Why are women more prone to constipation than men? 5 ways to help you!

There are many differences between men and women, but you may not know that it is really more difficult for women to poop than men .

Women usually spend more time squatting or sitting in the toilet, and this is true both in China and abroad. A study specifically analyzed papers related to constipation in Chinese people published from January 1995 to April 2014 and found that the prevalence of constipation in Chinese women is 40% higher than that in men. [1]

A survey in the Netherlands showed that women are twice as likely to suffer from constipation as men . [2]

Why are women more prone to constipation than men? Let’s talk about it in detail today.

01

Why are women more prone to constipation than men?

1. Physiological differences

From a physiological perspective, women have certain characteristics that make it easier for stool to remain in the body. Studies have found that women have longer colons than men (155cm vs 145cm)[3], which means that food and excrement stay in the colon longer. During this process, the colon may absorb more water, causing the stool to become dry and hard.
Estrogen and progesterone, the characteristic hormones of women, can inhibit smooth muscle contraction and slow down intestinal peristalsis, so women’s gastrointestinal transit speed is slower than men’s. [4] Walking slowly and over a long distance naturally makes it difficult for stool to pass out.

2. Pelvic floor muscle dysfunction

Pelvic floor muscle dysfunction and constipation are a pair of brothers who affect each other. Due to pregnancy and other reasons, pelvic floor muscle dysfunction is common in women and is estimated to affect up to 50% of women of childbearing age. When trying to defecate, the pelvic floor muscles contract abnormally or relax insufficiently, which can easily lead to difficulty in defecation .

Difficulty in defecation can lead to longer squatting time, requiring greater exertion and increased abdominal pressure, which can further aggravate pelvic floor muscle dysfunction. [5]

3. Women are less willing to use public toilets

Compared with men, many women are reluctant to go to public toilets or are stopped outside by long queues due to concerns about cleanliness, availability of facilities and privacy protection, and have to hold their urine and feces.
This behavior will not only increase the retention time of stool in the body, making the stool larger, drier and harder to pass, but also cause pelvic floor muscle dysfunction due to overuse of the pelvic floor muscles, which will undoubtedly increase the risk of constipation.

02

How to relieve constipation?

1. Change your eating habits

To relieve constipation, we should first change our eating habits. There are three main points:

1) Eat more high-fiber foods to increase intestinal motility

We know that dietary fiber will not be digested and absorbed by the digestive tract after entering the body. It will mix with food residues to form stool, making the stool softer and promoting intestinal peristalsis, making it easier to pass out. Here are some foods rich in dietary fiber:

whole grains , such as whole-wheat bread and pasta, oatmeal, and bran flake cereals;

Legumes , such as lentils, black beans, kidney beans, soybeans, and chickpeas;

Fruits , such as apples, oranges, and pears with skin;

vegetables , such as carrots, broccoli, green beans, and kale;

Nuts , such as almonds, peanuts, and pecans.

2) Drinking enough water can soften stool

Dietary fiber can promote intestinal peristalsis, but if you want to solve the problem of defecation, you can't do without the help of water. If you don't drink enough water, the stool may dry up in the intestines and be difficult to expel.

3) During constipation, you also need to avoid or reduce the following foods:

Dairy products : Cheese, ice cream, and other dairy products are high in calcium, which has high binding properties and may cause constipation in some people.

High-fat, high-protein foods , such as eggs and red meat, are slow to digest and empty the gastrointestinal tract, which is not friendly to people with constipation. Fried foods are also slow to digest;

Processed snacks and desserts are low in water, high in fat and salt, and lack dietary fiber, making them unfriendly foods.

2. Get regular physical exercise

Physical exercise can reduce the time it takes for food to pass through the large intestine, thereby improving the overall efficiency of the digestive tract. It is recommended to start exercising 1 hour after a meal. The form and intensity of exercise are not limited. It can be walking, running, swimming, jumping jacks, etc.

3. Perform toilet training

You can try to fix the time of defecation every day to give the intestines a habitual signal. This time can be 15 to 45 minutes after breakfast. It is easier to defecate after eating.
During training, make sure you have enough time to go to the bathroom as soon as you feel the urge to defecate. Try to relax your muscles when defecating, or put your feet on a footstool when sitting on the toilet to facilitate defecation.

4. Use over-the-counter drugs or health products

You can use some over-the-counter drugs or health products, such as dietary fiber supplements, mineral oil, stool softeners, etc., but avoid using irritating laxatives. Here is a personal experience. When using mineral oil, try to buy capsules. Drinking it directly is really hard to drink and easy to lose your appetite.

5. Seek medical attention for constipation if necessary

Most of the time, there is no need to worry, but you need to seek medical attention in the following situations:

If these 4 situations occur, seek medical attention immediately

If constipation persists or you have not had a bowel movement for more than 3 days

The constipation came on suddenly and has never happened before

Accompanied by blood in the stool, and/or nausea, vomiting, and abdominal pain

Family history of colon cancer and new onset of constipation

Finally, the normal frequency of bowel movements is 3 times a day to once every three days. Don’t panic if constipation occurs occasionally . Adjust your diet + exercise moderately, relax, and poop healthily together!

References:
[1]Chu H, Zhong L, Li H, et al. Epidemiology characteristics of constipation for general population, pediatric population, and elderly population in china. Gastroenterol Res Pract. 2014;2014:532734.
[2]Verkuijl SJ, Meinds RJ, Trzpis M, et al. The influence of demographic characteristics on constipation symptoms: a detailed overview. BMC Gastroenterol. 2020;20(1):168.
[3]Saunders BP, Fukumoto M, Halligan S, et al. Why is colonoscopy more difficult in women?. Gastrointest Endosc. 1996;43(2 Pt 1):124-126.
[4]Kim YS, Kim N. Sex-Gender Differences in Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2018;24(4):544-558.
[5]Grimes WR, Stratton M. Pelvic Floor Dysfunction. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available

from: https://www.ncbi.nlm.nih.gov/books/NBK559246/

Author: Jiang Yongyuan, Master of Internal Medicine, Third Military Medical University

Reviewer: Wang Qiang, deputy chief physician, Department of Gastroenterology, Peking Union Medical College Hospital