Do Women Experience Constipation More Frequently Than Men?

Constipation, an often hushed-up yet prevalent issue, affects millions of people globally, with women disproportionately shouldering the burden. Studies indicate that women were more than twice as likely as men to encounter constipation, raising questions about the underlying factors contributing to this gender disparity. 

While conventional wisdom points to differences in diet, lifestyle, and exercise, a deeper look reveals a complex interplay of hormones, physiology, and societal norms that make women more susceptible to this digestive discomfort. This exploration into the multifaceted nature of constipation aims to shed light on the reasons behind the unequal distribution of this condition, empowering women with the knowledge to address and manage this commonly overlooked aspect of their health and well-being.

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What is Constipation?

Constipation is a prevalent yet frequently under-discussed digestive concern that affects millions of individuals worldwide, with women disproportionately experiencing the condition. This common issue, characterized by infrequent, difficult, or painful bowel movements, can lead to abdominal discomfort, bloating, and in some cases, severe complications if left unaddressed. 

To understand why women face constipation more frequently than men, it's important to consider the complex interplay of factors such as hormonal fluctuations, physiological differences, and societal norms. These factors, which range from variations in estrogen and progesterone levels throughout a woman's menstrual cycle to differences in gut transit time, contribute to the higher prevalence of constipation among women. 

Despite the challenges and potential impact on quality of life, early recognition, open dialogue, and proactive management can help alleviate discomfort and prevent long-term complications, emphasizing the need for increased awareness and understanding of this common digestive ailment.

Common Women's Constipation Symptoms

Constipation can manifest differently in women, with a range of symptoms that vary in intensity and duration. However, it's crucial to recognize that not all women experiencing constipation will exhibit every symptom. Some women might have mild or occasional symptoms, while others might endure more severe or persistent issues. It's also important to note that the severity of symptoms does not necessarily correlate with the underlying cause or overall impact of constipation.

Common symptoms include (6,7,8):

• Infrequent bowel movements (typically less than three times per week)
• Straining during bowel movements
• Hard, dry, or lumpy stools
• A sensation of incomplete evacuation after a bowel movement
• Abdominal pain or discomfort
• Bloating and gas
• Lower back pain
• Fatigue and irritability due to ongoing discomfort

In some cases, women may also experience complications related to constipation, such as hemorrhoids or anal fissures, which can exacerbate the pain and discomfort associated with the condition.

What Causes Constipation in Women?

Various causes contribute to constipation. Below are some of the most common causes seen:

Anatomical Factors

Anatomical differences contribute to the higher prevalence of constipation among women. In addition, women are more susceptible to pelvic floor dysfunction, which can cause inadequate muscle coordination during bowel movements and worsen constipation.

Hormonal Factors

Hormonal fluctuations during a woman's menstrual cycle, pregnancy, and menopause can impact bowel function. Increased progesterone levels during pregnancy, for instance, can slow down the digestive system, leading to constipation. Additionally, the decline in estrogen levels during menopause can cause changes in bowel habits, making women more prone to constipation during this stage of life.

Diet, Gut Health and Hydration

A diet low in fiber and other nutrient deficiencies significantly contributes to constipation, especially among women who may not consume enough fiber-rich foods such as fruits, vegetables, and whole grains. This can lead to harder stools that are difficult to pass, which can be exacerbated by inadequate hydration, as water is essential for maintaining soft, easily passable stools.

In addition to fiber, nutrient deficiencies such as magnesium and potassium can also slow down the digestive process and weaken the muscles in the colon, making it harder for stool to pass through. Poor gut health can also contribute to constipation, as a disrupted gut microbiome can damage the gut lining and alter the balance of bacteria.

Physical Activity

A sedentary lifestyle can contribute to constipation in women. Regular physical activity promotes healthy bowel movements by stimulating intestinal muscles and increasing the efficiency of the digestive system. Women who engage in less physical activity may have a higher risk of experiencing constipation.

Stress and Psychological Factors

Stress and psychological factors can also play a role in the development of constipation. Women may be more prone to experiencing stress-related digestive issues, which can slow down the gastrointestinal system and lead to constipation. Furthermore, societal norms and the reluctance to use public restrooms may contribute to delayed bowel movements, causing constipation over time.

