Sex Hormones and Irritable Bowel Syndrome

Women, in far greater numbers, deal with Irritable Bowel Syndrome (IBS). Several models have been proposed to examine the role of sex hormones in gastrointestinal function.

  • Sex hormones may influence peripheral and central regulatory mechanisms of the brain-gut axis involved in the pathophysiology of IBS contributing to the alterations in visceral sensitivity, motility, intestinal barrier function, and immune activation of intestinal mucosa.
  • Sex differences in stress response of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, neuroimmune interactions triggered by stress, as well as estrogen interactions with serotonin and corticotropin-releasing factor signaling systems are being increasingly recognized.

Middle-aged men presenting with IBS typically have lower LH levels while younger men who present with IBS are seen to have elevated SHBG values. Androgens, higher in males than females, appear to protect against the development of chronic pain disorders in humans, and testosterone exerts an analgesic effect in experimental pain models, in both men and women.

Differences in androgen levels, their receptors as well as sites of action may play a role in the sex difference in the risk of developing chronic pain disorders. There are only few reports concerning the role of sex hormones in male patients with IBS.

Houghton et al found that testosterone levels, although similar in the patient and control groups, correlated negatively with perceptual thresholds of rectal distension and overall well-being in IBS patients.

“Sex hormones in the modulation of irritable bowel syndrome,” World Journal of Gastroenterology, 2014 March 14,