The most common symptoms of Crohn’s disease are the same for everyone. But this condition can also specifically affect menstruation and pregnancy, for example.
Crohn’s disease is a form of inflammatory bowel disease (IBD). It causes your immune system to drive chronic inflammation and form ulcers in your gut. It can affect any part of the gut, from the mouth to the anus.
In Western countries, like the United Kingdom, females have a lower risk of developing Crohn’s disease than males until puberty. After this time of life passes, females have a higher risk.
Many symptoms of Crohn’s disease relate to your gut, such as how your gut feels or how often you need to go to the loo. But unmanaged Crohn’s can also impact many other areas of the body.
Read on for more information about the symptoms of Crohn’s disease and how this condition can affect menstruation, fertility, pregnancy and sex.
Female-specific symptoms
As we’ve noted, Crohn’s disease primarily causes gut-related symptoms. But if the condition isn’t managed effectively, it can affect other aspects of health.
It’s worth mentioning that Crohn’s symptoms appear during ‘flare-ups’ of the disease, and receiving treatment can help reduce and even prevent flare-ups from happening.
With that in mind, here are some areas of health more specific to females where Crohn’s disease can cause symptoms.
Menstruation
Crohn’s disease can lead to changes in your menstrual cycle. This could mean having shorter periods more often, or having longer gaps between periods.
On top of this, the menstrual cycle can affect gut symptoms. So, if you experience these symptoms, they may get worse during menstruation – especially diarrhoea.
Finally, both Crohn’s disease and heavy periods can increase your risk of anaemia: low levels of red blood cells. This may be due to blood loss or, for people with Crohn’s, not getting enough of certain nutrients.
Pain during sex
Evidence suggests that people with Crohn’s disease (or other forms of inflammatory disease) are more likely to report issues during sex than the general population.
One aspect of this is dyspareunia, the term for pain during sex. Research has found that females with Crohn’s disease are more likely to report pain during sex and more difficulty having an orgasm than others.
One possible reason for this pain involves contraction of the pelvic floor muscles. These muscles contract in response to diarrhoea and tummy pain, and it can affect how you feel in your pelvis, vulva and vagina.
Other factors that might contribute to pain during sex include complications with surgery, changed pelvic floor function, vaginal fistulas and Crohn’s disease activity.
Fertility
Fertility rates among people with controlled Crohn’s disease are similar to those who don’t have the condition. However, if you’re not receiving treatment, some aspects of Crohn’s could reduce your fertility.
Gut inflammation during a Crohn’s disease flare-up could affect the ovaries and fallopian tubes.
And if Crohn’s is also causing stress or making it difficult to get adequate nutrition, this can negatively affect reproductive hormones.
And of course, if sex is painful, you may be less inclined to try and conceive this way.
It’s worth noting that while the medicines for treating Crohn’s disease don’t impact fertility, some aren’t safe to take during pregnancy.
So, if you’re planning a pregnancy, be sure to discuss how this might affect your treatment plan with a doctor first.
Pregnancy
It’s important to keep in mind that most people with Crohn’s disease who become pregnant have normal pregnancies and births.
However, studies have found that Crohn’s disease could increase the risk of a number of pregnancy complications, including:
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preterm delivery
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low birth weight
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the need for a Caesarean delivery (C-section)
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foetuses and babies being small for their age during pregnancy and at birth
If you have Crohn’s disease and you’re pregnant, it’s important to have discussions with your IBD and maternity teams. They’ll recommend any necessary changes to your medication and help you meet your nutritional and other dietary needs.
General symptoms of Crohn’s disease
The most common symptoms of Crohn’s disease include:
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tummy pain
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an urgent need to go to the toilet
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blood or mucus in your poo
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pain in your bottom
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fatigue
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loss of appetite
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unintended weight loss
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generally feeling unwell
Other, less common, symptoms include:
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joint pain
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eye pain
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skin rashes
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mouth ulcers
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swollen lips or gums
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tears in the skin around your bottom
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small bumps or raised areas around your bottom
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abscesses around your bottom
Many other conditions can cause similar symptoms, such as irritable bowel syndrome (IBS), ulcerative colitis and coeliac disease.
We have an article on the differences between IBS and IBD, including Crohn's, if you want to learn more.
Crohn’s disease symptoms range from mild to severe, and they can differ from person to person.
Symptoms tend to flare up then go away over time, and flare-ups may last from a few days to several months.
If you think you might have Crohn’s disease, or a condition that causes similar symptoms, it’s important to see a doctor for a diagnosis – especially if you have bloody diarrhoea or poo that’s black or dark red.
