities (3), work, and overall quality of life.


A recent survey by the American Gastroenterological Association (AGA) shows how much IBS can put life on hold. The survey found that IBS affects patients' productivity for an average of 11 days and for personal activities an additional 8 days each month.


  • 77% avoid situations with limited bathroom access.

  • 72% say it is difficult to make plans because they never know when symptoms will flare.

  • 72% stay home more often because of their symptoms.


Stress can make IBS symptoms worse (12), adding another layer of unpredictability. The good news is that IBS isn't dangerous. It doesn't damage the bowel tissue or increase the risk of colorectal cancer (3). But that doesn't mean you shouldn’t take it seriously.


For some people, the symptoms can be extremely disruptive. They often cope with urgency (13) that has them rushing to the bathroom in the middle of an evening out to dinner. When planning a long car trip, they need to know where all the rest stops are.


The main symptoms of IBS are stomach pain (7) that keeps coming back and changes in bathroom habits. This includes constipation, diarrhea, or both. These symptoms can be embarrassing to talk about, so many women with IBS suffer in silence.


What Is IBS?


IBS is a functional disorder that affects the digestive system. It's a chronic, long-term condition. Doctors diagnose IBS based on specific symptoms after ruling out other medical problems (9). IBS is one of the most common conditons gastroenterologists (degestive system specialists)(4) diagnose.


It affects about 10% to 15% of adults in the United States. IBS is divided into 4 different types based on bowel movement patterns. Most people with IBS have normal bowel movements on some days and abnormal ones on others. The stool type on abnormal days defines the type of IBS. This determines treatment because certain treatments work only for specific IBS types (5).


  • IBS-C with Constipation: Most of your stool is hard and lumpy. It's hard to poop, and you aren't going to the bathroom very often.

  • IBS-D with Diarrhea: Most of your stool is loose and watery. You often feel a frequent, urgent need to use the bathroom.

  • IBS-M (Mixed Bowel Habits): You experience both hard/lumpy stools and loose/watery stools. You alternate between constipation and diarrhea, sometimes on the same day (5).

  • IBS-U (Unclassified): Your symptoms vary, and your stool type does not fit a steady pattern (15).


Women more often experience constipation or mixed symptoms, while men are more likely to have IBS with diarrhea (6). Hormones, physical differences, and nerve signals all play a role in why IBS is more common in women. These factors help explain why women may experience symptoms more often or more intensely than men (16).


Hormones Play a Major Role in IBS


IBS symptoms can change with hormonal shifts during the menstrual cycle, pregnancy, perimenopause, and menopause (16, 22).


Hormones such as estrogen (7) and progesterone (8) can affect gastrointestinal motility and visceral pain sensitivity. These effects may help explain why IBS symptoms can change at different stages of a woman’s life (6).


Progesterone can relax the smooth msucles in the digestive tract and delay intestinal transit. This may contribute to constipation and bloating. Changes in estrogen levels can also affect gut movement and pain sensitivity.



Hormonal changes can affect (17):


  • How quickly food and waste move through the digestive tract

  • How strongly the gut responds to sensations of pain

  • How the muscles of the digestive tract contract and relax

  • How the gut responds to physical and emotional stress (6)


Hormonal changes may also influence inflammation. These fluctuationsmay help explain why some women notice that their IBS symptoms worsen at certain points in their period.


IBS and the Menstrual Cycle


Many women with IBS notice that symptoms worsen during their period. In fact, more than 50 percent report more bloating, cramping, and pain. They also report changes in bowel habits (9).

Hormone changes during the menstrual cycle can slow digestion and make the gut more sensitive to pain.


Many women with IBS observe:


  • Symptoms are worse right before or during menstruation.

  • Abdominal pain and bloating may increase.

  • Bowel habits may shift toward diarrhea or constipation.

  • Symptoms flare up at different points in the menstrual cycle (9).


Differences in Women’s Anatomy


On average, women's food and digestive contents move through the intestines more slowly than men's. Anatomy plays a role, too.


A woman’s intestines have to fit into a smaller space in the lower abdomen and pelvis than a man's. They sit next to pelvic organs such as the uterus and bladder. Women also have colons that are about 3 longer than men’s (10); however, it must be noted, that the difference in length varies significantly across cohorts. These differences may lead to constipation, bloating, and other IBS symptoms.


