Hormone Replacement Therapy May Decrease Inflammatory Bowel Disease (Crohn's Disease or Ulcerative Colitis) in Menopausal Women

(Jan, 2008) In a recent study, women who received estrogen replacement therapy for menopause were ~ 80% less likely to experience a flare-up of inflammatory bowel disease (Ulcerative Colitis, Crohn's Disease) symptoms in the 2-year period after the menopause than the other women.

The study suggests that menopausal women with Crohn's disease or ulcerative colitis may benefit from hormone replacement therapy to reduce their risk of bowel disease symptoms. As Premarin has been shown to be dangerous, however, in my patients I would use a trial of Bioidentical Hormone Replacement with a mix of Estriol and Estradiol, which research suggests is safer and beneficial. Estriol can have beneficial effects on immune function in other illnesses as well. For example, symptoms and MRIs of women with multiple sclerosis improve on Estriol.

To investigate the effect of the menopause on inflammatory bowel disease activity, the researchers studied data on 45 women with Crohn's Disease and 20 with Ulcerative Colitis. Bowel disease symptoms were assessed in the women both before and after they had gone through the menopause.

The researchers found that 35% of the women experienced bowel disease flare-ups in the 2-year period before the menopause and, similarly, 38% experienced flare-ups in a 2-year period after the menopause. Because of this, the researchers concluded that menopause had very little, if any, effect on inflammatory bowel disease activity.

This interpretation is questionable, however, because women develop estrogen deficiency for ~ 5-12 years before periods stop and blood tests become abnormal. So a better comparison would have been with women in their 20's.

Nonetheless, the team did find that women who received hormone replacement therapy had a dramatic decrease in symptom severity.

Dr.s Kane and Reddy conclude: "We found that overall the percentage of women experiencing a flare of their disease during menopause was not significantly higher than that prior to menopause," a conclusion which may not be accurate.

"However, when taking into account the use of hormone replacement therapy, we found a significant protective effect of hormone replacement therapy use in women with Inflammatory Bowel Disease."

But they added: "Studies with larger numbers of women observed for longer periods of time need to be done to verify this association."

The research appears in an advance online publication by the American Journal of Gastroenterology, 2007.