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Hormone-Induced IBS: Mastering Symptom Management

While irritable bowel syndrome (IBS) can affect everyone – men and women, young and old – women’s hormone fluctuations can make symptoms worse. This article is a comprehensive guide on managing hormone-induced IBS symptoms. 

The Time of The Month Counts

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If you’ve noticed that your IBS symptoms worsen at certain times of the month, you’re not alone. In this article, we delve deep into the intricate relationship between hormones and gastrointestinal distress. We’ll provide you with actionable strategies to take control of your hormone-induced IBS symptoms.

Understanding the Role of Hormones

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Hormones serve as essential messengers within the body, regulating various functions of the endocrine system. The most familiar hormones include estrogen, progesterone, testosterone, adrenaline, and cortisol. This article primarily focuses on women’s hormones, specifically estrogen and progesterone, as they play a significant role in hormone-induced IBS symptoms.

Gender Differences in IBS

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Research indicates that gender influences the development, primary symptoms, incidence, and treatment options for IBS. Women are twice as likely as men to experience IBS, and their symptoms often manifest as bloating, constipation, abdominal pain, and incomplete bowel movements. Conversely, men more commonly report diarrhea as their main symptom. These gender-specific differences in symptoms can be attributed to variations in gastrointestinal (GI) transit time.

Women also tend to experience higher rates of anxiety and depression compared to both healthy women and men with IBS. Consequently, IBS tends to have a more profound impact on the quality of life among women.

Onset of Symptoms

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Gender-based disparities in IBS symptoms often begin during puberty and peak in early adulthood for women. As women age, they may notice a decline in symptoms, while men tend to experience consistent symptoms throughout adulthood.

The Hormone Roller Coaster

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To understand how hormones impact IBS, let’s take a closer look at the menstrual cycle, divided into four phases: menstruation, the follicular phase, ovulation, and the luteal phase. Estrogen and progesterone levels fluctuate throughout these phases, affecting various aspects of IBS symptoms. 

For instance, lower estrogen levels during menstruation are associated with higher incidences of stomach pain, diarrhea, bloating, and nausea. Bloating tends to occur more frequently during the luteal phase.

These hormonal fluctuations influence the gut-brain axis, a key player in the development of IBS and its symptoms. Sex hormones play a vital role in regulating the nervous system, which in turn affects factors like visceral sensitivity, motility, transit time, intestinal permeability, fluid and enzyme secretions, and immune functions—all contributing to the spectrum of IBS symptoms.

A Few Facts

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  • 40% of women observe the effects of their menstrual cycle on IBS symptoms, water retention, and concentration compared to 33% of women without IBS.
  • IBS sufferers may experience dysmenorrhea and premenstrual distress syndrome more frequently than healthy women.
  • Conditions like PCOS (polycystic ovary syndrome) can further complicate hormonal influences on IBS.

Menopause

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The impact of menopause on IBS remains a subject of ongoing study. While some data suggests that IBS symptoms improve over time after menopause, others indicate a worsening of symptoms for certain women. The relationship between menopause and IBS is complex and requires individual assessment.

Pregnancy

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During pregnancy, increased levels of ovarian hormones and opioid-mediated antinociception may contribute to symptom reduction in some women. Longer GI transit times during pregnancy can lead to constipation, gas, and bloating. Additionally, increased visceral sensitivity and abdominal pressure from the growing fetus may cause discomfort in IBS sufferers during pregnancy.

Birth Control Pills & HRT

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The effects of birth control pills and hormone replacement therapy (HRT) on IBS symptoms vary among individuals. While some women report symptom improvement, others experience worsened symptoms. It’s advisable to consult your healthcare provider when considering changes in hormonal medication.

Endometriosis

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Recent research suggests a connection between IBS symptoms and endometriosis. Both conditions share symptoms such as visceral sensitivity, bloating, diarrhea, constipation, and abdominal pain. Before diagnosing IBS, healthcare professionals often recommend ruling out endometriosis, especially in women. Treating endometriosis can lead to a resolution of IBS symptoms.

Strategies to Manage Hormone-Induced IBS Symptoms

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  1. Awareness and Symptom Tracking: Start by keeping an IBS symptom log, paying close attention to symptom severity in relation to your menstrual cycle.
  2. Low FODMAP Diet: Consider stricter adherence to the low FODMAP diet during times when you experience more hormone-induced IBS symptoms. Adjust portion sizes and explore low FODMAP meal and snack options.
  3. Fiber Modification: Adjust your fiber intake, focusing on low FODMAP fiber sources or supplements to regulate bowels.
  4. Alternative Therapies: Explore therapies like yoga and meditation, particularly during challenging times, to enhance motility and improve the gut-brain connection.
  5. Stress Management: Implement stress reduction techniques such as exercise, meditation, deep breathing, targeted hypnotherapy, and therapy to minimize the negative impact of stress on IBS symptoms.
  6. Exercise: Engage in light, low-intensity exercises like walking, hiking, swimming, or biking to alleviate symptoms like constipation and excessive gas. Avoid intense workouts if they exacerbate symptoms.
  7. Hydration: Maintain proper hydration with a focus on water intake. The recommended daily fluid intake is 64 to 80 ounces, which may vary based on individual factors.
  8. Supplements: Consider peppermint capsules, gas relief products with Simethicone, and digestive enzymes as potential supplements to ease IBS symptoms.

The Takeaway

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By following these strategies and being mindful of hormonal fluctuations, you can take control of your hormone-induced IBS symptoms and improve your overall well-being. Remember, consult with your healthcare provider for personalized guidance and recommendations.

Original article by Vanessa Vargas RDN written for FODMAP Everyday®.

For More Gut Health Guidance

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Our sister publication FODMAP Everyday is at the forefront of IBS education, particularly in relation to the low FODMAP diet. We have brought versions of many of the articles here for you:

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Author

  • Dede Wilson

    Dédé Wilson is a journalist with over 17 cookbooks to her name and is the co-founder and managing partner of the digital media partnership Shift Works Partners LLC, currently publishing through two online media brands, FODMAP Everyday® and The Queen Zone.

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