Women with Crohn’s and Colitis – 7 Questions to Ask
Women & IBD: 7 Questions Women Ask Most About Crohn’s Disease and Ulcerative Colitis
If you’re a woman with Crohn’s or Colitis and you have questions about how to manage inflammatory bowel disease (IBD)–we have you covered. Maybe you’re curious how IBD affects women differently than men. We talked to our gastroenterologists here at GI of the Rockies to answer your top questions about women with Crohn’s disease and ulcerative colitis.
1. Why Does My IBD Get Worse Around My Period?
Let’s discuss period symptoms and IBD. If you’ve noticed different digestive symptoms at the start of your menstrual cycle, just know, you’re in good company. IBD symptoms can change during your period, so if this sounds like you, just know, it’s fairly common.
Common Period Symptoms with IBD
- Bloating
- Cramping
- Frequent diarrhea
- Abdominal pain
- Increased fatigue
Some women also notice heavier bleeding from hormonal fluctuations when their period arrives.[i]
To better understand how hormones affect IBD, talk to your GI specialist or gynecologist.
Info Box
Want to learn more about how IBD affects women? Read about women’s health on Crohn’s & Colitis Foundation – or visit their Rocky Mountain Chapter to stay locally connected.
2. Can IBD Cause Fatigue Even When My Symptoms Seem Under Control?
IBD fatigue is a common symptom for people dealing with Crohn’s or ulcerative colitis. Are you asking—’Why am I tired all the time? Here’s what you need to know about IBD and fatigue—especially if you’re juggling work, parenting or caregiving for a family member.
About 80 percent of people with active IBD report fatigue, according to the Crohn’s and Colitis Foundation.
Common reasons for feeling tired with IBD stem from sleep disruptions to a lack of nutrient absorption during flare ups. Some people may notice low levels of B12, folate or iron.
Another contributor to feeling tired—inflammation.
When your immune system reacts to inflammation, the body consumes massive amounts of energy as it tries to get back to homeostasis. This process is thought to trigger brain messengers, known as cytokines, that bring on feelings of tiredness.
Researchers also note that fatigue with IBD is observed in low levels of physical activity; emotional fatigue, or low interest and possibly mood swings; and psychological factors, which may affect memory and concentration tasks at home, work or school.
Source: International Journal of General Medicine, 2025
A Call for More Research on IBD and Fatigue
While more research is needed to better understand IBD-related fatigue, women who battle constant exhaustion say that it’s often challenging to explain their symptoms. We get it. The frustration is real. It’s important to practice self-compassion when symptoms show up or won’t go away. Talking to a caring medical provider can help you cope with both the physical and emotional aspects of IBD.
3. IBD and Pregnancy: Can I Still Have a Healthy Pregnancy if I Have Crohn’s Disease?
Here’s what Kelly Zucker, DO, gastroenterologist with GI of the Rockies said, when asked about getting pregnant if you have Crohn’s.
“Yes, you can definitely still have a healthy pregnancy with Crohn’s disease (CD)! The best way to reduce any risks from CD is to ensure clinical remission before conception, during pregnancy, and in the post-partum, said Dr. Zucker.
“The best way to do this is with medication and follow up imaging and procedures for objective evidence of remission rather than just relying on symptoms alone.”
Dr. Zucker also discussed the safety of biologics during pregnancy.
“It is safe to continue biologics throughout pregnancy and it’s encouraged. Mesalamine is also safe, as is sulfasalazine but it does require additional folic acid starting three months prior to conception,” she said.
Wondering which Crohn’s medications to stop during pregnancy?
Dr. Zucker breaks down this medication question so you can have some guidelines around a healthy pregnancy with Crohn’s Disease.
“Medications that need to be stopped are methotrexate, thalidomide, and ozanimod, six months prior to conception. The best way to ensure a healthy, safe pregnancy is to work with your GI doctor prior to conception and maintain in close contact with your OB and GI doctors throughout pregnancy,” Dr. Zucker said.
4. Is it hard to conceive when you have Crohn’s or ulcerative colitis?
The conception question and how Crohn’s or colitis can affect your chances of getting pregnant is a common question. Joshua Steinberg, MD, gastroenterologist and director of IBD at Gastroenterology of the Rockies said, “Active inflammation can make it harder to conceive and may increase pregnancy risks, which is why maintaining remission is so important.”