Medications

Certain medications, including antidepressants, painkillers, and calcium or iron supplements, can cause constipation as a side effect. Women taking these medications should be aware of the potential impact on their bowel function and discuss any concerns with their healthcare provider.

How to Relieve Constipation

Relieving constipation requires a multi-faceted approach that focuses on lifestyle modifications, dietary adjustments, and incorporating supportive therapies. By increasing fiber intake through whole grains, fruits, vegetables, and legumes, and ensuring adequate hydration, it is possible to promote regular bowel movements and soften stools. Engaging in regular physical activity can stimulate the digestive system and improve bowel function. Additionally, stress management techniques such as meditation, yoga, and deep breathing exercises can help alleviate stress-related constipation. 

Functional Medicine Labs to Test for Root Cause of Constipation

Functional medicine labs can be used to help uncover some underlying causes of constipation. Below are some of the most commonly run labs to get to the root cause:

Comprehensive Stool Analysis

The Comprehensive Stool Analysis by Doctor's Data is a valuable test for evaluating gut health in women experiencing constipation. The test analyzes stool samples for various markers of gastrointestinal health, including microbial balance, digestive enzyme levels, and inflammation. By identifying potential imbalances and digestive issues, the Comprehensive Stool Analysis can help uncover the root cause of constipation and guide targeted treatments to improve bowel function.

Organic Acids Test

The Organic Acids Test (OAT) by Great Plains Laboratory is a comprehensive metabolic assessment that measures over 70 markers in a urine sample, including those related to gut health, nutrient absorption, and detoxification. The OAT can provide insights into potential imbalances or deficiencies contributing to constipation by evaluating these markers. For example, certain organic acids can indicate dysbiosis or yeast overgrowth in the gut, which could be contributing factors to constipation.

Micronutrient Testing

The Micronutrient Test by SpectraCell Laboratories is a comprehensive assessment of your nutritional status, measuring the levels of various vitamins, minerals, and antioxidants in your blood. Certain nutrient deficiencies, such as magnesium and vitamin C, can contribute to constipation. You can optimize your diet and improve bowel function by identifying and addressing any deficiencies.

SIBO Testing

The SIBO Breath Test by Genova Diagnostics is a non-invasive test that measures hydrogen and methane gases in your breath to assess the presence of small intestinal bacterial overgrowth (SIBO). SIBO can cause various gastrointestinal symptoms, including constipation, bloating, and abdominal pain. If SIBO is identified as a contributing factor to your constipation, targeted treatment with antibiotics, probiotics, or dietary changes can help restore gut balance and improve bowel function.

Food Sensitivity Testing

The Cyrex Array 10 - Multiple Food Immune Reactivity Screen by Cyrex Laboratories is a food sensitivity test that measures your body's immune response to various foods. This test analyzes your blood sample for IgG and IgA antibodies against common food proteins. Identifying food sensitivities and making dietary adjustments accordingly can help relieve constipation and support better digestive health.

Hormone Testing

The DUTCH Complete test by Precision Analytical is an all-encompassing tool for evaluating hormone levels, adrenal function, and other markers that can be particularly relevant to women experiencing constipation. Hormonal imbalances, such as low thyroid function or imbalanced sex hormones like estrogen and progesterone, can contribute to constipation. The DUTCH Complete test measures various hormones and metabolites in your urine sample, including estrogen, progesterone, cortisol, DHEA-S, testosterone, and melatonin. It provides an in-depth analysis of women's hormone balance, including the different estrogen metabolites and their ratios, which can be crucial in understanding the impact of hormones on constipation and overall health. By examining these markers, the DUTCH Complete test can help reveal any hormonal imbalances that may be contributing to constipation, guiding targeted treatment and lifestyle interventions aimed at balancing hormones and enhancing overall well-being.

Any other Lab Test to Check 

In addition to the tests mentioned above, healthcare practitioners may also consider evaluating liver function when investigating constipation in women. Liver function tests assess the liver's health, which is essential for proper digestion and detoxification. 

