Irritable Bowel Syndrome and Menopause

Irritable Bowel Syndrome (IBS) is a disorder of the gut-brain interaction resulting in abdominal pain and alterations in bowel function, both diarrhea and constipation. IBS affects about 12-15% of the population. The severity of gastrointestinal (GI) symptoms in women fluctuate during menstrual cycles continuing through the menopause transition and past menopause.

Sex hormones have been linked to GI function, with evidence showing a higher prevalence and more severe symptoms in women with IBS than in men. Alterations in sex hormones, such as lower estrogen during perimenopause, may cause an inflammatory response in the gut leading to increased permeability leaking water and nutrients that can exacerbate symptoms.  Women with IBS report more abdominal bloating and dyspepsia during and after the menopause transition. 

Does hormone therapy help? It depends. Research indicates that oral contraceptives may help relieve IBS symptoms in women under age 35, however a large population study of women over age 50 had the opposite results. 

Symptoms of IBS can be managed with holistic lifestyle changes for most midlife women by following these tips:

• Try to discover and eliminate food triggers by following an elimination diet, such as low FODMAP diet.
• Exercise daily to normalize gut motility.
• Prioritize stress management and self-care.
• Get at least seven hours of good sleep every night.