Impact of Female Gender in Inflammatory Bowel Diseases: A Narrative Review

Inflammatory bowel diseases show a gender bias, as reported for several other immune-mediated diseases. Female-specific differences influence disease presentation and activity, leading to a different progression between males and females. Women show a genetic predisposition to develop inflammatory bowel disease related to the X chromosome. Female hormone fluctuation influences gastrointestinal symptoms, pain perception, and the state of active disease at the time of conception could negatively affect the pregnancy. Women with inflammatory bowel disease report a worse quality of life, higher psychological distress, and reduced sexual activity than male patients. This narrative review aims to resume the current knowledge of female-related features in clinical manifestations, development, and therapy, as well as sexual and psychological implications related to inflammatory bowel disease. The final attempt is to provide gastroenterologists with a roadmap of female-specific differences, to improve patients' diagnosis, management, and treatment.

Automated summary

Inflammatory bowel diseases show gender bias, with female-specific differences influencing disease presentation and activity. Female genetic predisposition related to the X chromosome and hormonal fluctuations can affect gastrointestinal symptoms, pain perception, and pregnancy outcomes. Female patients with inflammatory bowel disease experience poorer quality of life, higher psychological distress, and reduced sexual activity compared to males. This narrative review aims to summarize the current knowledge of female-related features in clinical manifestations, development, therapy, and implications for sexual and psychological well-being. The goal is to provide gastroenterologists with guidance on female-specific differences to improve patient diagnosis, management, and treatment.