IBS and the menopause: what’s the link?

Advice on managing this complex gut condition

What is IBS?

Irritable Bowel Syndrome (IBS) is a common problem that aﬀects the gut. Symptoms can include abdominal pain or discomfort, bloating and a change in bowel habit – these are symptoms that people without IBS can experience from time to time, but with IBS they tend to be more frequent and more severe.

IBS can start at any age, often in early adulthood, and it’s usually a longterm condition. The exact cause is unknown, but it has been linked to genes, diet and infection, and is often associated with times of stress or life changes. IBS is twice as common in women as it is in men [1].

How is IBS linked to the menopause?

If you already have IBS, your symptoms may become exacerbated by the hormonal changes during the perimenopause or menopause.

A study also found that postmenopausal women with IBS have more severe IBS symptoms that premenopausal women, while no comparable age-related changes were seen in men who had IBS. This suggests that the effect of oestradiol (a form of oestrogen) and progesterone on modulating the brain-gut interactions could be a contributing factor [2].

How can I treat IBS?

While there is no one diet or medicine that works for everyone, lifestyle and diet changes can have an impact. People with IBS usually ﬁnd a low FODMAP diet very helpful. It means avoiding foods high in certain sugars (carbohydrates) that are hard to digest, including some fruits, vegetables, cereals and dairy foods.

The IBS Network has an Eatwell Guide that offers guidance on healthy eating and how to have a rich and varied diet while minimising gut discomfort [3]. It’s also important to keep hydrated, and limit or avoid alcohol, fizzy drinks, tea and coffee.

If diet changes don’t help your symptoms, consult your GP. Similarly, see your GP if you have:

Lost a signiﬁcant amount of weight without trying to
Bloody diarrhoea or bleeding from your anus
New symptoms of indigestion that persist despite changes in your diet and lifestyle
A persistent change in your bowel habit with no explanation, such as loose bowel motions for several weeks
A feeling you need to open your bowels but nothing comes out.

References

1. NICE guidance: Irritable Bowel Syndrome in adults

2. Lenhart A, Naliboff B, Shih W, Gupta A, Tillisch K, Liu C, Mayer EA, Chang L. 2020, ‘Postmenopausal women with irritable bowel syndrome (IBS) have more severe symptoms than premenopausal women with IBS’, Neurogastroenterol Motil. 32(10):e13913. doi: 10.1111/nmo.13913

3. The IBS Network: so what can I eat?

Resources

The IBS Network

NHS: Irritable Bowel Syndrome