So THAT's Why Women Are More Constipated Than Men

When it comes to toilet habits, women really do have it hard — pun intended. 

Recently, ZOE conducted the largest study into bowel habits that the world has ever seen and the results might surprise you. The Big Poo Review (as it’s been called) – in partnership with Steph’s Packed Lunch, on Channel 4 – provides an unabridged peek into the bathrooms of Britain. 

The study rounded up 142,768 people in the United Kingdom aged 18 or older, including 110,627 women, 32,023 men and 118 people who selected ‘other’. The good news is that the data revealed that 97.2% of people fall between the healthy ranges of poo frequency (yes — that’s a thing). However, ZOE also uncovered that constipation is actually pretty common.

Up to 25% of us are constipated – but, a significant amount of frequently constipated participants were women (23% compared with male participants 13%). Why?

Dr Will Bulsiewicz, ZOE’s US medical director and a board-certified gastroenterologist, explains that there could be a number of reasons for this difference

Why are women more constipated than men?

Biologically speaking, women have longer bowel transit times than men. Which means that it takes longer for the food to move through your body and through your bowel. 

Colonic motility (the movement of poop through the colon) is greatly affected by female sex hormones. Particularly, progesterone. 

Hormones fluctuate frequently in the female body to account for the four phases of the menstrual cycle. Interestingly, research shows that the luteal phase (which begins around day 15-28 of your cycle) is when you’re most likely to become constipated, because of the increase in progesterone, which has an ‘inhibitory’ effect (i.e. slows down colonic motility).

Constipation is also more common in menopause. Menopause typically starts between the ages of 45-55 and during this time, progesterone and estrogen production declines. This has a huge effect on the female body as a whole as the fertility function begins to clock out, which can be tremendously disruptive.

Hormones are our body’s signallers. They singlehandedly work in unison (if you’re lucky) to help keep everything regulated. When our hormones become dysregulated (like in menopause, pregnancy or throughout our menstrual cycle) it can result in getting a bit bunged up... so to speak.

Women are also more susceptible to a number of under-researched and underfunded chronic endocrine-related (hormone) conditions that can disrupt bowel health, like polycystic ovarian syndrome (PCOS) and endometriosis. One in ten women (AFAB) will develop PCOS, while the commonality of endometriosis is similar to that of diabetes. 

Researchers have questioned whether there is a link between PCOS and irritable bowel syndrome (IBS), but having PCOS doesn’t mean you’ll have IBS, or vice-versa. However, some people with PCOS symptoms do meet the Rome IV criteria (a poo scale!). Perhaps this is unsurprising as the syndrome creates disturbances in the endocrine, metabolic and immune systems.

Endometriosis, a gynaecological condition that has the power to fuse organs together and cause an immense amount of pain can be found throughout the body. It is especially common in areas where female sex hormones are created, like the ovaries (where oestrogen and progesterone are produced) and in the gastrointestinal tract (where our gut microbiome lives).

Stress can also affect our poo, as stress is signalled by elevated hormones cortisol and adrenaline, which if felt in a chronic state can shake up our entire endocrine system and make us feel quite unwell. And, stress can cause constipation.

Women are more stressed out than men too, with 84% reporting perceived stress to men’s 67%.

Every which way you look, from societal factors and the likelihood of developing chronic ill-health to the way our bodies function. The constipation odds are truly stacked against us.