BY MARIA SHAPOVAL (ND)
Did you know that estrogen, progesterone and testosterone influence your digestive health? In fact, many studies show that during pregnancy, when your hormones are going haywire, the symptoms of irritable bowel syndrome (IBS) are often improved; and sometimes, this fluctuation leads to aggravations in constipation. This hormonal-digestive connection and the fact that men and women produce different hormones (or different amounts of the same hormones) explains why IBS, inflammatory bowel disease (IBD) and gallstones affect women more often than men and why men are more prone to developing gastric ulcer and gastric cancers.
Find out what impact sex hormones have on several gastrointestinal conditions.
GASTRIC ULCERS
Gastric ulcers are sores, or openings, in the inner lining of the stomach. They typically lead to epigastric pain, nausea, frequent bouts of hunger and possible weight loss. Ulcers are more prevalent in men than women, and, according to an animal study by Machowaska and other researchers, may be aggravated by testosterone.
INFLAMMATORY BOWEL DISEASE (IBD)
IBD is a chronic inflammatory condition that involves various parts of the gastrointestinal tract and produces symptoms of bloody diarrhea, abdominal pain, reduced appetite and low-grade fever. Ulcerative colitis (UC) and Crohn’s disease are examples of this condition and are more prevalent in women than men. Dehydroepiandrosterone (DHEA), a precursor to several sex hormones, has been shown to be reduced in patients with IBD.
IRRITABLE BOWEL SYNDROME (IBS)
Irritable bowel syndrome is defined as a sensory-motor disorder of the digestive tract with symptoms of abdominal pain and alternating bowel habits, ranging from constipation to diarrhea. According to Mulak, IBS is more prevalent in female patients. It’s obvious that sex hormones influence IBS, as the symptoms change throughout the menstrual cycle and respond to oral contraceptive and hormone replacement therapies.
Estrogen has an inhibitory effect on colonic contractility, which results in slower transit time while progesterone appears to have dual function, with high dose reducing motility (the contraction of the muscles that mix and propel contents in the gastrointestinal tract) and low dose administration increasing motility. Fluctuations of progesterone throughout the menstrual cycle could play a role in the alternating constipation and diarrhea symptoms seen with irritable bowel syndrome.
While there are several physiological explanations of how the hormones impact IBS, more research needs to be done to determine the exact mechanism of how this happens.
In a pilot study by Andus and other researchers, 20 participants with UC and Crohn’s were supplemented with 200 milligrams DHEA once per day for 56 days. Supplementation resulted in clinically significant improvement in both groups with six of seven patients with Crohn’s and six of 13 patients with UC achieving remission and a decrease in blood diarrhea, abdominal pain and liquid stools.
GALLBLADDER DISEASE
Gallstones, in particular stones predominantly made of cholesterol, occur twice as frequently in women than men and are believed to be promoted by estrogen. Oral contraceptives and conjugated estrogen hormone replacement therapy both result in increased cholesterol gallstone formation. According to Wang, similar impact is demonstrated in men receiving estrogen for prostatic cancer therapy.
COLORECTAL CANCER (CRC)
Estrogen has been linked to not only reproductive cancers, such as breast and uterine, but also non-reproductive cancers like colorectal cancer. Women’s Health Initiative observation study supports the connection between hormones and CRC. According to Caiazza, it demonstrated a 30 per cent reduction in CRC incidence in post-menopausal women who received hormone replacement therapy (HRT).
CLOSING WORDS
While more research needs to be done to understand the role that sex hormones play in gastrointestinal health, exploring the connection between sex hormones and your gastrointestinal health may yield additional therapeutic approaches and interventions that you may not have been considered otherwise. VM
