Irritable bowel syndrome across the lifespan: roles of female sex hormones and gender

Abstract

Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction characterized by abdominal pain and changes in bowel pattern. The prevalence of IBS is higher among females than males; sex-related differences emerge around puberty and increase during early adulthood, highlighting potential sex- and gender-related implications in IBS. This article reviews the impacts of sex and/or gender on the epidemiology, symptomatology, and pathogenesis of individuals with IBS across the lifespan. Sex hormones do not act in isolation on the reproductive system; rather they have a systemic impact throughout the gastrointestinal system. Gender, the social construct related to femininity and masculinity, may influence psychosocial factors, economic status, caregiving responsibilities, and health-care utilization in general and among those with IBS. Although the roles of sex hormones within the context of IBS have been discussed in existing literature, much of the previous studies did not account for the possible role of fluctuations in hormones across the menstrual cycle, hormonal contraceptive use, and sociodemographic characteristics and were limited to be cross-sectional studies. Longitudinal research is needed across the lifespan from puberty to menopause and beyond to bring a better understanding about the roles of sex hormones and gender in IBS.

Keywords

• Sex. Gender. Irritable bowel syndrome.