Menopause and ulcerative colitis: what to know

ahsan65@gmail.comSeptember 10, 2025

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Menopause and ulcerative colitis: what to know

Some people with UC declare the symptoms during menopause, which improve with estrogen therapy, a form of replacement hormone therapy (HRT), but research has not constantly confirmed this link.

“We think that higher levels during years of reproduction offer a protective effect against enlightening rockets. However, nothing can be established in a conclusive manner with available evidence, and we may need additional studies to deepen, ”explains Gupta.

In addition, the symptoms of menopause and CU can overlap. These may include bloating, abdominal pain, gas, nausea, indigestion, constipation and diarrhea.

“It is often difficult to discern what condition causes symptoms, and they should be assessed by a gastroenterologist,” explains Adalberto Gonzalez, MD, gastroenterologist of the Cleveland Clinic in Florida.

Women with UC can experience menopause earlier

Some evidence suggest that menopause can take place earlier in women with Cu than those without UC, although more studies are necessary to confirm it. A small study of 171 women found that those with MII finished menopause at 50, on average, while those without MII reached the same stage about a year and a half later.

That this affects the symptoms of the UC is not entirely clear. “Some women report a postmenopause symptoms worsening, while others are improving or no change,” said Gupta.

Estrogens can influence the functioning of your intestines

Experts believe that hormones and estrogen help manage inflammation in gastrointestinal tract, and a healthy intestinal microbiome helps the estrogen metabolism – how your body breaks down the hormone.

“The relationship between estrogens and ulcerative colitis is complex and not fully understood,” explains Asma Khapra, MD, gastroenterologist in Fairfax, Virginia. Estrogens act through various intestine receptors, influencing intestinal inflammation, the epithelial barrier and the immune system. “Depending on how he interacts, estrogens can have both positive and negative effects,” said Dr. Khapra.

But the evidence remains mixed, explains Gupta. Some studies suggest a slight increase in the risk of risk of postmenopause CU symptoms, while others find no significant effect. The impact probably varies according to individual factors, including genetic predisposition, the severity of the disease and the sensitivity to hormonal receptors, explains GUPTA.

Menopause can worsen mental health in people with ulcerative colitis

“Menopause changes in sleep, stress levels and metabolism can indirectly affect the activity and quality of life of the disease in women with CU, also part of the brain link of the intestine,” said Gupta.

Estrogens play a big role in the functioning of neurotransmitters (brain messengers), and the drop in levels can cause changing moods.

Anxiety and depression often accompany MIIs and menopause.

“Support care, including psychological advice or the reference to women’s health specialists, are essential to manage both health problems with a healthy integrated approach,” said Gupta.

Ulcerative colitis and menopause can both affect the health of bones and hearts

Beyond mental health problems, menopause and CU share certain risks for other medical conditions, including osteoporosis.

“UC patients, in particular those who have history to use corticosteroids or malabsorption, are already at risk of osteoporosis – a risk more amplified by menopause,” explains GUPTA.

Menopause and CU also increase the risk of heart disease.

Chronic inflammation of the CU can be difficult for blood vessels and during menopausic transition, cholesterol increases, which can add to the risk of heart problems.

Does the treatment of ulcerative colitis change during menopause?

Basic treatments for CU, such as drugs, do not change with menopause, but additional treatments can be added to treat bone health and the potential replacement of hormones, explains GUPTA. “”[For strong bones,] I recommend dexa scans (bone imaging), by ensuring adequate exercises in calcium, vitamin D and in force training exercise, ”explains GUPTA.

Some people choose to try replacement hormone to increase their estrogen levels after menopause, but this treatment has contradictory evidence regarding its effect on CU, explains Dr. Gonzalez.

“However, HRT seems to decrease the risk of colorectal cancer, which women with CU have an increased risk,” notes Gonzalez.

Some studies have shown an improvement in CUD symptoms with HRT, while others suggest that this therapy could increase the risk of CU relapse. “If he is considered, HRT should be discussed in collaboration with gynecology,” explains Gupta. “The advantages and risks must be assessed on a case -by -case basis and must be individualized.”

Lifestyle changes can help manage ulcerative colitis and menopause

Regardless of your menopause status, Gonzalez recommends making protective lifestyle changes for the CU, such as limiting or avoiding non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and maintaining healthy weight.

“I advise to follow a healthy Mediterranean diet, to exercise regularly (in particular strength training), to sleep adequate and to manage stress – which are all important during menopause,” explains Khapra, who also recommends get a lot of protein to help prevent muscle loss.