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Digestion in Women

  • The Impact of Hormones and Female Anatomy

  • Women’s gastrointestinal (GI) systems are different than that of men’s. Not only are women physically dissimilar, some organs also operate differently, and then there are the hormones!

    “There are two major differences between male and female GI tracts,” explains Shakti Singh, M.D., a gastroenterologist and hepatologist at Sutter Gould Medical Foundation in ModestoOpens new window. “One involves the fact that women have a uterus and ovaries and the colon has to go around them, hypothetically making the colon’s route more convoluted. The second difference is hormones and their effect on the female GI tract.”

    Hormones and a GI system that’s more sensitive to irritants may explain the propensity of women to be six times more likely to have irritable bowel syndrome - their most common GI complaint - compared to men.

    Some more differences:

    • Women have more sensitive bitter and sweet tastebuds.
    • Certain organs in a woman’s GI tract—the esophagus, small intestine, colon or large intestine and rectum—are more sensitive. This can make women experience heartburn more strongly than men. Because aspirin and aspirin-like compounds known as non-steroidal anti-inflammatory drugs (NSAIDs) can increase a woman’s risk of developing stomach ulcers, gastritis or inflammation of the stomach, and bleeding from the stomach, a woman should work with her doctor to create a plan to protect her stomach if she takes NSAIDs.
    • A woman’s muscles that prevent the backflow of food and stomach acid into the esophagus and windpipe are stronger and more efficient. Although this can increase the sensation of having a “lump in your throat,” these strong muscles may also increase a woman’s protection against esophageal damage caused by heartburn and acid reflux.
    • A woman secretes less stomach acid than a man, reducing her risk of developing acid-related ulcers.
    • A woman’s stomach empties food more slowly than a man’s, increasing the incidence of nausea and bloating.
    • Until old age (when the difference disappears), a woman’s large intestine empties more slowly than a man’s, increasing her risk of constipation.
    • Anatomical differences in the rectum and anal canal make a woman less able to handle an episode of diarrhea.
    • The hormones progesterone and estrogen can make a woman’s gallbladder empty more slowly and increase the cholesterol in her gallbladder, doubling her risk of developing gallstones.
    • A woman has a different enzyme system that breaks down medications in the small intestine and liver, so she tolerates various medications differently.
    • Hormones produced during pregnancy can affect a woman who has been diagnosed with inflammatory bowel disease such as Crohn’s Disease or ulcerative colitis, making the problem get better, get worse or remain unchanged. Hormones can also increase a pregnant woman’s experiences of nausea, gallstones and heartburn.
    • For women, colon cancer (the third most frequent type of cancer for American women) may be associated with breast cancer, never giving birth to children, and cancer on the right side of the colon.

    “A healthy lifestyle can go a long way in maintaining GI health,” Dr. Singh observes. Both women and men should drink at least eight glasses of water — approximately 64 ounces — every day, and juices, teas and coffee don’t count. Along with that, maintain a healthy weight, eat a nutritious diet that includes foods which are high in fiber, and get regular exercise.”

    It’s also important that women of average risk for colon cancer get a colonoscopy when they reach age 50, Dr. Singh says. “Cancer on the right side of a woman’s colon can be missed with a routine flexible sigmoidoscopy test, which only looks at the left side of the colon.”

    In addition, mothers should educate their daughters about their family history of cancers, including but not limited to colon and stomach cancers, Dr. Singh adds. “A family history of certain types of breast, bladder and ovarian cancers can increase a woman’s risk of developing colon cancer. If certain risk factors exist in your family history, your doctor may recommend screening at an earlier age and at more frequent intervals.”

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