Perimenopause and IBD: Just Another Setback?

Mood swings. Hot flashes. Night sweats. Difficulty sleeping. Constant fatigue. Desert-dry conditions in the nether regions. Doesn't this sound like I'm just living my best life? Yep, indeed. I'm living the life of "luxury" here in Perimenopause Land. Throw in IBD, and someone might want to warn my husband to run... far, far away.

During this past year, I turned 51 and unknowingly received the gift of "estrogen depletion." I knew something didn't feel right internally. I just wasn't my usual self. I guess I'm a slow learner... But after experiencing months of distress, I worked up enough nerve to seek out an appointment with a menopause specialist at the Cleveland Clinic (Ohio). With her guidance and administration of various tests, my suspicions were confirmed that I was, without a doubt, making less estrogen.

This assessment got me wondering: As a woman who also suffers from ulcerative colitis, could menopause impact gastrointestinal flares?

Can menopause trigger IBD?

With due diligence, I've worked to remain in UC remission. In 30 years of living with UC, I had never experienced remission until about 5 years ago. Would hormone changes now knock me off my kumbaya throne?

Driving back home with a prescription for Premarin that contains conjugated estrogens, I knew I needed to kick into Nancy Drew mode and research if a connection exists between this new stage of womanhood and UC. Would I fall out of remission? Should I prepare myself mentally for UC flares? How much do hormones impact the body's inflammation? Or, might this be a time that I finally shuck the IBD diagnosis? So many questions. And now so many articles to dig into online.

After hours of reading, I have determined... Almost nothing.

Lack of research on IBD and menopause

Not much data exists on menopause and UC or Crohn's. Really? After all the time I spent burning my eyes reading articles online, I'm no more informed on the topic. It seems no large studies have occurred relating to this matter – at least no large studies that I could find in my small search. One older study cited that women on hormone replacement therapy (HRT) were 80% less likely to flare, but I couldn't confirm this percent over multiple articles.

So, here's my challenge: As a believer in science and medicine, I offer myself up as a guinea pig. I'm willing to allow Pfizer (or any other accredited medical organization interested in analyzing the effects of menopause and IBD) to study me. Since I'm just 3 months into this new hormone replacement therapy path, I believe I'm a perfect candidate. (So, Pfizer, contact me!)

Incorporating menopause into my IBD care

To be honest, I haven't noticed any gastrointestinal changes since starting Premarin. With full disclosure, I still keep a strict diet, exercise, and maintain my supplement regimen as the focus of my UC journey. Now, I've added hormone therapy to help keep my perimenopause symptoms at bay.

As with any other medicinal journey, I believe it's essential to talk to a gastroenterologist and healthcare team about treatment options. My healthcare army includes not only my gastroenterologist but also my primary nurse practitioner and a menopause specialist. Hopefully, with this sort of medical backing, I can remain in UC remission while navigating the aging process with grace and dignity.

Now that hormone replacement therapy is added to my bodily mix, let's also hope I don't scare off my husband. It's a good thing he's tough. Wink wink.