Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
G Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA, USA.
Neurogastroenterol Motil. 2020 Oct;32(10):e13913. doi: 10.1111/nmo.13913. Epub 2020 May 29.
Although irritable bowel syndrome (IBS) is more common in women, little is known about the role of hormonal changes and menopause in IBS. This study aimed to evaluate for differences in gastrointestinal (GI) and psychological symptoms between pre- and postmenopausal women with IBS compared to age-matched men with IBS.
Patients with Rome-positive IBS were identified. Premenopausal women were <45 years of age with regular menses. Postmenopausal women were ≥45 years without menses for at least 1 year. Younger men were <45 years, and older men were ≥45 years. Questionnaires measured severity of IBS symptoms, somatic symptoms, health-related quality of life (HRQOL), and psychological symptoms. Multivariable linear or logistic regressions evaluating relationships between age and sex were performed.
190 premenopausal women (mean age 30.25 years), 52 postmenopausal women (mean age 54.38 years), 190 men <45 years (mean age 30.45 years), and 52 men ≥45 years (mean age 53.37 years) were included. Postmenopausal IBS women had greater severity of IBS symptoms (P = .003) and worse physical HRQOL (P = .048) compared to premenopausal women. No differences were observed between age-matched older and younger IBS men. Constipation increased with age for both sexes but was the principal IBS subtype in women only.
Postmenopausal women with IBS have more severe IBS symptoms than premenopausal women, while no comparable age-related changes were seen in IBS men. The modulatory effect of female sex hormones on brain-gut interactions which affect visceral perception and GI function likely contributes to these findings.
尽管肠易激综合征（IBS）在女性中更为常见，但对于激素变化和绝经在 IBS 中的作用知之甚少。本研究旨在评估与年龄匹配的 IBS 男性相比，绝经前和绝经后 IBS 女性的胃肠道（GI）和心理症状是否存在差异。
确定罗马阳性 IBS 患者。绝经前女性年龄<45 岁，月经规律。绝经后女性年龄≥45 岁，闭经至少 1 年。年轻男性<45 岁，老年男性≥45 岁。问卷调查评估 IBS 症状严重程度、躯体症状、健康相关生活质量（HRQOL）和心理症状。进行多变量线性或逻辑回归评估年龄和性别之间的关系。
共纳入 190 名绝经前女性（平均年龄 30.25 岁）、52 名绝经后女性（平均年龄 54.38 岁）、190 名<45 岁男性（平均年龄 30.45 岁）和 52 名≥45 岁男性（平均年龄 53.37 岁）。与绝经前女性相比，绝经后 IBS 女性的 IBS 症状严重程度更高（P=.003），身体 HRQOL 更差（P=.048）。年龄匹配的老年和年轻 IBS 男性之间未观察到差异。便秘在两性中随年龄增长而增加，但仅在女性中是主要的 IBS 亚型。
与绝经前女性相比，绝经后 IBS 女性的 IBS 症状更严重，而在 IBS 男性中未观察到可比的与年龄相关的变化。女性性激素对影响内脏感知和 GI 功能的脑-肠相互作用的调节作用可能导致了这些发现。
