From body image issues to menstrual disorders, Crohn’s disease symptoms can affect women in unique ways. Find out why and how to deal with it.

Men and women are equally likely to develop Crohn’s disease, an inflammatory bowel disease (IBD), but women tend to experience a different set of concerns than their male counterparts. In women, symptoms of Crohn’s disease can include pain during intercourse, fertility issues, missed periods, and a host of other issues. Here are a few things to be aware of.

1. Crohn’s disease in women tends to fluctuate along with hormone levels.

Rising and falling hormone levels appear to affect Crohn’s disease symptoms. For example, women with Crohn’s disease may report more bowel movements and cramping around the time of their period.

2. Crohn’s disease is associated with the absence of periods.

Crohn’s disease can worsen before and during periods of menstruation, but the absence of periods, called amenorrhea, can also be linked to the disease. This can happen due to Crohn’s disease medications, weight loss, hormonal changes, or problems absorbing nutrients. Missed periods are not uncommon in a woman with active Crohn’s disease. Young girls with Crohn’s disease can also be affected. According to a study published in January 2022 in the journal Digestive and Liver Disease, inflammation linked to IBD can interfere with the production of sex hormones, which can delay puberty.

3. Body image issues are more common in women with Crohn’s disease.

Women with Crohn’s disease may be more likely to be dissatisfied with their bodies than men with the disease, according to a review published in the February 2019 issue of BMJ Open Gastroenterology. The exact reason is unclear, but the journal Digestive and Liver Disease suggests that surgical scars, stomas and weight fluctuations can impact women’s body image.

4. Having Crohn’s disease can affect a woman’s sex life.

Crohn’s disease in women can affect the vaginal area. In addition to making life in the bathroom more difficult, it can complicate life in the bedroom. Specifically, Crohn’s disease can cause swelling in the genital area in women. The development of fistulas, unwanted passages between two organs, can also affect sexual intercourse. This is especially true for rectovaginal fistulas. Some women with Crohn’s disease fear sex because of the pain, and others may avoid sex for fear of leaking stool. Some women avoid dating altogether because they are bothered by symptoms, including gas or frequent trips to the bathroom. If your doctor doesn’t talk about it, it’s up to you to start the discussion. It is possible to have a healthy romantic relationship and sex life with Crohn’s disease.

5. Fertility can be a concern for women with Crohn’s disease.

If you are in remission from Crohn’s disease [lorsque vous essayez de devenir enceinte], you will likely be able to conceive and have an uncomplicated pregnancy and a healthy delivery. On the other hand, if your Crohn’s disease is active, it may be more difficult to conceive and have a healthy pregnancy. Discuss your plans with your doctor well before conception to ensure a healthy pregnancy. Some Crohn’s disease medications are dangerous to the developing baby. That’s why it’s so important to talk to your doctor before you start trying to get pregnant.

Infertility can also be caused by other Crohn’s disease-related issues, according to a study published in 2021. The study involved 533 patients, 90% of whom were women with IBD, and found that half of them had not had children, largely due to impaired body image or sexual dysfunction. Additionally, a study on the impact of IBD on women found that endometriosis, which can cause infertility, is more common in women with IBD than in others.

6. Crohn’s disease in women can affect pregnancy.

Just having Crohn’s disease, even if it’s in remission, slightly increases the possibility of pregnancy-related problems, such as miscarriage. The gastrointestinal tract and the reproductive system are neighbors. This means that what happens in one can affect the other. Examination of digestive and liver diseases found that women who begin pregnancy with active disease have a higher incidence of low birth weight infants. But, for some women, Crohn’s disease improves due to normal changes in the immune system caused by pregnancy.

It is important to work with your gastroenterologist as well as your obstetrician-gynecologist to determine which Crohn’s disease medications are safe to take during pregnancy. According to the Crohn’s & Colitis Foundation, if you stop all medications and then have a flare-up, being pregnant can make it harder to regain control of the disease. The good news is that a 2022 study published in the journal Clinical Gastroenterology and Hepatology showed that biologic drugs were not associated with negative pregnancy outcomes, such as low birth weight or premature birth. .

Women with Crohn’s disease may also be at greater risk of nutritional deficiencies during pregnancy than women without IBD. The ability to absorb nutrients can be compromised in Crohn’s disease, so eat well during pregnancy, as the baby only has access to the nutrients you absorb.

Once the baby arrives, be aware that some Crohn’s disease medications are not recommended for breastfeeding women. If you want to breastfeed, work out a medication regimen with your doctor to minimize the risk of flare-ups during this postpartum period.

7. Crohn’s disease may be linked to the risk of cervical cancer.

Women with Crohn’s disease are more likely to develop precancerous changes in the cells of the lining of the cervix (cervical dysplasia), which is a known risk factor for cervical cancer. according to a study published in the journal Clinical Gastroenterology and Hepatology. Another study, published in 2020, found that taking an immunosuppressant for IBD can make you more likely to catch the human papillomavirus, which can lead to cervical cancer, due to the suppression of the immune system. That’s why it’s important to get tested regularly.

8. Women with Crohn’s disease may be at higher risk of anemia.

Anemia due to blood loss is a condition marked by low levels of iron in the blood. In women with Crohn’s disease, blood loss during menstruation decreases iron stores, as does gastrointestinal bleeding resulting from the disease. Additionally, the long-term intestinal inflammation due to Crohn’s disease can make iron absorption more difficult. Ask your doctor if you need iron supplements.

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