Crohn’s disease is a type of inflammatory bowel disease that can cause a variety of symptoms. Women are just as likely to get Crohn’s disease as men, but their symptoms are often different and unique.
This article will look at what these symptoms are, how to treat them, and how to get support if you or someone you care for is living with Crohn’s disease.
Crohn’s disease is an autoimmune disease that can affect any part of your gastrointestinal (GI) tract. But it mostly affects the end of your small intestine.
Crohn’s disease is one of two main types of inflammatory bowel disease (IBD). The other is ulcerative colitis.
With Crohn’s, your digestive tract becomes swollen and irritated. The most common symptoms, which can affect both men and women, include:
- diarrhea
- rectal bleeding
- abdominal pain and cramps
- urgent need to empty bowels
- feeling like your bowels have not fully emptied
- constipation
- bloating
- anal fistula
- excessive gas
- ulcers
- weight loss
- loss of appetite
- fatigue
However, with Crohn’s disease, there are also certain symptoms that are specific to women. Let’s look at each of these in more detail.
Digestive distress and a loss of appetite can result in your body not properly absorbing the nutrients it needs. Together with inflammation of your digestive tract, this may affect your hormone levels and hinder hormone function.
If your hormone level and function is affected, it could cause the length of your menstrual cycle to fluctuate. It may also cause your periods to be painful.
The stress of coping with these symptoms may also affect your hormone levels and how they work.
Long-term inflammation and irritation in your digestive tract can interfere with your body’s ability to absorb iron properly. Having low levels of iron in your blood is the most common cause of anemia.
With Crohn’s disease, you may also have low levels of iron due to:
- bleeding in your digestive tract
- poor absorption of nutrients
- heavy menstrual periods
The most common symptom of anemia is fatigue. Other symptoms can include:
- feeling dizzy or lightheaded
- trouble concentrating
- constipation
- pale skin
- shortness of breath
According to the Crohn’s & Colitis Foundation, 30 to 60 percent of people with Crohn’s disease have a lower-than-average bone density — mostly in the form of osteoporosis. This condition is more common in women.
If you have Crohn’s disease, you may be at an elevated risk of having a high level of a specialized protein, called cytokines, in your blood. Cytokines can increase your body’s inflammatory response and also disrupt the pace at which new bone is formed and old bone is removed. This can increase your risk of osteoporosis.
Other factors that may raise your risk of osteoporosis with Crohn’s include:
- taking steroid medications for Crohn’s flare-ups
- not getting regular exercise due to fatigue
- nutritional deficiencies
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Subfertility rates have been tied to fallopian tube blockage and abdominal adhesions. Abdominal adhesions are bands of scar tissue that can form between tissues and organs in your abdomen after surgery.
Pain during sex is known as dyspareunia and is more common in women than in men.
Painful intercourse may be due to active Crohn’s disease in the part of your digestive tract that surrounds your vagina or anus.
It may also be due to a rectovaginal fistula.
This happens when an abnormal channel forms between your rectum and vagina. This can cause pain during sex and pain in your vagina or the area between your anus and vagina, known as the perineum.
It can also lead to frequent vaginal infections since stool and gas can leak from your bowels into your vagina.
Crohn’s disease has no cure. The goal of treatment is to:
- prevent and control flare-ups
- treat symptoms
- manage complications such as fistulas and intestinal blockage
It’s important to discuss your gastrointestinal and gynecologic concerns with your healthcare professional. Knowing more about the issues you face can help your doctor determine the best care plan for you.
Medication for Crohn’s disease
Common medications for Crohn’s disease include the following:
- Aminosalicylates. These anti-inflammatory drugs are used to help control mild inflammation that occurs if your symptoms are mild.
- Corticosteroids. These anti-inflammatory drugs help subdue the immune system and are used short-term for moderate to severe symptoms.
- Immunomodulators. These drugs help suppress the immune system and ease inflammation in your digestive tract. They are often prescribed for long-term use when other treatments have not helped, but they can take a while to take full effect. This is why they are sometimes started along with other meds that work to take care of symptoms in the short term.
- Biologics. These drugs are used long-term to treat moderate to severe Crohn’s disease. These drugs impede the action of specific proteins that trigger inflammation. Drug classes include:
- integrin antagonists
- interleukin inhibitors
- Other medicines. Other medicines used to treat symptoms or complications include:
- acetaminophen (Tylenol) for mild pain
- antibiotics to treat infections
- antidiarrheals to reduce or stop severe diarrhea; these are only for short-term use as they raise the risk of toxic megacolon
Bowel rest
Severe Crohn’s disease symptoms may call for a few days or weeks of bowel rest. This involves not eating and only drinking approved liquids such as water and nutrient-rich shakes.
Soft and then solid foods are slowly added back to your eating plan as you can tolerate them.
Surgery
If medication or lifestyle changes don’t help improve symptoms, surgery may be a consideration to help treat Crohn’s complications. Surgery options include:
- Small bowel resection. This procedure removes the diseased section of your small intestine.
- Large bowel resection (colectomy). This resection surgery removes the diseased section of your large intestine.
- Total proctocolectomy. A total proctocolectomy involves the removal of your colon, rectum, and anus. An ileostomy or surgical opening is made in your abdomen where a disposable pouch is worn to collect waste.
- Strictureplasty. This procedure widens the stricture or narrowed section of your intestine.
About surgeryThe American Society of Colon and Rectal Surgeons clinical practice guidelines note that after Crohn’s disease diagnosis:
- 16 percent of people will need surgery within a year
- 33 percent will need surgery within 3 years
- 47 percent will need surgery within 5 years
- up to 35 percent will need bowel resection repeated within 10 years
Getting support can help you better cope with the challenges and stress of living with Crohn’s disease.
The following resources may help you get the support you need and connect with others who are dealing with the same issues and have similar questions.
Helpful resources
- Crohn’s & Colitis Foundation. The foundation provides a listing of support groups across the country and also offers support through its:
- online community
- Facebook page
- Power of Two peer-to-peer program
- IBD Healthline. The IBD Healthline app offers one-on-one support and group advice from others living with irritable bowel disease (IBD).
- MyCrohnsandColitisTeam. MyCrohnsandColitisTeam is a social app that lets you share photos, virtual hugs and likes, comments, and updates. You can also share and learn about suggestions to help you manage flare-ups and boost your quality of life.
Although women are just as likely to develop Crohn’s disease as men, they may experience additional symptoms that may not always be associated with Crohn’s disease.
Some Crohn’s symptoms that may be unique to women include painful or irregular periods and painful sex. Other symptoms may include:
- anemia
- osteoporosis
- lower levels of fertility
Be sure to talk with your doctor or healthcare professional if you have symptoms of Crohn’s disease, including the symptoms that are unique to women.