A Link Between IBD and Endometriosis?

Did you know that Inflammatory Bowel Disease is associated with other health conditions? For example, some people with Inflammatory Bowel Disease are more likely to develop gallstones, inflammation, liver problems, osteoporosis, and colon cancer.1,2 Recently, researchers have found that Inflammatory Bowel Disease (IBD) is also associated with endometriosis, a condition that affects 10% of US women.3 In fact, women who have been diagnosed with IBD may have a higher risk of developing endometriosis, and women who have been diagnosed with endometriosis may have a higher risk of developing IBD.

What is Endometriosis?

Endometriosis occurs when endometrial tissue (tissue from the lining of the uterus) grows outside of the uterus.4,5 For women with endometriosis, this tissue will usually form on the ovaries, or on the lining surrounding the abdominal organs (known as the peritoneum).5 For some women, endometrial tissue grows on the intestine, which is known as ‘intestinal endometriosis’.

What Does the Research Tell Us About IBD and Endometriosis?

Studies show that women who have been diagnosed with IBD may have greater chances of developing intestinal endometriosis.4 Similarly, women who have been diagnosed with endometriosis may have a higher risk of developing IBD. For example, in one study of over 37,000 women with endometriosis, a significant number later developed IBD, usually around 10 years after their initial endometriosis diagnosis.6

How Are Endometriosis and IBD Related?

There are several reasons why women with IBD may have a higher risk of endometriosis, and vice versa. While endometriosis is not an autoimmune condition like IBD, endometriosis has been linked to several other autoimmune conditions (including Lupus, Sjogren’s syndrome, multiple sclerosis, and rheumatoid arthritis).7 Because endometriosis is associated with several autoimmune conditions, researchers believe that there may be an autoimmune connection between endometriosis and IBD.4,6,8

To treat endometriosis, many women are prescribed hormonal therapies, such as birth control pills, patches, or vaginal rings.9 In looking at the connection between endometriosis and IBD, some researchers believe that these hormonal therapies may actually increase the risk of developing IBD.4,6,8 While the association between birth control pills and IBD is not absolute, some doctors have recommended that endometriosis patients be treated with immunotherapy (rather than hormonal therapies) to reduce their risk of IBD.3

Similarities Between Endometriosis and IBD

Due to the similarities between endometriosis (especially intestinal endometriosis) and IBD, it can be difficult for doctors to distinguish and correctly diagnose these two conditions.5 Both endometriosis and IBD are considered chronic inflammatory disorders, and for both conditions, symptoms typically begin in early adulthood. Intestinal endometriosis and IBD also share several symptoms, including abdominal cramps, abdominal pain, diarrhea, and rectal bleeding.5,10,11,12 However, while approximately 10% of US women will experience endometriosis, only 0.5% of the US population will be diagnosed with IBD.3

Other Concerns for Women with IBD

Along with endometriosis, some women with IBD experience an increased risk of other health issues. For example, research shows that women with IBD have higher chances of abnormal Pap smears, and possibly an increased risk of cervical cancer.8 Some women also experience menstrual symptoms related to their IBD, such as menstrual cycle irregularity, and varying GI symptoms based on hormonal changes throughout the menstrual cycle.8

Research shows that women with IBD may have an increased risk of endometriosis, and women with endometriosis may have an increased risk of IBD. Given the similarities in symptoms, it is important for healthcare providers to consider both conditions when making a diagnosis, and it is important for women with one condition to be aware of the other. If you have endometriosis or IBD, consider asking your doctor about the other condition, and check out “What Women Should Know When Living with IBD” to learn more.

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