Navigating the Change: New Insights for Women Managing Crohn’s disease Through Menopause
New York, NY – Women navigating menopause while living with Crohn’s disease face a complex interplay of hormonal shifts and inflammatory conditions, requiring a highly individualized approach to care, experts say. While research is ongoing,current guidance emphasizes open interaction with healthcare providers and a focus on holistic management strategies.
Crohn’s disease and menopause can both present overlapping symptoms, making diagnosis and management challenging. Symptoms like fatigue, body aches, and gastrointestinal distress can be attributed to either condition, or a combination of both.
Hormone Replacement Therapy (HRT) remains a nuanced topic. Dr. Shilpa gupta, a gastroenterologist, does not reccommend HRT specifically for Crohn’s disease, but also doesn’t discourage its use for menopausal symptoms when 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.”
Experts caution against a one-size-fits-all approach. Dr. Maria Gonzalez highlights the increased risk of blood clots associated with HRT,suggesting it may be best avoided in those with active Crohn’s disease or those taking certain Crohn’s medications like tofacitinib,which also carry a thromboembolism risk.
Nonetheless of menopausal status, core Crohn’s treatments generally remain consistent. However, the hormonal shift of menopause necessitates additional monitoring. Dr. Gupta stresses the importance of bone health monitoring, particularly for patients currently or previously on corticosteroids, or with a history of malabsorption. She frequently enough recommends DEXA scans (bone imaging) and ensuring adequate calcium and vitamin D intake.
Lifestyle interventions are crucial for managing both conditions. Dr. Asma Khokhar emphasizes the foundational benefits of “clean eating and daily exercise.” Specific recommendations include:
* Limiting or avoiding nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
* Daily exercise, including muscle-strengthening activities at least twice a week.
* Maintaining a healthy weight.
* limiting or avoiding alcohol.
* Smoking cessation, with support from a doctor if needed.
Dr. Gonzalez notes that lifestyle changes can be harder to maintain during menopause,as decreased estrogen can contribute to weight gain,potentially worsening IBD outcomes. She also cautions that joint pain experienced during menopause may lead to NSAID use, which can trigger IBD flares.
Ultimately, healthcare providers recommend proactive communication and a collaborative approach to develop a realistic and effective treatment and lifestyle plan tailored to each individual’s needs.
