Postmenopausal Women With Irritable Bowel Syndrome (IBS) Have More Severe Symptoms Than Premenopausal Women With IBS

Neurogastroenterol Motil. 2020 May 29;e13913. doi: 10.1111/nmo.13913. Online ahead of print.

Adrienne Lenhart 1, Bruce Naliboff 1 2, Wendy Shih 3, Arpana Gupta 1 2, Kirsten Tillisch 1 2, Cathy Liu 1 2, Emeran A Mayer 1 2, Lin Chang 1 2


Author information

1Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

2G Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA, USA.

3Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.


Background: Although irritable bowel syndrome (IBS) is more common in women, little is known about the role of hormonal changes and menopause in IBS. This study aimed to evaluate for differences in gastrointestinal (GI) and psychological symptoms between pre- and postmenopausal women with IBS compared to age-matched men with IBS.

Methods: Patients with Rome-positive IBS were identified. Premenopausal women were <45 years of age with regular menses. Postmenopausal women were ≥45 years without menses for at least 1 year. Younger men were <45 years, and older men were ≥45 years. Questionnaires measured severity of IBS symptoms, somatic symptoms, health-related quality of life (HRQOL), and psychological symptoms. Multivariable linear or logistic regressions evaluating relationships between age and sex were performed.

Key results: 190 premenopausal women (mean age 30.25 years), 52 postmenopausal women (mean age 54.38 years), 190 men <45 years (mean age 30.45 years), and 52 men ≥45 years (mean age 53.37 years) were included. Postmenopausal IBS women had greater severity of IBS symptoms (P = .003) and worse physical HRQOL (P = .048) compared to premenopausal women. No differences were observed between age-matched older and younger IBS men. Constipation increased with age for both sexes but was the principal IBS subtype in women only.

Conclusions and inferences: Postmenopausal women with IBS have more severe IBS symptoms than premenopausal women, while no comparable age-related changes were seen in IBS men. The modulatory effect of female sex hormones on brain-gut interactions which affect visceral perception and GI function likely contributes to these findings.

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