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The Complicated Relationship Between IBD and Menstrual Cycles

It’s probably completely normal to dread that time of the month, but for us ladies with IBD, our relationship with our periods can get even more complicated. Today, I want to have a chat about how our menstrual cycle can be linked to our disease – and also how our hormones can impact our disease activity and symptoms.

Disappearing Periods

But firstly, let’s consider the opposite: what if your periods disappear altogether? Looking back, this was actually one of the first signs of my Crohn’s disease – although it took me another 12 years to get my formal diagnosis.

My periods started fairly late – at around 16 years old – and then seemed to vanish altogether at 18. It was at this time that my suspected ‘IBS-type’ symptoms seemed to get a lot worse.

Missing periods, or amenorrhea as it’s scientifically known, can happen for all sorts of reasons. But for those of us with IBD, it’s often a sign we’re in a flare-up. This happens because our bodies divert resources away from other parts of the body to deal with the inflammation (this is why stress can also cause your period to be delayed or skipped altogether). It can also be due to weight loss and nutritional deficiencies – anaemia being the most common.

Crazy Periods

Don’t worry, it’s normal for patients with IBD to have erratic cycles too. A 2014 study of about 120 woman with IBD found that 25% experienced a change in cycle interval in the year prior to IBD diagnosis, and 21% experienced a change in the duration of flow 1. That’s quite a significant number and it’s a surprise doctors aren’t asking this as one of the key factors of diagnosis.


When the disease is under control, it’s thought that the cycles eventually will regulate themselves again. But if your period is acting erratically, do talk to your doctor as it could well be linked to your IBD.

Endometriosis – a condition which is also associated with particularly heavy and painful periods – could also linked to IBD. A 13-year-long Danish study found that those with Endometriosis had a 50% higher risk of getting Inflammatory Bowel Disease than those without 2. It doesn’t necessarily suggested those with IBD will get the condition, or vice versa, but certainly implies a possible link.

IBD symptoms get worse during your period

This is a question I’ve always tried to find the answers to. Does having your period make it more likely to have a flare? It certainly feels like it. At the start and end of my period, frequent toilet trips are inevitable, regardless of what medication I’m on or what I’ve eaten.

Doctors have acknowledged a link between hormones and IBD (in fact, when women are pregnant they often find either a significant improvement or worsening of symptoms) but they aren’t quite sure how periods fit in. There are not many studies, but one by Lim et al 2013 showed that women with IBD did have more frequent diarrhea during their period3.

Yet interestingly, other symptoms related to IBD (such as joint pain) did not seem to change at all, suggesting that the change in toilet habits we have during that time of the month could be because of a surge of hormones rather than disease activity.

It’s clear there’s lots more to understand in relation to our menstrual cycle and IBD, and that could perhaps be the key to understanding how hormones are linked to disease activity.

Do share your experiences of how IBD has affected your periods below!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The InflammatoryBowelDisease.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Saha S, Zhao Y, Shah SA, et al. Menstrual Cycle Changes in Women with Inflammatory Bowel Disease: A Study from the Ocean State Crohn’s and Colitis Area Registry. Inflammatory bowel diseases. 2014;20(3):534-540. doi:10.1097/01.MIB.0000441347.94451.cf.
  2. Jess T, Frisch M, Jørgensen KT, et al. Increased risk of inflammatory bowel disease in women with endometriosis: a nationwide Danish cohort study. Gut Published Online First: 19 December 2011. doi: 10.1136/gutjnl-2011-301095
  3. Lim SM, Nam CM, Kim YN, et al. The Effect of the Menstrual Cycle on Inflammatory Bowel Disease: A Prospective Study. Gut and Liver. 2013;7(1):51-57. doi:10.5009/gnl.2013.7.1.51.

Comments

  • thedancingcrohnie moderator
    11 months ago

    Thank you so much for writing about this! I had always told my GI that whenever I get my menstrual cycle, I get thrown into a flare. They always, always looked at me like I was crazy and that really bothered me. I always knew there was a correlation. It wasn’t until I saw a Naturopathic Medical Doctor that he confirmed what I was saying. Thank you for sharing this information.

    Always dancing,
    Elizabeth (team member)

  • BeeJWall
    12 months ago

    Thank you SO much for this article Jenna! I can relate to this on many and varied levels. I’ve recently been diagnosed with Collagenous Colitis after years of IBS & major flare a few months back. I’ve also gone through 12months of IVF (with no success), which I have no doubt has played heavily into all of this too. Such a challenging chicken & egg scenario, but I’m so pleased to hear all of this isn’t merely in my mind. THANK YOU again.

  • JDYoung
    2 years ago

    I totally agree they are connected. Almost every month I would have what was considered a flare up along with an irregular period before my diagnosis.

  • CrohnsInHeels
    2 years ago

    This article!! My doctor and his colleagues, including on-staff nurses, told me they hadn’t ever heard from their patients of any connection between menstrual cycle and CD. My OBGYN put me on a 90-day pill because I was certain it was much worse during that 10-day to 2-week period. Right now after 9 months of Humira the only flare ups or mini flares have been during my cycle every 3 months. (It is improving!) They include nausea, back pain and extreme bloating, and I have to be careful about what eat daily. I rarely see any articles about this and I’m really happy to see one!

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