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Living with irritable bowel syndrome (IBS) often means you never know when a flare-up is going to strike. Will it be a first date? That big presentation? IBS to the rescue!

It may be one of the most common gastrointestinal disorders out there, but the symptoms of IBS are different for everyone, including between the sexes.

Studies have shown that IBS is more common in women than in men. And in a world that pressures women to pretend they don’t poop at all (lest we tarnish our feminine purity with a case of TBS — Taco Bell Shits), debilitating abdominal pain and abnormal bowel habits are less than ideal.

IBS can be exhausting and frustrating, but knowing what to expect and how to treat your symptoms can go a long way. Here’s a complete guide to what IBS feels like for women and how to stay ahead of your symptoms.

Constipation

While many people assume that IBS always means going to the bathroom often, that’s not true: constipation is a common symptom, especially among women.

In fact, studies have shown that IBS with constipation (sometimes called IBS-C) is more common in women. Constipation causes infrequent stools, and when they do come, they’re typically hard, dry, and difficult to pass (all in all, not a fun time).

Women with IBS will likely also experience abdominal pain and bloating that often go hand in hand with being constipated.

Diarrhea

Even though diarrhea can strike at any time, many women with IBS will experience diarrhea right before they get their period.

Unlike constipation, diarrhea means frequent loose stools. When you have it, you’ll usually also experience lower abdominal pain and cramping before it happens. You might also notice that there’s mucus in your stool.

Bloating

Bloating is described as a tight feeling in the upper abdomen and makes you feel full faster — it also may make you feel (and look) like you’ve got a balloon lodged in your stomach.

Women are more likely to experience bloating in IBS, especially when it comes to their menstrual cycles: Women with IBS have been found to experience more bloating during PMS than women who don’t have IBS.

Fatigue

All of that pain in your abdominal area is no joke, and if you find yourself exhausted whenever a flare-up happens, it’s not a coincidence. Fatigue is a frequent symptom of IBS, and some evidence shows that it might affect women more than men.

Researchers have found that poor sleep quality and insomnia can be linked to fatigue from IBS. The level of fatigue seems to be dependent on the severity of other symptoms.

Urinary incontinence

Urinary incontinence basically means a loss of control when it comes to urination and often leads to leakage of urine. It may also include more frequent urination, increased urgency (as in, “I have to pee, and I have to pee NOW”), excessive urination at night, and painful urination.

A small 2010 study found that women who have IBS are more likely to experience this than women without IBS.

Depression

When it comes to IBS, it’s not just about physical stuff. Women with IBS are also found to experience depression related to their IBS, which is probably because the disorder can seriously affect your daily life.

One study found that women were more affected than men by how IBS interrupts their responsibilities as mothers and partners as well as at work.

In other words: Women may get depressed over the way IBS affects their daily life.

Anxiety

Women with IBS can also experience a lot of anxiety related to the disorder.

Some research speculates that this is because women are socialized to believe that their bodily functions are private, and to lose control of them is embarrassing — and IBS can definitely cause you to lose control of them.

Researchers show that women with IBS are more worried about that loss of control than men are, and that they’re particularly worried about diarrhea.

Unfortunately, anxiety has also been linked to IBS as a trigger for symptoms. So while symptoms can cause anxiety, anxiety can also bring on the symptoms, making it a vicious circle that is hard to escape.

The good news? Nowadays there are more treatments for anxiety than ever. From exercise and meditation to seeking out a therapist who specializes in chronic illness, chat with your doctor about your options. They can help you determine what treatments are best for you.

Pelvic organ prolapse

A descending or drooping of the pelvic floor organs, pelvic organ prolapse happens when the muscles and tissues that hold the pelvic organs in place become weak or loose.

That weakness can lead to organs falling out of place.

Research has shown that women with IBS are more likely to experience this due to the chronic constipation and diarrhea that often goes along with IBS.

Higher risk of endometriosis

Research has shown that women who have IBS have a higher risk of being diagnosed with endometriosis.