Differences in Gut-Brain Communication​


IBS is a gut-brain disorder (11). It involves changes in the gut-brain axis, the two-way communication system between the digestive tract and the brain. Think of it like a phone line connecting your brain and your gut. With IBS, this communication system struggles to send messages normally.​



  • women have more sensitivity to gut pain

  • signals from the gut may feel more intense for women

  • the brain processes digestive signals differently in women than in men

  • women are extra sensitive to intestinal gas (6)


For most people, this communication happens without you noticing. But with gut-brain disorders like IBS, the system can become too sensitive. Gut nerves may react more than usual. Normal digestive activity can feel much stronger. Normal stretching in the gut after eating or gas can feel uncomfortable or even painful for people with IBS.


This extra gut sensitivity is called visceral hypersensitivity (12). Once visceral hypersensitivity develops, the nervous system can stay on high alert, which connects closely to stress.

​

Stress, Trauma, and the Nervous System


If stress or anxiety makes your IBS symptoms worse, it does not mean they are “just in your head.” Stress causes real changes in how your nervous system reacts to gut functions (13), so the link is physical as well as emotional.


When you feel stressed, your nervous system can strengthen signals between your brain and gut. This can make pain, the urge to go to the bathroom, or changes in digestion feel more intense.


The cycle goes both ways. Ongoing gut pain and digestive problems can raise stress, and you may notice every feeling in your body. This keeps your nervous system on guard and can make symptoms feel even worse.


This two-way link between the gut and brain may help explain why IBS and anxiety often happen at the same time.


​Women, on average, have higher reported rates of:


  • chronic stress

  • anxiety and depression

  • many stressors across their lifespan

  • past trauma, including early-life stress (14)


When these effects add up, they can make the gut-brain axis more sensitive and alter gut function in women with IBS. This can also help explain why symptoms may feel harder to manage when several factors overlap.  


Common IBS Triggers in Women


IBS often occurs alongside certain conditions, which are more common in women. As a result, symptoms may become more noticeable or severe.


Differences in Health-Seeking Behavior


Women seek medical care for IBS symptoms more than men do. This could be one reason why IBS is diagnosed more frequently in women. Because men might not visit the doctor as often as women, IBS may be underdiagnosed in men. This difference in care-seeking may also affect how symptoms are recognized (18).


Social and Emotional Effects of IBS in Women


IBS affects more than just a woman’s physical health. Women with IBS often worry about losing control of their bowel movements, especially when it comes to diarrhea. This fear can make women feel uncomfortable in social situations.


They may also be more concerned about how IBS affects their appearance and how others see them. Issues like bloating, body odor, feeling unclean, or wanting to look slim can add to their stress.


These worries can make women feel embarrassed, anxious, or self-conscious. As a result, they might avoid certain foods, activities, or social events.


​Managing IBS: Diet, Lifestyle, and Medications


There is no single diet or treatment that works for everyone with IBS. What helps one person may make another person feel worse. The goal is to find the foods, habits, and treatments that help manage your symptoms without unnecessarily restricting your diet.

​

A few simple habits may help keep IBS symptoms under control (19-21):


  • Eat regular meals. Skipping meals or going long periods without eating may worsen symptoms.

  • Eat slowly. Taking your time and chewing your food well can make meals easier on your digestive system.

  • Keep a food and symptom diary. Tracking what you eat and how you feel afterward can help you identify patterns and possible triggers.

  • Stay hydrated. Drink plenty of water throughout the day, especially if you have diarrhea or constipation.

  • Move your body. Regular physical activity can support healthy bowel function and may help reduce stress.

  • Find ways to manage stress. Because the brain and gut are closely connected, relaxation techniques, breathing exercises, meditation, gut-directed therapies, or other stress-management strategies may help some people.

  • Consider probiotics. Some people find that probiotics improve their IBS symptoms, although results vary.

  • Use heating pads. This helps relax the muscles in your gut and may reduce painful spasms and cramping.


Foods that may trigger IBS symptoms (20):

​

Certain foods and drinks can make IBS symptoms worse, although triggers vary from person to person. Common ones include:


  • ​High-fat or greasy foods

  • Spicy foods

  • Alcohol

  • Carbonated drinks

  • Caffeine

  • Certain artificial sweeteners, such as sorbitol

  • Foods that cause excess gas, such as beans, onions, and some vegetables


You don't necessarily need to avoid all of these foods. Instead, pay attention to your own symptoms and look for patterns.


Bloating and gas can be especially frustrating when you have IBS. Some people find relief by limiting foods that are difficult to digest or that produce excess gas. Soluble fiber may also help some people.


If bloating continues despite dietary changes, talk with your doctor or a registered dietitian. A low-FODMAP diet may help some people with IBS, but it is best done with guidance from a dietitian so you don't end up unnecessarily cutting out too many foods (20).


Over-the-counter medications such as Imodium can help control diarrhea for some people. Ask your doctor or pharmacist whether it is appropriate for you (22).


