Crohn’s disease isn’t fun for anyone, but women living with the condition have a few extra things to consider. Like, “Am I bloating because of my period or Crohn’s? Or both!”

From weight gain to weight loss to pain during sex, Crohn’s disease symptoms in women can appear in all sorts of ways. This article is here to help you understand how Crohn’s can affect you and the best ways to keep symptoms at bay.

Crohn’s is a tricky devil. During flare-ups, many people can’t eat (or can only eat a little) because the results after that are so painful. So, most people think that everyone who has Crohn’s is skin and bones.

But Crohn’s disease doesn’t always cause weight loss. Sometimes, it causes the scale to go up. One study found that 40 percent of people with Crohn’s had a body mass index in the overweight or obese range.

It’s not clear exactly why some people gain weight with Crohn’s, but there are a number of possible causes.

Inactivity

During a Crohn’s flare-up, the digestive tract becomes inflamed, which leads to pain. When you’re in a lot of persistent pain, do you feel like hitting the gym? Probably not. Since flares can make work outs hard (if not impossible), the lack of exercise can lead to weight gain.

Dietary choices

Some people find processed foods less painful to eat during flares. The combination of pain, lack of sleep (due to said pain), and limited mobility doesn’t exactly inspire you to whip up a batch of nutritious meals. But turning to processed foods can also lead to weight gain over time.

Crohn’s medications

Diet and exercise aren’t the only factors to blame. Steroids (a common Crohn’s medication) can also contribute to water retention and rapid weight gain.

Though this is often temporary because you generally lose that weight when you no longer take steroids, it can be understandably worrying to suddenly put on extra pounds.

Overall, even though weight gain can happen with Crohn’s, it’s not usually serious. Your body is going through a lot during a flare-up, and weight fluctuation comes with the territory.

Be kind to yourself, try to mostly eat nutrient-rich foods, and get some exercise. As the condition goes into remission, you’ll likely be able to go back to a weight that’s manageable for you.

With Crohn’s, food moves quickly through your body. This leads to problems like needing to poop all the time, pain after eating, and malnutrition, which can all contribute to weight loss.

Then comes the bizarre scenario of feeling physically like garbage yet having people comment on how “lucky” you are to have lost so much weight.

Weight loss can be mild or extreme and varies greatly from person to person. If you start losing weight out of the blue, you might be experiencing a flare-up.

To stave off weight loss and malnutrition, try to eat. That’s the most obvious advice in the world, but food can cause so much pain that people with Crohn’s end up eating as little as possible to ward off discomfort.

Experiment to find out which foods trigger your symptoms the least, and aim to eat small but frequent meals. Consider supplementing with vitamins to make sure you’re properly nourished.

Crohn’s + hormones = a whole slew of symptoms. Gynecological problems vary greatly from person to person and are often mild. But it’s good to be aware of these symptoms (and maybe cut yourself extra slack when Aunt Flo visits).

Irregular periods

Periods and Crohn’s seem to work together to make your life a little extra miserable.

For some people, hormonal fluctuations during their menstrual cycle can worsen typical Crohn’s symptoms. That means more bloating, pain, and running to the bathroom. Sarcastic yay.

Others may experience more unpredictable cycles. Unexpected weight loss from Crohn’s can stop periods or make them irregular. The inflammation related to Crohn’s can also mess with your menses.

Either way, irregular periods can happen with Crohn’s. Luckily, one 2014 study showed that periods tend to become more regular when the disease is in remission.

Heavy periods

It’s a little odd that Crohn’s can stop your period or make it heavier, but it happens. Again, this is different person to person.

If you start experiencing heavier periods, it could mean your Crohn’s is flaring up. Once the disease is in remission, heavy periods should go back to their regular level.

Iron deficiency

Fluctuations in your menstrual cycle can make you more susceptible to iron deficiency. Heavy periods can also lower iron levels. When these powers are combined, anemia is a real possibility.

