Irritable bowel syndrome (IBS) symptoms are similar in people of all sexes. However, some data suggest females may be more likely to experience certain symptoms than males. This includes constipation, anxiety, and fatigue.

This information comes from a 2018 review in the Journal of Neurogastroenterology and Motility.

The review also states that IBS is much more common in females than in males, and data suggest it may have a more significant impact on females’ quality of life. Researchers are not sure why this is. However, a combination of biological and social factors may play a role.

Keep reading to learn more about IBS in females, including differences in symptoms, IBS complications, and more.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

A female who is sat down using a heat pad for IBS symptoms.Share on Pinterest
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The main symptoms of IBS are:

Some people also experience white mucus in their stool and incomplete evacuation, which is a feeling that a bowel movement has not finished.

These symptoms can affect anyone with IBS. However, research suggests females may be more likely to experience constipation than diarrhea.

Females with IBS often report that their symptoms worsen before or during a period. This may cause an increase in:

A flare-up in symptoms at this time may be due to an overlap between IBS and premenstrual syndrome (PMS). PMS is a collection of symptoms that many females experience before their period, whether they have IBS or not. Bloating, bowel habit changes, and cramping are common PMS symptoms.

However, it is also possible that the hormonal changes that occur before a period aggravate IBS. The medical term for this is premenstrual exacerbation.

Other hormonal shifts such as puberty, pregnancy, and menopause may also impact IBS symptoms.

In addition to some differences in symptoms, females may be more likely than males to experience certain complications of IBS. These include:

Anxiety and depression

The 2018 review states that in previous research, females with IBS have reported more anxiety and depression than males. It is difficult to know whether this is a result of the condition or vice versa.

Although IBS is a physical condition, people with this diagnosis often have a history of anxiety, depression, and traumatic life experiences. Scientists believe that stressful life experiences may alter how the gut functions, which could be how IBS develops in some people.

Anxiety and depression are also more common in females overall than in males, which may explain why IBS is, too.

Body image

According to a 2022 article, social and cultural factors may cause females to perceive their symptoms in different ways than males.

For example, the pressure for females to be thin may cause some to feel distressed about bloating because of its impact on their body image and self-confidence, in addition to being uncomfortable.

Impact on sexual health

A 2019 study found that females with IBS engaged in less sexual activity than a control group. The participants with IBS also had higher rates of sexual dysfunction, particularly those with severe symptoms. The authors suggest that chronic pain and the psychological impact of living with IBS may cause this.

Because the study did not compare males with females, it is unclear if IBS affects male sexual health at similar rates.

Pelvic organ prolapse

Pelvic organ prolapse (POP) is when an organ in the pelvis moves out of position and protrudes into the vagina. POP is more common in people with chronic constipation, which can be a symptom of IBS.

Experts do not fully understand what causes IBS, so they do not yet know why it is more common in females. That said, there are several theories.

Sex differences in IBS may occur due to a combination of factors, such as:

  • Biological differences: A 2021 review suggests that female sex hormones, such as estrogen and progesterone, may influence bowel function, pain perception, and gut flora. However, researchers are still learning about this.
  • Adverse childhood experiences (ACEs): People with IBS often have a history of traumatic experiences early in life. Females who experience ACEs are more likely than males to develop mental health conditions later in life, which may contribute to IBS.
  • Health inequity: Females have higher rates of many chronic conditions than males. This may be partly due to sexism, which can lead to discrimination, abuse, poverty, and inadequate healthcare. These, in turn, may contribute to physical and mental illness. For example, a 2017 study found that females who experienced sexual assault in the military often went on to develop conditions that cause chronic pain, including IBS.

Learn more about gender discrimination and health.

Several other conditions can cause similar symptoms to IBS in females, including:

  • PMS: People who only experience changes in bowel movements around their period may be experiencing PMS. This can also cause mood swings, breast tenderness, cramping, bloating, gassiness, and tiredness.
  • Fibroids: Fibroids are growths in the wall of the uterus. The symptoms can include bloating or pressure in the belly, constipation, pain, heavy or painful periods, and tiredness due to anemia.
  • Endometriosis: This condition can cause pelvic pain, back pain, constipation, diarrhea, nausea, painful periods, and pain during or after sex.
  • Pelvic floor disorders (PFDs): These conditions affect the muscles of the pelvis that hold organs in place. A person with a PFD may experience constipation, difficulty controlling gas or bowel movements, and a sensation of fullness, aching, or pulling in the vagina.

Inflammatory bowel disease (IBD) and other digestive conditions can also have similar symptoms to IBS.

Learn more about the differences between IBS and IBD.

IBS symptoms are often similar among all sexes. However, females may be more likely than males to experience constipation rather than diarrhea. They also report higher levels of anxiety and depression and lower quality of life than males with the condition.

Biological and social factors that affect females may also influence their experiences of IBS. For example, hormonal changes may cause IBS symptoms to worsen at certain times, and social attitudes may affect how people feel about their symptoms.

Researchers are still learning about symptom differences and why IBS is more common in females. By understanding how sex and gender affect IBS, health professionals may develop a better understanding of how to prevent and treat the condition.