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chapter 1 the guts behind the woman It's no secret that women are different from men. We think differently, we feel differently, we communicate differently. And women live longer than men-an average of 5.4 years, to be exact. To some extent, women and men even have different digestive systems. In fact, the two sexes seem to be separate subspecies when it comes to gastrointestinal health problems. Menstruation, pregnancy, and menopause all put a distinct feminine stamp on your digestive tract. So although you may have the same digestive symptoms as a man, you may not be suffering from the same digestive health problem. After all, men don't experience the nine months of digestive disturbances that can come with pregnancy. Nor do they cope with the bloating, diarrhea, or constipation that waxes and wanes with menstrual cycles. And men certainly don't get painful hemorrhoids after delivering a baby. These are just a few of the reasons why you, as a woman, need a digestive health book that you can call your own. Although you might reach for the Pepto-Bismol that your husband or boyfriend uses, the cause of your symptoms may be completely different. You may require a different diagnostic workup and a different course of treatment. It's for this very reason that I, as a gastroenterologist, decided to focus my practice on women's health. I wanted to address the special concerns of women like you. I really came to understand the importance of gender differences in gastrointestinal (GI) disorders after medical school, during my gastroenterology fellowship training in the early 1990s. I began to see so many women with diverse digestive problems that stemmed from a wide range of sources such as eating disorders, pregnancy, hormone replacement therapy, and childbirth. At that time sex-based differences in disease weren't included in my medical school or specialty training. I knew, of course, that when it came to digestive problems, women had unique issues that set them apart from men. But I really gleaned my knowledge from experience and by digging up GI research studies that highlighted women's health issues. A decade ago women weren't included in clinical trials. It was assumed that diseases in men and women were the same and that women would react to medications the same way men did. This was a very wrong assumption to make, as researchers found out when they began including women in studies. The National Institutes of Health now have an Office of Research on Women's Health that funds studies performed exclusively on women. As a result of these pioneering efforts, researchers have gathered a significant amount of evidence delineating differences in GI function in men and women. Women are unique. And there is a definite connection between a woman's reproductive tract and her digestive tract. One study published in the Gastroenterology, the official journal of the AGA, found that women with gastrointestinal disorders like irritable bowel syndrome (IBS) and inflammatory bowel disease are far more likely to experience premenstrual syndrome (PMS) than healthy women. The study also found that women who had digestive disorders and PMS often reported that their symptoms-like diarrhea, constipation, and abdominal pain-got better and worse during the course of their menstrual cycle. The latest research shows that female hormones, such as estrogen and progesterone, affect the function of your GI tract. Here's just one example: A 2002 finding from the landmark Heart and Estrogen/Progestin Replacement Study (HERS) found that postmenopausal women who used hormone replacement therapy for six years had a 45 percent increased risk of developing gallbladder disease compared to their counterparts who did not take hormones. Some exciting research findings have dramatically altered the way digestive problems are diYoshida, Cynthia is the author of 'No More Digestive Problems The Answere Every Woman Needs-Real Solutions to Stop the Pain and Achieve Lasting Digestive Health', published 2005 under ISBN 9780553588750 and ISBN 0553588753.
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