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What Women Should Know When Living with IBD

With all of the organs involved with Crohn's Disease, it's easy to see how there can be issues with "neighboring parts."

How can the menstrual cycle be affected when you have IBD?

Will my sex drive be affected? Are hormones a factor? How does self-image play a role psychologically when dealing with complications like cutaneous fistulas, especially when setons are placed? Will fertility be an issue?

I've decided to write a series that will deal specifically with Women's Health & what you may need to know if you are experiencing symptoms in your genital & perineal area. In this series, I will discuss the complications of things that are not openly talked about enough among our community and sometimes even between our specialists. We'll also talk about why that lack of communication between patient and physician may happen later on.

Obviously there are many differences in physical body parts between male & female genitalia. With women, there is more risk of infections & extra-intestinal manifestations and complications of Crohn's disease due to openings in the vagina in comparison to the male genitalia.

Because of how our sexual organs are physically laid out, sometimes knowing when something is wrong is difficult, as there can be many changes with our reproductive system as we age. For women with IBD, we must be diligent when things don't appear to be normal. It's important to see a specialist or a care team that can help with each of the symptoms as we may not know exactly just how many complications can arise from living with Crohn's Disease as a woman.

Here are a few examples:

Did you know that your hormone levels can fluctuate with IBD?

During their cycles, many women can experience very heavy bleeding, increased bowel movements, and extreme cramping when menstruating. When you're in a flare, having your period can result in 2-3 times as many trips to the bathroom. The pain can be excruciating and can really impact your quality of life during those 1-2 weeks, based on your cycle length. Some women may not even experience menstruation or experience frequent interruptions with their cycles, which is referred to as amenorrhea. Many Crohn's patients discuss this with their Gynecologist to help alleviate certain symptoms, and control periods to prevent further blood loss if they are already anemic.

Both men and women can experience a decrease in their sexual activity.

Some patients sex drive may decrease at many points throughout their active disease. But for women, there are many reasons that we may lose interest in sex. Body image, physical pain during sex, fistulas, ulcers or other complications can all impact those moments. Feeling comfortable in your own skin can be tremendously important for a woman's psychological state and mental health.

Some women with IBD are afraid to reproduce for many reasons

Too many of these fears result from seeing misinformation regarding infertility. Yes, it is factual that a small percentage of women may have a hard time conceiving under certain circumstances because of certain surgeries, but it's all so personal and should be discussed with your OBGYN & your GI/colorectal surgeon care teams.

Stay tuned for my next article, when we go into depth about the individual complications of Vaginal Crohn's in this series of Women's Health with IBD.

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