Women are significantly more likely than men to have irritable bowel syndrome, the gastrointestinal disorder characterized by diarrhea, gas, bloating, cramping and pain, mucus in the stool and constipation. Because the chronic condition is linked to bathroom business, however, ladies may be hesitant to openly discuss it — only a small percentage of those affected seek medical help. But knowing the signs and symptoms of IBS could help women identify whether it is affecting their colon.

Pooping is not always pleasant; having irritable bowel syndrome makes it worse. Most cases are uncomfortable yet not severe, and can improve when someone manages their diet, lifestyle and stress level, the Mayo Clinic says. “There will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.”

However, the symptoms are not limited to just the bowels. The constant diarrhea and constipation can “aggravate hemorrhoids” and avoiding certain foods to ease IBS can lead to malnutrition. Then there is the mental health aspect of the condition: “The condition's impact on your overall quality of life may be the most significant complication. These effects of IBS may cause you to feel you're not living life to the fullest, leading to discouragement or depression.”

Read: 4 Rare Causes of Terrible Diarrhea

Signs of IBS may also indicate that something more serious is going on in your body, like colon cancer. The Mayo Clinic advises seeing a doctor if you have a “persistent change in your bowel habits” or if you have rectal bleeding or weight loss.

IBS affects men and women differently. The International Foundation for Functional Gastrointestinal Disorders estimates that between 25 and 45 million Americans have the condition, but two-thirds of those people are women — many of them young women. The exact reason for the disparity is not entirely clear, although hormones may play a role: “Women both with and without IBS report changes in [gastrointestinal] symptoms just prior and through the menstrual cycle, with symptoms reported as more intense in women with IBS.” And though male and female intestinal anatomy is the same, both hormones and other factors may affect what is inside them. “There are suggestions that the male gut may be less sensitive than that of females,” the foundation says.

Read: Why Coffee Makes You Poop

Or, according to the Mayo Clinic, people with IBS may have abnormal contractions in the walls of their intestines to push food through. If they are too strong and long-lasting, it could lead to diarrhea and gas. Too short and weak, and someone could become constipated from hard and dry stools.

Being a young woman is a risk factor for being diagnosed with irritable bowel syndrome, but women with mental health conditions are especially vulnerable. The Mayo Clinic reports that anxiety and depression increase someone’s risk, as do abuse — such as childhood sexual abuse or domestic abuse.

See also:

When Poop Is Used As Medicine

Don’t Grunt When You Poop