Hormones and Crohns Disease.

Inflammatory bowel disease and Crohns present with unique hormonal issues. Inflammation, malnutrition and the medications used to treat the inflammation can slow the onset of menses in teen patients, and can prevent menstruation in women with active symptoms.

Menopause brings about many changes in a women’s body and there is much controversy regarding Hormone replacement therapy in menopausal women.

Hormones and Crohns Disease
Image Courtesy: tanenbaumtjm.com

Studies suggest that HRT can protect against flares in inflammatory conditions in the first two years of menopause. (1)(2)

According to studies with patients who have inflammatory bowel disease (including Crohns and Ulcerative colitis) there is an increased prevalence for osteoporosis. (3)

There is also evidence that suggests that osteoporosis is more prevalent in patients with IBD than in the general population. Hormone replacement therapy is effective in treating and preventing osteoporosis. (4)

There are also many symptoms of hormone deficiency that may be masked by the inflammatory bowel state.

Hormone deficiency may present in these ways:

Symptoms of hormone deficiency in Women:
Water Retention
Increased Facial hair
Pain
Migraine
Muscle pain
Vaginal dryness
Fatigue
Memory loss
Urinary incontinence
Symptoms of Hormone deficiency in Men:
Lethargy
Sleep disturbances
Irritability
Low Libido
Loss of concentration
Mood swings
Anxiety
Changes in Metabolism
Changes in Muscle mass
Irritability/anger
Anxiety
Mood swings
Loss of Libido
Acne
Hot flashes
Sleep Disturbances

Many Physicians have previously prescribed anti-depressants to treat the symptoms while the underlying cause (hormone deficiency) has gone untreated. If you have a look the list above once again I am sure you will associate some of these symptoms with what you previously thought were symptoms of IBD. While it is impossible for me to say that treating the underlying hormone deficiency will help with your IBD treatment there certainly seems to be a correlation between the symptoms expressed as being caused by IBD and those symptoms that may have the underlying cause in hormone deficiency.

It is essential to remember that you should always consult a medical practitioner before beginning treatment but the correlation here seems at least to me (a pharmacist with a history in the family of Crohns) that treating the underlying hormonal deficiency may produce some beneficial results in your fight against IBD.

REFERENCES:
(1) Khan KN, Kitajima M, Hiraki K, et al.
(2) Am J Reprod Immunol. 2008; 60: 383-404. Immunopathogenesis of Pelvic Endometriosis: Role of Hepatocyte Growth Factor, Macrophages and Ovarian Steroids
(3) D.Clements, J.E.Compston, W.D. Evans, J.Rhodes.
(4)  McFarlane XA, Dixey J, Dumfrey J, et al. (1996) Increased risk of bone fractures in coeliac disease [abstract]. Gastroenterology 110:A821.

Source:
By Saul Kaye Bpharm MPS
askthepharmacist@israelpharm.com
(available for consultation) 
16 April 2013

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