Conventional Treatment for Constipation 

Conventional treatment for constipation typically involves the use of over-the-counter laxatives, stool softeners, and fiber supplements to help promote bowel movements. Increasing fluid intake and engaging in regular exercise are also recommended to support healthy digestion. In some cases, prescription medications may be necessary to address more severe or persistent constipation or treat conditions such as SIBO. However, it is essential to avoid over-reliance on laxatives, as they can potentially worsen constipation over time. 

Natural Remedies for Constipation

Addressing the underlying causes of constipation, such as anatomical factors, hormonal fluctuations, diet, hydration, physical activity, stress, and medications, can help alleviate symptoms. Evidence-based natural remedies for constipation encompass a range of lifestyle modifications, dietary adjustments, and complementary therapies that can effectively support healthy bowel function.

Hydration

Adequate fluid intake is crucial for maintaining soft, easily passable stools. Consuming sufficient water and other hydrating beverages, such as herbal teas and electrolyte-rich drinks, can help prevent and alleviate constipation. 

Physical Activity

Regular exercise promotes healthy bowel movements by stimulating intestinal muscles and increasing the efficiency of the digestive system. Engaging in various forms of physical activity, such as walking, swimming, or yoga, can help prevent and alleviate constipation.

Stress Management

Stress and psychological factors can negatively impact bowel function. Incorporating stress management techniques, such as deep breathing exercises, mindfulness meditation, or progressive muscle relaxation, can help alleviate stress-related digestive issues and improve overall well-being.

Fiber Supplements

Various evidence-based fiber supplements can help alleviate constipation. Psyllium husk, a natural soluble fiber, has been shown to be effective in promoting regular bowel movements. Other fiber supplements, such as methylcellulose and inulin, may also be helpful. Ensure adequate fluid intake when using fiber supplements to avoid worsening constipation.

Probiotics

Probiotic supplements, which contain beneficial bacteria, can help improve gut health and alleviate constipation. Look for products containing well-researched strains and follow the recommended dosing guidelines on the product label.

Herbal Remedies

Certain herbal remedies, such as senna, aloe vera, and flaxseed, have been used traditionally to treat constipation. Senna contains natural compounds called sennosides, which stimulate bowel movements by irritating the intestinal lining. Aloe vera and flaxseed, on the other hand, act as natural laxatives by softening stools and increasing their bulk. 

However, if SIBO is detected on testing, it is important to address this condition first, as it can contribute to constipation. Treatment for SIBO may involve a course of antibiotics (if treated conventionally) or herbal antimicrobials, along with dietary changes to eliminate foods that feed the bacteria in the small intestine.

Liver and Thyroid Support

If your liver needs support look for products that are specifically formulated to support liver function and detoxification. Supplements containing ingredients such as milk thistle, N-acetyl cysteine (NAC), alpha-lipoic acid (ALA), and glutathione are known to support liver health. For thyroid support, it is important to consume nutrients that are essential for thyroid hormone production and metabolism, such as iodine, selenium, zinc, and vitamin D. Supplements containing these nutrients may be beneficial for those with thyroid imbalances.

Hormone Imbalances

If hormone imbalances are responsible for constipation, remedies such as adding fiber-rich foods to the diet, regular exercise, adequate sleep, various supplements, and stress management may help alleviate symptoms. However, it is always important to consult with your doctor to determine the underlying cause and develop an appropriate treatment plan which may include hormone replacement therapy or other medical interventions.

Other Considerations

It is also important to note that if you are found to be low in essential vitamins or minerals, it is important to replete them either through dietary changes or supplements, as deficiencies can contribute to constipation and other health issues.

In addition, delaying a bowel movement can worsen constipation. It is advised to respond to the urge to have a bowel movement as soon as possible to prevent stool from becoming hard and difficult to pass.

As described above, some medications, such as antidepressants, can cause constipation as a side effect. If you suspect that the medications you are taking are contributing to your constipation, it is essential to speak to your doctor before abruptly stopping them, as this can lead to other health complications. Your healthcare provider may suggest alternative medications or changes in dosage to alleviate your constipation symptoms.

