Gender Differences in IBS

In the United States and other western countries, it's twice as likely for people with female physiology to seek treatment for irritable bowel syndrome (IBS) than it is for those with male physiology. In fact, IBS is largely perceived as a "women's health issue" even though people of any sex can have this condition.

The reasons for the disproportional rates of diagnosis could lie in the differences between the sexes, including those that are:

  • Physical
  • Chemical
  • Social
  • Emotional
Man sitting on the edge of his bed, holding his stomach
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Physical Differences

Some research indicates that part of the large discrepancy in the number of males and females diagnosed with IBS may lie in physical differences, such as response to pain.

In general, those assigned female at birth have been shown to be more sensitive to certain types of pain than those assigned male at birth, and that includes visceral pain (from internal organs) like that of IBS. So it's possible that female anatomy means noticing the abnormal sensations more and thus being more likely to seek and receive a diagnosis.

Chemical Differences

Many people say their IBS symptoms are worse during certain phases of their menstrual cycle, such as pre-menstrual or ovulation periods. This association led researchers to speculate that if female hormones exacerbate IBS, male hormones may be responsible for “protecting” men from IBS.

In one study of those assigned male at birth, people with IBS were found to have lower levels of male hormones than those without IBS. This could mean that higher levels of male hormones in the body somehow prevent IBS symptoms, but researchers are unsure why.

Another study showed that biological males with a lower testosterone level experienced more pronounced IBS symptoms.

Social Differences

Another possible reason for the low IBS-diagnosis rate in cis men is that they may not seek medical treatment as readily as others because society views pain as "not masculine."

Those with female physiology may seek treatment for IBS more often because of the lack of social stigma combined with more visits to a doctor due to yearly visits for a Pap screen or other testing.

Reporting abdominal pain or changes in bowel habits during these routine visits might lead to a referral for a follow-up with a general practitioner or a gastroenterologist.

Meanwhile, cis men who are young or otherwise healthy may not see a doctor on a regular basis and therefore have less opportunity to report symptoms and potentially a lower comfort levels as well.

Emotional Differences

While researchers don't yet understand the link, they suspect a connection between psychological conditions and IBS.

Depression and anxiety are generally more common—or at least more often diagnosed—in biological women than biological men, which may partly explain the prevalence of IBS in women.

Studies have shown that those assigned female at birth and have IBS are more likely to have a history of sexual abuse, which may contribute to a higher risk of developing IBS.

A Word From Verywell

It appears that all these factors may play a role in explaining the lower rate of reported IBS in biological men than biological women. There could also be other social reasons why men may not seek care or why women are more likely to seek care for digestive conditions.

Studies about the sex-based differences in IBS have increased in recent years, and researchers say more work is needed to understand them and how they impact the illness.

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