“On the one hand, women with Crohn’s disease whose symptoms worsened with fluctuating estrogen levels during their menstrual cycles may find relief after menopause because of an overall decrease in estrogen levels,” says Dr. Gonzalez. On the other hand, decreased levels of estrogen and progesterone from menopause may cause GI symptoms similar to those of Crohn’s disease, he says.
Menopause and Crohn’s Symptoms May Overlap
While hot flashes and night sweats are hallmark menopausal symptoms, they can worsen fatigue and impact quality of life for someone with Crohn’s. “Conversely, Crohn’s-related inflammation, pain, or malabsorption can exacerbate mood swings, bone loss, and vaginal dryness commonly seen in menopause,” says Gupta.
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Gupta doesn’t recommend HRT for managing Crohn’s disease itself, but also doesn’t discourage its use for menopausal symptoms if needed. “I believe more research is needed, particularly prospective, well-controlled studies that account for disease phenotype, biologic use, and hormonal fluctuations over time,” she says. “Until then, individual risk-benefit discussions with shared decision-making are key when considering hormone therapy in women with Crohn’s.”
Individualized Management of Crohn’s and Menopause Is Critical
While core Crohn’s treatments typically don’t change with menopause, this hormonal shift should prompt some additional considerations. “[For example,] bone health monitoring is crucial, especially in patients currently on corticosteroids or with a remote history of corticosteroid use and a history of malabsorption,” says Gupta. “I often recommend DEXA scans (bone imaging) and ensure adequate calcium and vitamin D intake.”
Lifestyle Factors Can Help Both Menopausal and Crohn’s Symptoms
For both menopause and Crohn’s disease, lifestyle changes can reduce uncomfortable symptoms. “Clean eating and daily exercise are simple building blocks,” says Dr. Khokhar.
- Limit or avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
- Try to exercise (a walk or jog) daily or most days of the week and do muscle-strengthening exercises at least twice a week.
- Maintain a healthy weight.
- Limit or avoid alcohol.
- If you smoke, stop. If you need help quitting, ask your doctor for recommendations.
“Some of these lifestyle changes may be more difficult to maintain during menopause,” says Gonzalez. “For example, decreased estrogen may lead to weight gain, which has been associated with worse outcomes in IBD.” Women with joint pain after menopause may be inclined to use NSAIDs for pain relief, which [may also be] associated with IBD flares, says Gonzales.
If you have difficulty with any of these habits, or need help finding a treatment plan and lifestyle that’s both realistic and effective, ask your healthcare provider for their recommendations.
Great Job Abby McCoy, RN & the Team @ google-discover Source link for sharing this story.