Foods to Avoid When Constipated

To further support bowel health, avoiding foods that can contribute to constipation is important. Foods that may cause constipation include processed foods, high-fat foods, excessive dairy products, refined carbohydrates, red meat, and fried items. Some specific examples are white bread, pastries, chips, fast food, and processed meats like hot dogs and sausages. Additionally, caffeine and alcohol can contribute to dehydration, exacerbating constipation. Identifying any personal food sensitivities and adjusting your diet accordingly may alleviate constipation and enhance overall gut health.

Foods That Help With Constipation

Maintaining a well-balanced, nutrient-dense diet is crucial in preventing and managing constipation. A diet abundant in whole grains, fruits, vegetables, and healthy fats, such as a Mediterranean-style diet, has been shown to enhance digestive health and improve gastrointestinal function. To alleviate constipation, it is essential to incorporate fiber-rich foods, including whole grains, fruits, vegetables, and legumes. Consuming foods high in soluble fiber, like apples, oranges, and oats, can help soften stools, while the insoluble fiber found in vegetables, whole grains, and seeds can add bulk to stools, promoting regular bowel movements.

Best Fiber Supplement for Constipation

Finding the best fiber supplement for constipation can be essential in providing relief and promoting regular bowel movements. Psyllium husk, a natural soluble fiber, is one supplement that has been shown to be effective in promoting regular bowel movements. As a soluble fiber, psyllium husk absorbs water in the gut, forming a gel-like substance that helps soften stools and ease their passage. 

In addition to psyllium husk, other fiber supplements that can aid in relieving constipation include methylcellulose, which is a non-fermentable fiber derived from plant cellulose, inulin, a prebiotic fiber found in various plants, and flaxseed. Flaxseed is a rich source of both soluble and insoluble fiber, as well as omega-3 fatty acids, which can help promote bowel regularity and overall digestive health. 

Yoga for Constipation

Yoga can be an effective natural remedy for constipation, as it encourages physical movement, reduces stress, and promotes relaxation, which can all contribute to better digestive health. Various yoga poses, such as twists, forward bends, and inversions, can help stimulate the digestive system and encourage bowel movements. Practicing yoga regularly may lead to long-term improvements in bowel function and overall gut health.

In addition to yoga, other complementary therapies can also help alleviate constipation. Acupuncture, for example, has been found to promote bowel movements by stimulating specific points on the body, thereby improving digestive function. Chiropractic care, which often involves spinal adjustments and soft tissue therapy, may help relieve tension in the pelvic region, potentially reducing constipation-related discomfort.

Vitamin therapy, including supplementation of essential nutrients like magnesium, can support proper muscle function and bowel movements. 

Massage therapy can help relax tense muscles in the abdomen and pelvic region, which may contribute to constipation. Massage can promote better digestion and encourage regular bowel movements by easing muscle tension.

Meditation and other mindfulness practices can also play a role in managing constipation, as they can help reduce stress and promote relaxation. Stress has been linked to digestive issues, including constipation, so finding ways to manage stress can improve gut health.

Lastly, physical therapy can help address any underlying musculoskeletal issues or pelvic floor dysfunction that may be contributing to constipation. A physical therapist can provide personalized exercises and stretches to target problem areas and improve bowel function.

Pressure Points for Constipation 

Acupressure is another alternative therapy that can help with constipation. Several studies have shown that this technique positively affects constipation symptoms, including stool frequency, stool consistency, and straining during bowel movements. Applying pressure to specific points on the body, such as the Large Intestine 4 (LI4) point, located between the thumb and index finger, or the Conception Vessel 6 (CV6) point, located a few finger-widths below the navel, may help stimulate bowel movements and alleviate constipation. 

Summary

Constipation is a common digestive issue that affects many people worldwide. Women tend to experience constipation more frequently than men due to factors such as anatomical differences, hormonal fluctuations, and lifestyle habits. Addressing constipation through a comprehensive approach that includes dietary adjustments, increased physical activity, and stress management can help improve bowel function and overall well-being. Understanding the unique factors that contribute to constipation in women and adopting a holistic approach to managing the condition can alleviate symptoms and enhance overall digestive health.