He added that a big misconception he hears is that some people believe IBD medications should be stopped during pregnancy, but Dr. Steinberg says that’s not true.
“In reality, many IBD therapies are considered safe and continuing treatment is often much safer than allowing the disease to flare during pregnancy,” Dr. Steinberg said. “Patients who have had prior pelvic surgery may experience reduced fertility, but many still successfully conceive with the right support and care.”
He also said that it’s important to have an individualized treatment plan to help maintain disease control–especially when trying to conceive.
“At our practice, we work closely with OB/GYN and maternal-fetal medicine teams to help patients navigate pregnancy safely and confidently. With the right planning and care, most patients with IBD can successfully build a family,” Dr. Steinberg said.
5. Menopause and IBD: Is It Normal for IBD Symptoms to Change in Your 40s and 50s?
Women in their 40s and 50s know when things start to change. Yes. Digestive symptoms during perimenopause and menopause are expected changes for women to anticipate.
Here’s what Dr. Steinberg says about what to expect with IBD for women in their 40s and up.
“Hormonal changes can affect digestion, inflammation, sleep, energy, and stress levels, sometimes making symptoms feel different during this stage of life,” he said.
When it comes to menopause and IBD-you might wonder if your having a flare or if it’s related to hormones.
Here’s what’s important to remember with menopause and IBD, according to Dr. Steinberg—not all of your symptom changes are IBD flares. He added that it’s important to check in regularly with your doctor. These assessments with your GI specialist can help them see how well your IBD therapy works — or whether it needs to be optimized, Dr. Steinberg said.
“Bloating, bowel changes, fatigue, and abdominal discomfort can also be related to hormonal shifts, IBS or other factors. That’s why ongoing monitoring and open communication with your care team are important,” Dr. Steinberg said. “Menopause is also an important time to focus on bone health, nutrition, sleep, and overall wellness — all of which can impact IBD and quality of life.”
6. How Do You Know if It’s IBS or IBD?
IBS vs IBD- let’s compare
Inflammatory Bowel Disease (IBD) is characterized by inflammation of the bowel wall with visible sores or ulcers. IBD is also linked to narrowing of the intestines. The physical damage from sores and inflammation causes IBD symptoms. During a colonoscopy, your doctor may see chronic inflammation and ulcers in the GI tract. IBD is an umbrella term that refers to diseases like ulcerative colitis and Crohn’s disease.
Common IBD symptoms
- Abdominal pain
- Diarrhea
- Weight loss
- Urgency to defecate
- Fecal incontinence
Irritable Bowel Syndrome (IBS) also targets the gastrointestinal (GI) tract. With IBS, symptoms are real; however, the current tests like colonoscopy, stool or blood tests do not detect the root cause for your symptoms.
Some people may have both IBD and IBS.
Common IBS symptoms
- Abdominal pain or cramping during bowel movements
- Diarrhea or constipation — or a mix
- Bloating
- Gas
- Mucos in stool
Source: Cleveland Clinic
7. When an IBD Evaluation Matters
If you suspect that you may be experiencing Crohn’s or ulcerative colitis, it’s important to talk to a doctor who can properly evaluate your symptoms. Finding a GI specialist you trust can help you understand the disease and how to manage it.
“Many patients with chronic GI symptoms may benefit from earlier GI evaluation, particularly those with persistent diarrhea, rectal bleeding, unexplained anemia, weight loss, elevated inflammatory markers, or family history of IBD,” Dr. Steinberg said. “Early recognition of possible IBD can significantly improve outcomes, reduce steroid exposure, and help prevent complications such as hospitalization and surgery.”
Do you have questions about how to manage Crohn’s or ulcerative colitis? Book a consultation with our team of female GI specialists. Request an appointment today.
- Curious about IBD clinical trials?
Visit our Crohn’s and Colitis clinical trials page.
Our team is here for you. From the first consultation through follow up care, we focus on clear communication, evaluation and guidance for your overall GI health. Digestive health plays a big part in your wellness. If you have questions about digestive symptoms, screening options or specialty care, we encourage you to contact Gastroenterology of the Rockies to schedule a consultation.
Written by Elise Oberliesen, digital marketing specialist; medically reviewed by Emily Marshall, PA-C, with Gastroenterology of the Rockies.
Additional Sources
[i] Menstrual cycle abnormalities in women with inflammatory bowel disease and effects of biological therapy on gynecological pathology – PMC