If constipation is your main symptom, drinking enough water and staying physically active may help. Soluble fiber can also make bowel movements easier by softening and regulating stool. Good sources include oats, certain fruits and vegetables, and psyllium (22).


Increase fiber gradually rather than adding a large amount all at once, since too much fiber too quickly can increase gas and bloating.


Some people also benefit from over-the-counter laxatives (25). Your doctor can help you choose the right option.


When you're constantly worried about symptoms, it can be tempting to keep removing foods from your diet. But avoiding many foods can make it harder to get the nutrition you need and can make eating stressful.


If you find yourself eliminating too many foods to control your symptoms, talk with your doctor or a registered dietitian who understands IBS. You don't have to figure it all out on your own.


Brain-Gut Therapies for IBS


The American Gastroenterological Association (AGA) now recommends brain-gut therapies, including gut-directed hypnotherapy, as part of evidence-based treatment for IBS. Digital therapies accessed through apps on your smartphone, tablet, or computer are also recognized as a way to help people access these treatments.


This matters because IBS involves communication between the brain and the digestive system. Treatments that target this connection can help manage IBS symptoms and provide patients with convenient treatment options they can use from the privacy of their home.


Gut-directed therapy, often called gut-directed hypnotherapy, is a mind-body approach that focuses on the brain-gut connection. The goal is to help calm an overly sensitive gut and reduce symptoms such as pain, bloating, and changes in bowel habits.


​Gut-directed hypnotherapy is recommended in European and North American gastroenterology guidelines as a treatment option for IBS (24). Nerva (25) and The Calm & Happy Gut are two examples of digital services that offer guided gut-directed hypnotherapy sessions you can do from the comfort of your home.


A clinical trail, involving 244 participants, found that patients using Nerva had about  81 percent symptom improvement, including decreased gut pain, less anxiety, and improved quality of life.

​Gut-directed hypnotherapy uses deep relaxation, focused attention, and guided suggestions to help change how the brain and gut respond to each other.


During a session, you may listen to a practitioner or recording that guides you into a relaxed state. The session may use calming images or suggestions designed to help your digestive system respond more normally to sensations and movement.


The idea isn't to make you believe that your symptoms aren't real. Instead, it works with the brain-gut connection to help reduce the intensity of signals coming from the gut.


Treatment often involves short, regular sessions that you can do at home. Many programs use guided audio sessions that last about 15 minutes a day. Some approaches may also include education about IBS or techniques based on cognitive behavioral therapy (CBT) (29).


When to See a Doctor



  • Blood in your stool

  • Persistent vomiting

  • Unexplained weight loss

  • Severe or worsening abdominal pain

  • Symptoms that wake you from sleep

  • A family history of colon cancer, celiac disease, or inflammatory bowel disease (IBD) (30)


These symptoms may point to a condition other than IBS. A doctor can evaluate your symptoms, rule out other causes, and determine whether IBS is the right diagnosis.

​

The Bottom Line


IBS can have a major impact on your daily life, even though it does not damage the intestines or increase your risk of colon cancer. The pain, bloating, bowel changes, and uncertainty can be exhausting—and your symptoms are real.


The good news is that IBS is manageable. Understanding how the gut and brain communicate can help you make sense of your symptoms and find treatments that work for you. No single treatment works for everyone, so finding the right combination may take some trial and error.


Key Takeaways


  • Women are more likely to develop IBS than men.

  • IBS is real. Your symptoms are not “all in your head.”

  • IBS does not damage the intestinal lining.  

  • IBS doesn't increase your risk of colon cancer.

  • IBS affects the gut-brain connection, which can influence pain, digestion, and bowel habits.

  • Treatment is individualized. Diet changes, medications, gut-directed therapies, and lifestyle approaches all play a role.

  • You don't have to live with your symptoms. If IBS is interfering with your daily life, talk with a healthcare professional about treatment options.


References:


American Gastroenterological Association. (2025, August 7). IBS in America: Despite advances, IBS remains a burden for many millions. https://gastro.org/press-releases/ibs-in-america-despite-advances-ibs-remains-a-burden-for-many-millions/


Berumen, A., Edwinson, A. L., & C Grover, M. (2021). Post-infection Irritable Bowel Syndrome. Gastroenterology clinics of North America, 50(2), 445–461. https://doi.org/10.1016/j.gtc.2021.02.007


Binod, M., Chang, L., Hung, M. W., C et al. (2025). Multi-omics analysis reveal clinical-gut-brain interactions in female IBS patients with adverse childhood experiences. Biology of Sex Differences, 16, 101. https://doi.org/10.1186/s13293-025-00757-w


