Margaret M Heitkemper1, Lin Chang. 1. Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington 98125-7266, USA. heit@u.washington.edu
Abstract
BACKGROUND: An increase in gastrointestinal (GI) symptoms, including bowel discomfort, abdominal pain/discomfort, bloating, and alterations in bowel patterns, has been reported during premenses and menses menstrual cycle phases and the perimenopause period in women with and without irritable bowel syndrome (IBS). OBJECTIVE: This article reviews the literature related to one possible physiological mechanism-declining or low ovarian hormone levels--that may underlie the occurrence or exacerbations of abdominal pain/discomfort at times of low ovarian hormones (menses, menopause) in women with or without IBS. METHODS: To identify English-only review and data-based articles, PubMed was searched between January 1980 and September 2008 using the following terms: irritable bowel syndrome, functional gastrointestinal disorders, gastrointestinal motility, immune, pain, hyperalgesia, menstrual cycle, menopause, pregnancy, estrogen, estradiol (E(2)), and progesterone. Studies in animals and in humans were included; drug trials were excluded. RESULTS: From our review of the literature, 18 papers were identified that were related either to the mechanisms accounting for menstrual cycle fluctuations (n = 12) or to the impact of menopausal status on symptoms of IBS (n = 6). One study reported that visceral pain sensitivity was significantly higher during menses than at other menstrual cycle phases in women with IBS (P < 0.05). Other menstrual cycle phase-linked symptoms, dysmenorrheal symptoms (cramping pain) in particular, were more intense in women with IBS. Animal studies have shed some light on the relationship of ovarian hormones to GI sensorimotor function. CONCLUSION: The increase in GI symptoms around the time of menses and early menopause occurs at times of declining or low ovarian hormones, suggesting that estrogen and progesterone withdrawal may contribute either directly or indirectly. This review highlights the need for confirmatory preclinical and clinical studies to unravel the role of ovarian hormones in women with IBS.
BACKGROUND: An increase in gastrointestinal (GI) symptoms, including bowel discomfort, abdominal pain/discomfort, bloating, and alterations in bowel patterns, has been reported during premenses and menses menstrual cycle phases and the perimenopause period in women with and without irritable bowel syndrome (IBS). OBJECTIVE: This article reviews the literature related to one possible physiological mechanism-declining or low ovarian hormone levels--that may underlie the occurrence or exacerbations of abdominal pain/discomfort at times of low ovarian hormones (menses, menopause) in women with or without IBS. METHODS: To identify English-only review and data-based articles, PubMed was searched between January 1980 and September 2008 using the following terms: irritable bowel syndrome, functional gastrointestinal disorders, gastrointestinal motility, immune, pain, hyperalgesia, menstrual cycle, menopause, pregnancy, estrogen, estradiol (E(2)), and progesterone. Studies in animals and in humans were included; drug trials were excluded. RESULTS: From our review of the literature, 18 papers were identified that were related either to the mechanisms accounting for menstrual cycle fluctuations (n = 12) or to the impact of menopausal status on symptoms of IBS (n = 6). One study reported that visceral pain sensitivity was significantly higher during menses than at other menstrual cycle phases in women with IBS (P < 0.05). Other menstrual cycle phase-linked symptoms, dysmenorrheal symptoms (cramping pain) in particular, were more intense in women with IBS. Animal studies have shed some light on the relationship of ovarian hormones to GI sensorimotor function. CONCLUSION: The increase in GI symptoms around the time of menses and early menopause occurs at times of declining or low ovarian hormones, suggesting that estrogen and progesterone withdrawal may contribute either directly or indirectly. This review highlights the need for confirmatory preclinical and clinical studies to unravel the role of ovarian hormones in women with IBS.
Authors: S A Müller-Lissner; S Bollani; R J Brummer; G Coremans; M Dapoigny; J K Marshall; J W Muris; A Oberndorff-Klein Wolthuis; F Pace; L Rodrigo; R Stockbrügger; M H Vatn Journal: Digestion Date: 2001 Impact factor: 3.216
Authors: Bruno P Chumpitazi; Erica M Weidler; Danita I Czyzewski; Mariella M Self; Margaret Heitkemper; Robert J Shulman Journal: J Pediatr Date: 2016-09-14 Impact factor: 4.406
Authors: Richard J Traub; Dong-Yuan Cao; Jane Karpowicz; Sangeeta Pandya; Yaping Ji; Susan G Dorsey; Dean Dessem Journal: J Pain Date: 2014-06-26 Impact factor: 5.820
Authors: Arpana Gupta; Emeran A Mayer; Connor Fling; Jennifer S Labus; Bruce D Naliboff; Jui-Yang Hong; Lisa A Kilpatrick Journal: J Neurosci Res Date: 2017-01-02 Impact factor: 4.164
Authors: Pablo M Linares; Alicia Algaba; Ana Urzainqui; Mercedes Guijarro-Rojas; Rafael González-Tajuelo; Jesús Garrido; María Chaparro; Javier P Gisbert; Fernando Bermejo; Iván Guerra; Víctor Castellano; María-Encarnación Fernández-Contreras Journal: Dig Dis Sci Date: 2017-08-19 Impact factor: 3.199