I have Crohn’s and my stomach pain gets much worse during my periods. How do I know what’s causing it?
The question, asked by a woman aged 30 to 44
I have Crohn’s disease and usually manage my symptoms, but around my period everything seems to get much worse. I get more stomach cramps, bloating and loose stools, and sometimes the pain is difficult to tell apart from my usual period pain. It’s becoming hard to know whether I'm having a Crohn’s flare or if it’s just my cycle making my gut symptoms worse. Is this common with Crohn’s, and should I be discussing it with a gastroenterologist or gynaecologist?
It’s quite common. Many women with Crohn’s notice their gut symptoms get worse during periods. Here is why:
Prostaglandins are hormone-like chemicals that make the uterus contract during periods. They also act on the gut by causing cramps or loose stools. Now, these, along with Crohn’s, feel even stronger.
The hormonal shift of oestrogen and progesterone before the period can change gut movement and sensitivity.
Endometriosis is a condition that can affect the bowel and cause pain. It also causes bloating, loose stools, and can look like Crohn’s. It's quite common, more than people think.
Crohn’s and heavy periods can cause low iron, making you feel more tired and unwell.
It is not always a flare. Tracking symptoms across your cycle and testing inflammation at different points can show a difference. This case needs the involvement of your gastroenterologist as well as your gynaecologist.
Suggested Tests
- Faecal calprotectin
- CRP and CBC
- Ferritin and iron studies
- Stool culture, during a severe episode
- Transvaginal pelvic ultrasound, to check for endometriosis, fibroids or ovarian cysts
- MRI of the pelvis, at the gynaecologist's discretion, to look for deep endometriosis
- A symptom diary across two to three cycles, noting pain, bloating, stool pattern and bleeding by day of cycle
How Clinic Living Plus Can Help
At CLP, we look at your gut and hormones together because this is where your symptoms overlap.
Our functional medicine doctors work along with our women’s health specialist, Dr.Anita GS (OBGYN), and coordinate with your gastroenterologist.
Smart testing for inflammation markers during your period and mid-cycle, iron levels, and a pelvic ultrasound to check for endometriosis or cysts.
We keep track of your cycles for at least 2-3 months to detect a flare from period-related symptoms.
Our doctors guide you on period pain relief that does not affect your gut.
Anti-inflammatory, gut-friendly food that adjusts your cycle with extra support for iron.
We provide certain therapies, like IV nutrition, to correct iron and nutrient deficiencies and provide gut-healing support to keep Crohn’s calm.
Lifestyle & Nutrition Tips
- Track the symptoms like cramps, bloating, stool frequency, and bleeding for each day. At least 2-3 cycles of this can help your gastroenterologist and gynaecologist identify a pattern.
- During your periods, choose simple, nourishing meals and food items that you tolerate well, especially when the cramps and loose stools increase. Avoid experimenting with new foods or unnecessary restrictions during this particular phase.
- Be extra careful and keep yourself hydrated during loose stools. Increase fluid intake when bowel movements become more frequent, especially during periods. Oral rehydration solutions can also be of great help if diarrhoea is prolonged.
- Consult with your healthcare professional if you want to use any painkillers for periods, as it can aggravate Crohn’s symptoms in some people. Discuss suitable pain relief with your gastroenterologist or gynaecologist instead of self-medicating.
- Discuss with the specialists regarding the recurring cyclical pain, also assuming pain during periods should not be automatically assumed to be Crohn’s. A proper evaluation can help distinguish bowel inflammation from a gynecological condition called endometriosis.
What to Do Next
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