Cangemi, D. J., C Lacy, B. E. (2022, Febuary). A Practical Approach to the Diagnosis and Treatment of Abdominal Bloating and Distension. Gastroenterology & hepatology, 18(2), 75–84. https://www.gastroenterologyandhepatology.net/files/2022/01/0222-Cangemi-Lacy_final-1.pdf


Chiaffarino, F., Cipriani, S., Ricci, E., Mauri, P. A., Esposito, G., Barretta, M., Vercellini, P., & C Parazzini, F. (2021). Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis. Archives of gynecology and obstetrics, 303(1), 17–25. https://doi.org/10.1007/s00404-020-05797-8


Chu, B., Marwaha, K., Sanvictores, T., & C et al. (2024, May 7). Physiology, stress reaction. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK541120


Cleveland Clinic. (2026, April 4). Estrogen. https://my.clevelandclinic.org/health/body/22353-estrogen


Cleveland Clinic. (2022, September 14). Gastroenterologist. https://my.clevelandclinic.org/health/articles/24198-gastroenterologist


Cleveland Clinic. (2023, November 16). Irritable bowel syndrome (IBS). https://my.clevelandclinic.org/health/diseases/4342-irritable-bowel-syndrome-ibs



Cleveland Clinic. (2022, Decmeber 29). Progesterone. https://my.clevelandclinic.org/health/body/24562-progesterone


Cleveland Clinic. (2022, May 11). Visceral hypersensitivity. https://my.clevelandclinic.org/health/diseases/22997-visceral-hypersensitivity


Häuser W. (2024). Gut-directed hypnosis and hypnotherapy for irritable bowel syndrome: a mini-review. Frontiers in psychology, 15, 1389911. https://doi.org/10.3389/fpsyg.2024.1389911



Johns Hopkins Medicine. (n.d.). Irritable bowel syndrome (IBS). https://www.hopkinsmedicine.org/health/conditions-and-diseases/irritable-bowel-syndrome-ibs


Kim, Y. S., & C Kim, N. (2018). Sex-Gender Differences in Irritable Bowel Syndrome. Journal of neurogastroenterology and motility, 24(4), 544–558. https://doi.org/10.5056/jnm18082


Marano, G., Traversi, G., Pola, R., Gasbarrini, A., Gaetani, E., & C Mazza, M. (2025). Irritable Bowel Syndrome: A Hallmark of Psychological Distress in Women?. Life (Basel, Switzerland), 15(2), 277. https://doi.org/10.3390/life15020277


Mayer, E. A., Ryu, H. J., & C Bhatt, R. R. (2023). The neurobiology of irritable bowel syndrome. Molecular Psychiatry, 28, 1451–1465. https://doi.org/10.1038/s41380-023-01972-w



Mayo Clinic. (n.d.). Irritable bowel syndrome: Diagnosis and treatment. https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/diagnosis-treatment/drc-20360064


Meleine, M., & Matricon, J. (2014). Gender-related differences in irritable bowel syndrome: potential mechanisms of sex hormones. World journal of gastroenterology, 20(22), 6725–6743. https://doi.org/10.3748/wjg.v20.i22.6725


Monash University. (2024). Hypnotherapy reduces irritable bowel syndrome symptoms—and now there’s an app for that. https://www.monash.edu/medicine/news/latest/2024-articles/hypnotherapy-reduces-irritable-bowel-syndrome-symptoms-and-now-theres-an-app-for-that


Monash University. (n.d.). Starting the low FODMAP diet. https://www.monashfodmap.com/ibs-central/i-have-ibs/starting-the-low-fodmap-diet/


National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Treatment for irritable bowel syndrome. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/treatment


National Library of Medicine. (n.d.). Soluble vs. insoluble fiber. MedlinePlus. https://medlineplus.gov/ency/article/002136.htm


Nerva Health. (n.d.). Nerva: Gut-directed hypnotherapy. https://www.nervahealth.com/


Pati, G. K., Kar, C., Narayan, J., Uthansingh, K., Behera, M., Sahu, M. K., Mishra, D., & Singh, A. (2021). Irritable Bowel Syndrome and the Menstrual Cycle. Cureus, 13(1), e12692. https://doi.org/10.7759/cureus.12692


Riehl M. E. (2018). The Emerging Role of Brain-Gut Therapies for Irritable Bowel Syndrome. Gastroenterology & hepatology, 14(7), 436–438.


The Calm and Happy Gut. (n.d.). The Calm and Happy Gut. https://thecalmandhappygut.com/


Utano, K., Nagata, K., Honda, T., Kato, T., Lefor, A. K., & Togashi, K. (2021, October 11). Bowel habits and gender correlate with colon length measured by CT colonography. Japanese journal of radiology, 40, 298–307. https://doi.org/10.1007/s11604-021-01204-7




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