Menopause and IBD: What a Gastroenterologist Wants You to Know

Dawn B. Borromeo Beaulieu, MD, Vanderbilt University Medical Center

Living with inflammatory bowel disease (IBD) isn’t easy. You are likely putting a lot of effort into getting into or staying in remission and don’t want anything to set you back. If you are currently in remission, you may be wondering if your IBD will change as you age.

Enter Dawn B. Borromeo Beaulieu, MD, a gastroenterologist at Vanderbilt University Medical Center. She shared with us the facts about menopause that every woman with IBD needs to know.

But before we learn about menopause and IBD, let’s first talk about what menopause actually is.

Dr. Beaulieu says that “menopause is when your ovaries stop making estrogen and your periods stop for 12 months without any other cause.” It’s important to understand that menopause is not an on-off switch. It’s a gradual change that takes place over multiple years.

According to Dr. Beaulieu, the “transition to menopause typically begins in your 30’s or 40’s” and this transitional period is called perimenopause. Your length of time in perimenopause can vary, but Dr. Beaulieu tells us that the “entire process typically takes around 4 years and starts when your ovaries start making less estrogen.”

While some women enter menopause earlier or later than others, the “median age of menopause is 51.4 years (ages 46-52),” says Dr. Beaulieu.

What can you expect as you transition into menopause? Dr. Beaulieu’s list of symptoms includes, “irregular periods, hot flushes, tender breasts, fatigue, night sweats, vaginal dryness, difficulty sleeping, decreased libido, [and] mood changes.”

Another side effect that Dr. Beulieu notes is that “menopause can also change the way fat is distributed in your body.” This can lead to more belly fat and is likely because of the change in hormones.

Now that you understand the process of transitioning into menopause, let’s discuss menopause and IBD.

Given the research that we’ve previously discussed on the effects of IBD on the menstrual cycle, you might be wondering if there are special considerations for menopause and IBD.

While there has been some research, Dr. Beulieu tells us that there is ”not a lot of data on menopause and IBD.” According to Dr. Beaulieu, a “study in 2008 did not show a difference in age of menopause” in women with IBD compared to women without IBD.³

That same study also looked at postmenopausal women with IBD on hormone replacement therapy (HRT). Dr. Beaulieu tells us that the women on HRT “were 80% less likely to flare” compared to women with IBD who were not on HRT. The researchers think this is because estrogen can have anti-inflammatory effects.³

Before you jump into taking HRT, Dr. Beaulieu cautions that more research is needed and that HRT “can increase [the] risk of breast cancer, heart disease, stroke and blood clots.” It’s essential that you talk to your gastroenterologist and healthcare team about your treatment options.

Menopause is often talked about as something that needs to be fought against, but Dr. Beaulieu reminds us that “it is a NORMAL part of aging.” As a woman with IBD, it’s important to know what to expect and work with your gastroenterologist to help you keep your IBD in check as you enter this new season of your life.

1. Bonthala N, Kane S. Updates on Women’s Health Issues in Patients with Inflammatory Bowel Disease. Curr Treat Options Gastroenterol. 2018 Mar;16(1):86-100. Doi: 10.1007/s11938-018-0172-4. Review. PMID:29479656

2. Donaldson EK, Huang V, Ross S, et al. Experience of menopause in women with inflammatory bowel disease: pilot study. Climacteric 2017; 20: pp. 545-555

3. Kane SV, and Reddy D. Hormonal replacement therapy after menopause is protective of disease activity in women with inflammatory bowel disease. Am J Gastroenterol 2008; 103: pp. 1193-1196

4. Marjoribanks J, Farquhar C, Roberts H, et al. Long-term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev 2017; Jan 17;1(1):CD004143. Doi: 10.1002/14651858.CD004143.pub5. PMID: 280937321:

5. Ona S, James K, Ananthakrishnan AN, Long MD, Martin C, Chen W, Mitchell CM. Association Between Vulvovaginal Discomfort and Activity of Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. 2020 Mar;18(3):604-611.e1. doi: 10.1016/j.cgh.2019.05.018. Epub 2019 May 18. PMID:31108226

Katelyn Collins, RD is a registered dietitian and health writer specializing in digestive health. Katelyn’s personal experience with a digestive condition first sparked her passion for nutrition and health. Since then, she has been a vocal advocate for the digestive health community and has dedicated her own nutrition practice to serving those with digestive conditions.