Crohn’s disease symptoms in females
Symptoms may vary from person to person, but there are some symptoms and complications that may be of particular concern for females living with Crohn's disease.
Crohn’s disease is a form of inflammatory bowel disease (IBD). The condition is characterized by inflammation in the gastrointestinal (GI) tract. Any part of the GI tract can be impacted, from the mouth to the anus.
People of any sex are equally likely to be diagnosed with Crohn’s disease.
Symptoms of Crohn’s disease may vary among patients, but many of the typical symptoms are experienced by people of any sex living with Crohn’s disease.
Common symptoms of Crohn’s include:
- Diarrhea that is persistent
- Urgency with bowel movements
- Bleeding from the rectum
- Abdominal pain
- Tenesmus (feeling of an incomplete bowel movement)
Symptoms in Females
People living with Crohn’s disease may experience a variety of symptoms, some of which are unique to females. Women living with ulcerative colitis, another form of IBD, may also experience these symptoms. Symptoms may vary among patients and not all women will experience these symptoms.
Menstrual Period Problems
People living with IBD (including Crohn’s) who menstruate may notice issues with their menstrual periods. Some may experience irregular periods. If Crohn’s disease is active, inflammation can trigger the body to stop regular hormone functions, which can impact the regularity of menstruation.
People with and without IBD may experience gastrointestinal symptoms in the lead-up to and during their menstrual periods. But research has found that females living with IBD, including Crohn’s, report more gastrointestinal symptoms during menstruation than their peers.
Forty percent of people with IBD (either ulcerative colitis or Crohn’s) who menstruate report changes to their symptoms during the time of menstruation. They are more likely to experience changes to their bowel movements during menstruation when compared with their peers (diarrhea is more likely than constipation).
A 2013 study found that females with IBD reported an increased level of premenstrual symptoms than their peers who didn’t have IBD. This was mainly the case for symptoms like abdominal pain, nausea, flatulence, and tenesmus.
The same study found that people with IBD had more severe abdominal pain, a higher number of bowel movements, and stools that were loose during menstruation and premenstrual phases. It is believed the fluctuation of hormones during menstruation may impact IBD symptoms.
As well as menstruation impacting Crohn’s symptoms, the reverse is also true. Diseases like Crohn’s can also have an impact on the menstrual cycle. Crohn’s disease may result in puberty being delayed, and a delay in a young female’s first period.
In adult females, Crohn’s may cause infrequent menstruation, also referred to as oligomenorrhea. These issues are believed to occur not directly because of Crohn’s, but because of related complications like poor nutrition, chronic inflammation, low body fat, and stress on the body due to the disease.
Females living with Crohn’s disease and other forms of IBD may experience challenges relating to their sex lives. There are a number of factors that could contribute to sexual dysfunction in females with Crohn’s disease. These include:
- Increased number of bowel movements
- Abdominal pain
- Perianal fistulas (an infected, abnormal connection or “tunnel” between the skin and anus)
- Abscesses (pocket of pus)
Some or all of the above factors can lead to an impairment in sexual function in females with Crohn’s disease.
A 2020 study of more than 1,000 women over age 18 with IBD found those whose IBD was active experienced increased levels of vulvovaginal discomfort compared with those with IBD who were in remission.
The study subjects were asked to complete a survey reporting symptoms like vulvar and vaginal itch, burning, irritation, vaginal discharge, vaginal dryness, and vulvovaginal pain. Of those surveyed, 41% reported experiencing at least one symptom.
With the exception of vaginal dryness, all vulvovaginal symptoms were more common in those with active IBD than in those who were in remission. The authors of the study concluded such vulvovaginal symptoms affect sexual function.
Another study found that 1 in 6 females with IBD reported dyspareunia (painful sex). This was associated with a significant impairment in overall quality of life. More than 50% of the females studied reported dyspareunia was still present after two years.
Females may be at risk of certain complications of Crohn’s disease.
Those living with Crohn’s disease are at an increased risk of developing osteoporosis. IBD is often treated with medications like prednisone and cortisone. These medications work to reduce inflammation in the body caused by diseases like Crohn’s. But in the long term, they can also impact bone health.
People with Crohn’s who have significant inflammation in the small bowel or have had areas in the small bowel removed through surgery may struggle to absorb calcium and vitamin D, leading to bone density and health issues.
Although people of any sex with Crohn’s can get osteoporosis, postmenopausal people are at the highest risk. People who menstruate and have IBD are at risk for osteoporosis even before reaching menopause.
This risk can be exacerbated in people who are malnourished and do not exercise. For those living with Crohn’s, poor appetite can lead to poor nutrition, and feeling unwell can make exercise difficult. These factors combined lead to an increased risk of osteoporosis in women with Crohn’s.
Anemia, a condition in which the body lacks enough red blood cells or hemoglobin, is the most common complication of IBD.
Those living with Crohn’s and other forms of IBD are at an increased risk of iron deficiency than their peers of the same age. Crohn’s can mean an increased risk of bleeding in the intestinal lining and poor absorption of iron due to inflammation in the small intestine.
People who menstruate are already at an increased risk of anemia due to loss of blood during menstruation. This, coupled with potential bleeding from the GI tract due to Crohn’s, as well as poor absorption of iron, means the risk is even greater for those with Crohn’s disease.
Crohn’s disease typically affects females during their prime reproductive years. Roughly 50% of females are under age 35 when they are diagnosed with Crohn’s disease. Twenty-five percent of these conceive during that time.
Females with Crohn’s disease that is inactive have the same fertility rates as their peers without Crohn’s. However, females with active Crohn’s disease have reduced fertility. Fertility is also reduced for females with Crohn’s disease following surgery. This may be due to adhesions in the pelvis or blocked fallopian tubes.
When to See a Doctor
Any new or unusual symptoms should be discussed with a doctor. People living with Crohn’s should contact their doctor as early as possible if they believe they are experiencing a flare.
This will enable the doctor to determine if the flare is because of an infection or other reasons. It will also determine appropriate treatment options and whether changes need to be made to any medications.
Crohn’s disease can cause a variety of symptoms, including abdominal pain, diarrhea, and bleeding from the rectum. Females living with Crohn’s disease may face a unique set of challenges due to their disease. These include issues with menstrual periods, sexual dysfunction, osteoporosis, anemia, and fertility problems.
Original source here.