Crohn and menopause: what to know

ahsan65@gmail.comSeptember 11, 2025

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Hormones like estrogens can help with gastrointestinal (GI) and intestinal microbiome inflammation, so that their decline can cause more serious Crohn symptoms.

“”[But] Studies on the relationship between menopause and inflammatory intestine diseases (MII) have shown mixed and not very conclusive results, “explains Adalberto Gonzalez, MD, gastroenterologist of the Cleveland Clinic in Florida.

“On the one hand, women with Crohn’s disease whose symptoms have worsened with fluctuating estrogen levels during their menstrual cycles can find relief after menopause due to a global decrease in estrogen levels,” said Dr. Gonzalez. On the other hand, a decrease in estrogen levels and menopause progesterone can cause gastrointestinal symptoms similar to those of Crohn’s disease, he said.

Menopause and Crohn symptoms can overlap

“Menopause and Crohn’s disease can have overlapping gastrointestinal symptoms, such as abdominal bloating and pain, gas, nausea, indigestion, constipation and diarrhea,” said Gonzalez.

Although heat puffs and night sweats are characteristic menopause symptoms, they can worsen fatigue and an impact on someone’s quality of life with Crohn. “Conversely, inflammation, pain or malabsorption linked to Crohn can exacerbate mood swings, bone loss and vaginal dryness commonly observed in menopause,” explains Gupta.

Menopause can start earlier with Crohn’s disease

Limited evidence suggests that Crohn’s disease can cause the start of menopause at an earlier age, Gonzalez explains. A small study of 171 women revealed that the participants with a Mii like Crohn began menopause on average a year and a half earlier than those without Mii.

Crohn and menopause can affect mental health

Crohn and menopause can cause mood changes. Mental health support is vital because Crohn and menopause are associated with increased anxiety and depression, Gupta explains.

“In general, menopause affects the general psyche of a woman and can have a direct impact on the axis of the brain,” explains Gupta.

Crohnopause can both increase the risk of osteoporosis

Crohn can often lead to malnutrition which, over time, can cause low bone density for lack of food calcium. In addition, people who had to take steroid prednisone from Crohn’s light rockets present an increased risk of osteoporosis.

Likewise, menopause can weaken bones, and women who have undergone this transition run a higher risk of osteoporosis, with or without Mii.

Hormonal replacement therapy shows a certain promise, but may have risks

Typically used to treat the hormone levels that fall during menopause, substitute hormone therapy (HRT) can have therapeutic uses for women who are undergoing this transition alongside Crohn. A small study of 37 people with Crohn who used postmenopause HRT noticed an improvement in their symptoms of MII.

“”[But] A recent systematic journal has revealed that few studies have examined menopause or substitute hormone therapy (HRT) compared to MII, “said Gonzalez.” Some studies have associated HRT with an increased risk of MII, while others have illustrated an improvement in MII symptoms. »»

Another study of 447 patients with MII and breast and prostate cancer revealed that HRT had actually caused MII eruptions.

But a broader study of more than 10,000 women suggests that using the post-Menopause HRT does not increase the symptoms of the MII.

For some, this may be worth the risk. “Crohn’s disease and menopause can predispose women to osteoporosis and depression, and the use of HRT can help the treatment of these conditions,” said Gonzalez.

GUPTA does not recommend HRT for the management of Crohn’s disease itself, but does not discourage its use for the symptoms of menopause if necessary. “I believe that more research is necessary, in particular prospective and well controlled studies which explain the phenotype of the disease, biological use and hormonal fluctuations over time,” she says. “Until then, individual risk-risk discussions with shared decision-making are essential when considering hormone therapy in women with Crohn.”

The individualized management of Crohn and menopause is critical

Experts highlight the importance of individualized management for each person with menopause with Crohn’s disease. “For example, a risk of known HSE includes blood clots, and it may therefore be preferable to avoid the use of HRT in people with active Crohn’s disease or the use of Crohn’s drug associated with thromboembolia, such as tofacitinib,” explains Gonzalez.

Although Core Crohn’s treatments generally do not change with menopause, this hormonal change should cause additional considerations. “”[For example,] Surveillance of bone health is crucial, especially in patients currently under corticosteroids or with history distant from use of corticosteroids and a history of malabsorption “, explains GUPTA.” I often recommend scans of Dexa (bone imaging) and ensures adequate consumption of calcium and vitamin D. “

Lifestyle factors can help both the symptoms of menopause and Crohn

For menopause and Crohn’s disease, lifestyle changes can reduce uncomfortable symptoms. “Clean food and daily exercise are simple construction blocks,” says Dr. Khokhar.

To improve the symptoms of menopause and Crohn’s disease, try these healthy habits:

Limit or avoid non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.

Try to exercise (a walk or jog) daily or most of the 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 smoking, ask your doctor recommendations.

“Some of these lifestyle changes can be more difficult to maintain during menopause,” says Gonzalez. “For example, a decrease in estrogens can cause weight gain, which has been associated with less good results in the MII.” Women with joint pain after menopause can be enclosed to use NSAIDs to relieve pain, which [may also be] Associated with MII eruptions, explains Gonzales.

If you have difficulty with one of these habits or if you need help to find a treatment plan and a lifestyle that are both realistic and efficient, ask your health care provider.