Experts aren’t entirely sure what causes Crohn’s disease to flare up, but factors such as family history, a previous gut infection and antibiotic use can play a role.
There are many things you can do to manage this condition with the help of your doctor and an IBD team. The right treatments can help keep symptoms at bay for long periods.
Treatment
When doctors start treating Crohn’s disease, they aim to reduce any inflammation in the gut. The next phase of treatment involves keeping inflammation under control.
The treatment mainly involves taking medicines to reduce and prevent Crohn’s symptoms. What doctors prescribe will depend on how Crohn’s disease is affecting you and how severe it is.
Medications for Crohn’s disease include:
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steroids to reduce inflammation, such as hydrocortisone or budesonide
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immunosuppressants to reduce your immune response, such as methotrexate or azathioprine
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biologic medications that target your immune system and stop specific proteins from causing inflammation, such as adalimumab or infliximab
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medications to treat specific symptoms, such as anti-diarrhoea or anti-sickness medicines, pain relief medications and laxatives
It’s important to speak with your IBD team before you try any new medications.
In more severe cases, when these medications aren’t making enough of a difference, or if Crohn’s is affecting a specific part of your gut, doctors may recommend surgery.
Surgery for Crohn’s disease could include:
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resection, which involves removing a damaged part of the gut and joining together the healthy parts
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stricturoplasty, which involves widening a part of the gut where scar tissue has built up due to inflammation
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ileostomy or colostomy, which involves bringing part of the intestine through an opening in the tummy, allowing part of the gut to rest or be removed
Diet and living with Crohn’s disease
Crohn’s disease can have a big impact on your routine and lifestyle. But alongside the right treatments, there are steps you can take to help manage this condition.
Though Crohn’s mainly affects the gut, there’s currently no evidence that certain foods or diets can cause or cure this condition. Still, your diet is an important consideration.
Crohn’s can cause inflammation in your gut, which can make it harder for your body to absorb nutrients. So, it’s really important to have a healthy, balanced diet to give yourself the best chance of getting all the nutrients you need.
Certain nutrients can help with some of the female-specific issues we’ve mentioned above, including the risk of anaemia and reduced fertility.
However, the effects of Crohn’s and some of its treatments can make it harder to get enough of many of these nutrients. A dietitian can describe how to get what you need, and they may recommend a supplement, in some cases.
Important nutrients include:
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iron
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vitamin D
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folate
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vitamin B12
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fibre
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zinc
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calcium
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omega-3s
Some people may find that certain foods make their symptoms better or worse. So, it can help to track your symptoms alongside what you’re eating, to see if any patterns emerge.
Keeping a food diary can also make it easier to discuss these things with your doctor.
Finally, it’s important to drink enough fluids – dehydration can be a risk, depending on your symptoms.
Summary
Crohn’s disease is a form of IBD. Many of its symptoms are gut-related, such as diarrhoea and tummy pain, but it can also affect menstruation, fertility, pregnancy and how sex feels.
Managing Crohn’s involves taking medications, and some people also require surgery. It’s also important to support your treatment plan with a healthy, balanced diet. This can help you get the nutrients you need, and it may relieve some symptoms.
You can find further support from Crohn’s and Colitis UK. Their website offers lots of information, plus links to other virtual and in-person resources.
To learn more about other gut health topics, visit Symprove’s Gut Hub.
Sources
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Crohn’s disease. StatPearls. (2024). Link.
Crohn’s disease and female infertility: Can nutrition play a supporting role? Nutrients. (2022). Link.
Crohn’s disease stricturoplasty. StatPearls. (2023). Link.
Familial and ethnic risk in inflammatory bowel disease. Annals of Gastroenterology. (2017). Link.
Gastrointestinal infection increases odds of inflammatory bowel disease in a nationwide case-control study. Clinical Gastroenterology and Hepatology. (2019). Link.
Impact of female gender in inflammatory bowel diseases: A narrative review. Journal of Personalized Medicine. (2023). Link.
Reproductive health and fertility. (2023). Link.
Review of pregnancy in Crohn’s disease and ulcerative colitis. Therapeutic Advances in Gastroenterology. (2021). Link.
Sex and relationships. (2024). Link.
Sex-based differences in inflammatory bowel diseases: A review. Therapeutic Advances in Gastroenterology. (2020). Link.
Sexual dysfunction in female patients with inflammatory bowel disease: An overview. Clinical and Experimental Gastroenterology. (2022). Link.
Sexual health in women with inflammatory bowel disease in the Danish National Birth Cohort. Journal of Crohn’s Disease and Colitis. (2020). Link.
