Why are women more prone to constipation?

Bowel movements are an important part of our body’s digestion process. It’s how our body gets rid of waste, basically what’s left after our digestive system absorbs all the nutrients and fluids from the food and drinks that we consume. Unfortunately, we don’t all have regular bowel movements. Having loose watery stools or going to the toilet too often is classed as diarrhoea, but if you’re not going at all, you might be constipated. 

Having an irregular bowel habit might mean different things to different people. After all, there is no hard and fast rule as to how often we should have a bowel movement. Some people have one or two bowel movements daily while others only go every other day or even once a week. You’re generally understood to have constipation if you have less than three bowel movements per week. 

Dr Emile John Tan, Head and Senior Consultant, Department of Colorectal Surgery, Singapore General Hospital, lists the symptoms of constipation – irregular bowel habit, reduced urge to pass motion, inability to initiate or complete motions or a feeling of incomplete emptying. 

“These can be accompanied by bloating or reduced appetite,” he adds.

Bowel changes during your period

How often you have a bowel movement is determined by a number of elements such as your age, diet and amount of physical activity. Some factors that can lead to constipation include not drinking enough water, stress, lack of exercise or side effects of medications. 

Your fibre intake plays a big part too. It’s recommended that we consume between 25 to 30 grams of fibre daily for proper bowel function. However, the average Singaporean consumes only between 12 to 30 grams of fibre per day. 

Women also seem to experience constipation more often than men. Dr Tan reveals that, in publications examining bowel health and regularity between genders, women appear to complain of symptoms of constipation three times more often than men. 

“These publications are, however, almost entirely based on personal recollection of symptoms and therefore the possibility of recall bias exists,” he says. 

If you’ve ever experienced a change in your bowel movements around the time of your period, you’re not alone. This is because of how our hormones fluctuate throughout our menstrual cycle. 

“Hormones like oestrogen and progesterone have some effect in regulating bowel habit and, hence, women at times of their menstrual cycle – such as during their period – may notice a change,” says Dr Tan. “Women who menopause also often notice this.”

During the course of our menstrual cycle, an increase in the levels of the hormone progesterone slows down the digestive process, which could make us constipated. This is experienced more in women who have endometriosis or Irritable Bowel Syndrome (IBS). 

If you’re prone to constipation around the time of your period, Dr Tan has the following advice: “The impact can be mediated by attention to dietary intake, such as having more fibre, which may help bulk stool and increase bowel urge, as well as maintaining good water intake and physical activity levels. 

“Soya beans contain phyto-oestrogens which may be helpful but evidence is patchy at best!” he adds.

Keeping things moving 

Having the odd experience with constipation is normal. In fact, about 80% of us suffer from constipation from time to time so don’t panic if you’re constipated every now and then. There are occasions, however, when you experience a persistent change in your bowel movements, which could mean you’re suffering from chronic constipation. This is when you should visit a doctor to find out if there’s any serious issues with your colon. 

If you find it hard to keep your bowel movements regular, there are certain foods you could eat to relieve constipation. Prunes are often cited as the easiest solution and this is because both the flesh and skin of prunes are laxatives, so they work remarkably well to get the job done. 

Another fruit that is backed by a lot of evidence is green kiwifruit (not the yellow/gold variety). And don’t take it in juice form or kiwi extract as a supplement as you’ll get more fibre from consuming the fruit itself.  

Even when you’ve consumed the right remedies to ease your constipation, it might not flow easily once you’re on the toilet bowl. The truth is, the old-fashioned squatting toilets actually provided us with the ideal position for our bowel movements (even though it’s not kind on our knees). 

You might have come across the numerous videos on TikTok on the best toilet bowl position for constipation. From a medical point of view, Dr Tan recommends putting a stool under your feet to elevate and flex your hips forward to relieve the tension in the pelvic floor. This can help ease the passing of stool as changing the angle of your legs also changes the angle of your colon. 

“Try leaning forward if you’re on a sitting toilet and you don’t have a stool,” he adds.