Menstrual cycle changes in women with inflammatory bowel disease: a study from the ocean state Crohn's and colitis area registry.
BACKGROUND
The effect of the inflammatory bowel diseases (IBD) on menstrual function is largely unknown. The aims of this study were to determine whether changes in menstrual function occur in the year before IBD diagnosis or in the initial years after diagnosis.


METHODS
Women aged 18 years and older in the Ocean State Crohn's and Colitis Area Registry with at least 2 years of follow-up were eligible for this study. All patients were enrolled within 6 months of IBD diagnosis and followed prospectively. Menstrual cycle characteristics were retrospectively assessed. To assess for changes over time, general linear models for correlated data were used for continuous outcomes, and generalized estimating equations were used for discrete outcomes.


RESULTS
One hundred twenty-one patients were studied. Twenty-five percent of patients experienced a change in cycle interval in the year before IBD diagnosis and 21% experienced a change in the duration of flow. Among women with dysmenorrhea, 40% experienced a change in the intensity of their menstrual pain and 31% experienced a change in its duration. Overall cycle regularity increased over time. Quality of life was significantly lower in women without regular cycles across all time points.


CONCLUSIONS
Changes in menstrual function occur frequently in the year before IBD diagnosis; therefore, screening for menstrual irregularities should be considered in women with newly diagnosed IBD. Patients can be reassured that cycles typically become more regular over time.
*Division of Gastroenterology and Hepatology, and †Department of Biostatics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; ‡Division of Gastroenterology, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island; §Division of Reproductive Endocrinology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; ‖Department of Pediatric Gastroenterology, Rhode Island Hospital, Providence, Rhode Island; ¶Division of Community Health, Centers for Disease Control and Prevention, Atlanta, Georgia; **Crohn's and Colitis Foundation of America, New York, New York; and ††Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine, Mount Sinai, New York, New York.
Sumona
S
Saha
Ying-Qi
YQ
Zhao
Samir A
SA
Shah
Silvia Degli
SD
Esposti
Sheldon
S
Lidofsky
Sana
S
Salih
Renee
R
Bright
Meaghan
M
Law
Heather
H
Moniz
Nicole
N
Flowers
Marjorie
M
Merrick
Bruce E
BE
Sands
D000328:Adult; D003093:Colitis, Ulcerative / Q000503:physiopathology*; D003424:Crohn Disease / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology*; D009792:Oceans and Seas; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data*