If you have this gynecological disorder, tissue that forms the lining of your uterus will grow outside of your uterine cavity. This is called endometrial tissue, and it can then grow on your ovaries, bowels, and tissues lining your pelvis.

Endometriosis is painful and can cause extreme discomfort, serious PMS symptoms, and even infertility.

Chronic pelvic pain

If you’re experiencing persistent pain below your belly button, it’s possible that you have chronic pelvic pain, and it usually lasts more than 6 months. Chronic pelvic pain is more common among women who have IBS.

One study found that one-third of women who have IBS also have long-lasting pelvic pain.

Painful sex

Women who have IBS are more at risk for experiencing painful sex and other types of sexual dysfunction. This pain typically happens during deep penetration.

And it’s not just about feeling pain: People with IBS often say they have a lower sex drive and have trouble getting aroused. If a women is having trouble getting aroused, then she may not be lubricated enough, which can in turn cause the painful sex.

Worse PMS

Don’t shoot the messenger, but research shows that women with IBS often have a worsening of PMS. At the same time, they also may have worse IBS symptoms during certain periods of their menstrual cycle. IBS can also cause periods to be heavier.

We know — it effing sucks.

Experts still don’t know exactly what causes IBS, and just about anyone can get it at any time in their life (boooo). Still, there are a few things that are known to increase your risk of getting the disorder:

  • being a woman
  • being under the age of 50
  • having a family history of IBS
  • having a mental health condition like depression or anxiety

Again, IBS is a tricky thing. Not only do experts not know the cause, but they also don’t have a definitive test to diagnose someone.

Getting diagnosed often comes down to a process of elimination. Your healthcare provider first needs information on your medical history and symptoms, and they’ll run other tests to rule out other conditions.

Some of the tests they may perform include:

  • sigmoidoscopy
  • colonoscopy
  • stool culture
  • X-ray
  • CT scan
  • endoscopy
  • lactose intolerance test
  • gluten intolerance test

You basically need to make sure there isn’t something else going on (like a gluten allergy or a parasite) before they can tell you that you have IBS.

After being tested, you’ll be diagnosed if you’ve also experienced the following:

  • Abdominal symptoms that have been pretty consistent, lasting at least 1 day a week for the past 3 months. If you only feel sick “once in a while,” you probably won’t get diagnosed.
  • Pain and discomfort that are relieved by having a bowel movement.
  • A consistent change in your bowel movements, whether it’s how often you go or what kind of stool you’re experiencing.
  • The presence of mucus in your stool. In other words: Look at your bowel movements to see what’s going on.

Let this be yet another reminder of how tricksy IBS can be: Treatments can vary from person to person, and finding what works for you can take a lot of trial and error.

There are some popular treatments worth trying as you attempt to figure out what calms your flare-ups.

  • Get regular physical exercise.
  • Try food elimination diets to figure out which foods trigger flare-ups for you, then eliminate those foods from your diet.
  • Cut back on caffeine, which can stimulate the intestines and make things more painful.
  • Eat smaller meals.
  • Minimize stress and anxiety through therapy or anti-anxiety medications.
  • Take probiotics to boost good bacteria in your gut.
  • Avoid deep-fried and spicy foods, which often trigger flare-ups.
  • Take doctor recommended medications to ease muscle spasms and relieve pain.

Keep in mind that there’s no known cure for IBS. All treatments are more about relieving symptoms and pain rather than curing your disorder. That being said, it is absolutely possible to live a healthy, happy life with IBS. It may just take some experimentation to find what treatments work best for you.

The bottom line

  • IBS is more common in women, who can experience different symptoms than men due to hormones.
  • Symptoms include: constipation, diarrhea, bloating, fatigue, urinary incontinence, depression, anxiety, pelvic organ prolapse, higher risk of endometriosis, chronic pelvic pain, painful sex, and worse PMS symptoms.
  • Being young, having a family history of IBS, and having a mental condition like stress or anxiety can increase your chances of having IBS.
  • Treatments vary greatly and finding what works for you can be a lot of trial and error.