Colorectal Cancer Symptoms in Women Are Easy to Miss. Here's Why.

By Dr. Sarah Berg, OB-GYN | Menopause Society Certified. 

Everyone poops. We know this at the very beginning of life, when new parents hover over diapers analyzing color, consistency, and frequency as if they hold the secrets of the universe. We know it again at the end of life, when conversations about bowel habits become clinical, necessary, and often surprisingly unfiltered.

And yet somewhere in the middle, when it might matter the most, we go quiet.

That silence has consequences.

Colorectal Cancer Is Rising in Women Under 50

Colorectal cancer has quietly climbed to the top of the list of cancer deaths in younger adults. It is no longer a disease that belongs exclusively to older populations. And for women moving through perimenopause — often in their mid-to-late 40s — the timing creates a particular blind spot.

This is the stage of life when bodies are already sending unfamiliar signals. Bloating. Fatigue. Changes in digestion. Shifts that are easy to attribute to hormones, to stress, to the general noise of midlife. When the body speaks, it can be genuinely difficult to know which system is talking.

That ambiguity is not an excuse to stop listening. It is a reason to listen more carefully.

Why Colorectal Cancer Symptoms Are Hard to Recognize in Women

In my clinical practice, the conversation often starts with hesitation. A pause before speaking. A softening of the voice. A quick attempt to minimize what is about to be said.

Changes in bowel habits. Blood that was hoped away. Fatigue that doesn't quite make sense.

There is often an apology attached, as if bringing it up is somehow inappropriate. It never is.

Women are accustomed to being told that what they're experiencing is probably nothing. That it's stress. That it's hormones. That it will pass. That instinct — absorbed over years of being underestimated in medical settings — makes women hesitant to raise the symptoms that feel small or embarrassing or hard to describe. And colorectal symptoms sit squarely in that category.

The result is delay – which is where this disease gains ground.

Why Perimenopause Creates a Dangerous Blind Spot

Colorectal cancer is one of the few cancers where early intervention can do more than detect disease — it can prevent it. Polyps can be identified and removed before they ever become something more serious. Caught early, the outcomes are dramatically better.

But the window for that intervention depends on a woman being willing to report what she notices, and a clinician being willing to take it seriously.

The perimenopausal years are noisy in exactly the right way to mask early warning signs. A change in bowel habits is easy to attribute to dietary changes, to fiber supplements, to the general disruption of a body in hormonal flux. Fatigue is assumed to be sleep disruption. Bloating becomes background noise.

None of those explanations are wrong, exactly. But they are incomplete if they become a reason not to investigate further.

Everyone poops. We understood that simplicity as children, but somehow we seem to forget it as adults. Poop is not embarrassing. It is information. And sometimes, it is the earliest signal your body has that something is wrong.

Pay attention when something changes. Changes in frequency, consistency, color, or comfort are worth naming out loud — to yourself first, and then to your doctor. Blood is never something to rationalize away. Fatigue that doesn't track with your sleep is worth mentioning. Abdominal discomfort that lingers deserves a conversation.

This is not about fear. It is about fluency — learning to speak your body's language clearly enough that you can advocate for the care you deserve. The goal of that advocacy is catching something early enough that it never has the chance to take more.

Women's Health Requires Whole-Body Thinking

Midlife is a moment of significant physiological change. It is also, for many women, a moment of heightened medical attention — regular appointments, conversations with clinicians, renewed focus on long-term health. That attention is an asset to be used.

If colorectal cancer screening is on your horizon, don't delay the conversation. If you've noticed symptoms you've been explaining away, bring them up at your next appointment. If your doctor dismisses what you raise, push back or seek a second opinion.

You are not being dramatic. You are being appropriately attentive to a body that is working hard and communicating clearly — if you're willing to listen. Understanding your body during midlife means more than tracking hot flashes. It means recognizing when a symptom deserves a closer look — and feeling informed enough to ask for one.

These questions are exactly what Selfority is built for. Explore more evidence-based women's health education at selfority.com.

Dr. Sarah Berg is a board-certified OB-GYN and Menopause Society Certified practitioner and the founder of Selfority, a menopause education platform built on medical integrity. She writes regularly about women's health across the lifespan.

This article is based on an article provided by Dr. Berg for Katie Couric Media. Read it here.

Colorectal Cancer FAQ

Q: What are the early warning signs of colorectal cancer in women? Early colorectal cancer symptoms in women include changes in bowel habits (frequency, consistency, or shape), rectal bleeding or blood in the stool, unexplained fatigue, abdominal discomfort or cramping, and a persistent feeling of incomplete bowel emptying. These symptoms are often subtle and easy to attribute to other causes, which is why many women delay reporting them to a clinician.

Q: Can perimenopause mask colorectal cancer symptoms? Yes. Perimenopause produces many overlapping symptoms — bloating, fatigue, digestive changes, and abdominal discomfort — that can make early colorectal cancer warning signs difficult to distinguish from hormonal shifts. Women in their mid-to-late 40s are at particular risk of attributing colorectal symptoms to menopause rather than investigating them further.

Q: Why are colorectal cancer symptoms in women often dismissed or ignored? Research and clinical experience both show that women are more likely than men to minimize or delay reporting gastrointestinal symptoms, partly due to social discomfort and partly because women are more frequently told their symptoms are stress- or hormone-related. Colorectal symptoms — changes in bowel habits, blood in stool — carry particular stigma, which compounds the delay.

Q: Is colorectal cancer increasing in younger women? Yes. Colorectal cancer has risen significantly among adults under 50, including women in the perimenopausal age range. It is now among the leading causes of cancer death in younger adults in the United States. This trend makes symptom awareness especially important for women in midlife.

Q: What should a woman do if she notices colorectal cancer symptoms? Any persistent change in bowel habits, rectal bleeding, unexplained fatigue, or abdominal discomfort should be reported to a clinician promptly — not explained away. Women who feel their concerns are dismissed should seek a second opinion. Early detection of colorectal cancer, and even precancerous polyps, significantly improves outcomes.