Irritable bowel syndrome is a gastrointestinal disorder characterized by abdominal pain and changes in bowel habits. It adversely affects the quality of life for women who have it and is a significant health care burden. The syndrome results from the interaction of many factors that are not clearly understood, including stress, environment (internal and external), and biological mechanisms. It affects women more than men, and clear biological, psychological, and physical differences exist between the sexes, creating the need for a specialized approach to management in women. The objective of this article is to explore the pathophysiology of irritable bowel syndrome and how it relates specifically to women and to apply these differences to the diagnosis and treatment of irritable bowel syndrome in women.