How gender impacts gut health

Gut health: men and women have completely different gut microbiomes – here’s why that’s important

Posted by for Wellbeing

Did you know that women have fundamentally different gut health profiles to men? We get the low down on the gender gut gap from The Gut Stuff’s Dr Laura Freeman.

I don’t know about you, but my gut seems to operate completely differently to my boyfriend’s. Like many people I know, my mood is often dependent on how bloated I am, while he rarely seems to blow up – despite us having very similar diets, sleep patterns and coffee habits. And it’s the same for my parents.

Most of us have a vague understanding of what we need to do to improve our gut health. Eating more fermented foods and fibre, drinking enough water, keeping stress low – the general advice tends to be centred around small, actionable steps that everyone can do regardless of age, area or lifestyle. But I’ve long suspected that the way in which our guts work may be sex-specific, and it turns out that there may be some truth to that assumption after all.

Dr Laura Freeman from The Gut Stuff tells Stylist that there’s emerging evidence to suggest “important variations” between male and female gut microbiomes. That sex-related difference, and the way in which our microbiomes interact with sex hormones and immune systems, she explains, is called the microgenderdome.

“It’s important because there are often significant differences in how some diseases affect women more than men and vice versa. For example, irritable bowel syndrome and autoimmune diseases are much more common in females. We also know that men and women exhibit sex-specific responses to the exact same diet – something that is both fascinating and important when we are discussing gut health and the importance of the community of microbes involved,” Dr Freeman says.

The gender health gap is something that’s gained a lot of attention in recent months; up until very recently, sex differences were largely ignored in health and fitness. Very few studies were done on female bodies, and as such, women have had to put up with generic advice tailored to men. That’s now changing, Dr Freeman believes. 

“More data is starting to come through that will hopefully help us to understand these differences more clearly. With new knowledge about the microgenderdome, we can work towards more specific and personalised approaches, diagnoses and treatments – especially for those conditions that are related to the digestive and connected systems.”

How are our guts different to those of men?

Despite the fact that much of the existing research is conflicting, says Dr Freeman, “there is enough to show that sex-related differences help with the predictability, maturity and diversity of out microbiome”.


That means, for example, that while there is a lot we still don’t know about the gut, sex can provide important and reliable information about different gut bacteria. For example, a 2016 study published in the journal Philosophical Transactions Of The Royal Society B, found that men have been found to have very distinct microbiome patterns in the gut compared to women.    


We also know that women tend to mature faster than men, and that maturity rate is replicated in the gut. “The female microbiome does appear to mature earlier than the male microbiome. It is also interesting to consider this in parallel with other research which suggests that in children, females tend to optimise brain connections earlier than males,” explains Dr Freeman. She goes on to suggest that it’d be plausible to suggest that the gut-brain axis might play an important role in the maturity of our biome, but more research is needed to confirm that link. 


Finally, some research suggests that female guts have more gut microbiome diversity than men, but that it becomes less diverse as we reach 40. Dr Freeman warns: “However, these findings were not always universal and some inconsistencies were shown across different populations,” as was the case among subjects in a Chinese study. “The reasons for this were not discernible in this study, showing that further research is needed to uncover novel patterns and further insights on the matter.”

What causes that gender gut gap?

The gender gut gap is multipronged, but Dr Freeman says that there’s a two-way street between the microbiome, sex hormones and our immune systems.


Our hormones are the main driver for gender-based differences, and they play no less a role in gut health. Dr Freeman points to studies that have looked at the same and opposite-sex twins before and after puberty, where “very clear differences were seen between opposite-sex twins before and after the period of time when hormonal changes are in full force”. Those studies suggested that oestrogen and testosterone have important effects on the gut microbiome.

Immune systems

“The differences between male and female immune systems are well recognised. In fact, most of our immune cells have receptors specifically for our sex hormones,” she explains. “We know our gut microbiota interacts with our immune system on many different levels and sex hormones play a role. This may in part explain why autoimmune diseases are more common among women.” 


According to a study published in Nature, our guts are affected by medication, and different sexes have different patterns of medication use. Many women, for example, have used oral contraceptives and antibiotics, while men are more likely to take heart medication – all of which affect the microbiome in different ways. 

“There is room for much more research to be done in this area so that we understand more about the microbiome and how and why different sexes influence it,” Dr Freeman concludes. That future research needs to look at how socially constructed roles, behaviours and personalities of men, women and non-binary people affect gut microbiota. As far as we know currently, however, there’s no clear winner when it comes to gut health – there’s no evidence to suggest that women have stronger guts than men, for example.

And while we have no control over our chromosomes, we do have control over our microbiomes. Perhaps understanding that our guts are inherently different from men’s might mean we’re more compassionate and in-tune with symptoms, and can be better advocates for our gut health. Dr Freeman says: “Luckily, we are able to change our diet and lifestyles, both of which influence it and that is a really helpful thing for our gut microbiota.”

For more good gut stuff, visit the Strong Women Training Club

Images: Getty

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Miranda Larbi

Miranda Larbi is the editor of Strong Women and Strong Women Training Club. A qualified personal trainer and vegan runner, she can usually be found training for the next marathon, seeking out vegan treats or cycling across London on a pond-green Tokyo bike.