It’s best to stay in the know about your iron levels at all times with Crohn’s. But if you start experiencing irregular periods, be sure to get your iron levels checked.

Pain during sex

Painful sex could be a symptom of active inflammation, which can bring on a flare. Changing your treatment regimen may help address the pain, as well as any underlying flare that’s brewing.

Pain during sex may also be a symptom of a fistula near your vagina. According to Crohn’s and Colitis UK, 1 in 3 people with Crohn’s experience fistulas.

It’s important to get fistulas treated as soon as possible. Untreated fistulas can lead to bowel or urinary concerns, infections, and potential surgery.

Pain during sex is by no means a guarantee that you have a fistula. But it’s worth checking with your doctor or gynecologist to make sure that your Crohn’s isn’t flaring up, and you don’t have any fistulas to worry about.

Potential fertility concerns

If your disease is in remission, Crohn’s doesn’t have much of an effect on fertility. According to a 2013 research review, people with inactive Crohn’s have the same fertility rates as people without the disease.

But if you’re in the middle of a flare, you may have greater difficulty getting pregnant. If possible, it’s best to try to get pregnant when Crohn’s is more manageable for you.

That’s because pregnancy tends to go a lot more smoothly when Crohn’s flare-ups don’t get in the way. Often, people who get pregnant in remission have typical pregnancies, meaning their Crohn’s don’t get worse.

In general, it’s thought that if your symptoms are mild at conception, they’ll likely stay mild throughout your pregnancy.

If you’re thinking of getting pregnant, it’s best to talk with a specialist first, since all Crohn’s pregnancies are technically high-risk. That doesn’t mean you can’t get pregnant or that it’ll be dangerous!

But pregnancy will be much easier for you and your baby if you can get your Crohn’s in remission for a few months before you conceive.

Living with Crohn’s disease is a different experience for everyone. It’s unlikely you’ll experience all these Crohn’s symptoms, but here are some to look out for:

  • frequent diarrhea
  • stomach or abdominal pain
  • pain in the eyes or changes in vision
  • swollen joints
  • tenderness in your abdomen
  • rectal bleeding
  • persistent vomiting
  • high fever
  • an abdominal lump or mass

There’s no cure for Crohn’s, and there’s no one treatment that works for everyone. But working with your doctor to develop a treatment and management plan to follow can lead to long stretches of remission and relief from the condition.

Your doctor may recommend following these steps.

Avoid triggers

When you have Crohn’s, certain foods can make symptoms worse. Try keeping a food diary and taking note of any ingredients that seem to cause flares.

Once you’ve identified your food triggers, try eliminating them from your diet to see if your symptoms improve.

Stress can also trigger a flare-up. You can’t really say “I can’t be stressed” to your boss when you’re given a deadline. But you can make time for meditation, exercise, or your stress-busting activity of choice.

A long bath is good for your health when it comes to Crohn’s, so schedule time for legitimate self-care on your calendar.

Medication

For very mild symptoms, over-the-counter acetaminophen can help. But stay away from options like ibuprofen, naproxen, and aspirin. These pain relievers can actually make Crohn’s symptoms worse.

Though some mild cases may not need prescription medication, many people who have Crohn’s do. Your doctor may prescribe:

  • Aminosalicylates. These drugs contain 5-aminosalicylic acid (5-ASA), and are used to help reduce inflammation and treat mild symptoms.
  • Corticosteroids. These types of steroids are used to help reduce immune system activity and inflammation. They’re typically used only during a flare to control moderate to severe symptoms.
  • Immunomodulators. Used to reduce immune system activity, these drugs can take weeks to months to start working. They’re usually only prescribed for those who haven’t responded to other treatments. Since immunomodulators reduce your overall immune function, they can also leave you vulnerable to infections and other diseases.
  • Biologic therapies. These medications target specific proteins in your immune system. They’re also used primarily for people who haven’t responded to other treatments.

Bowel rest

It’s a funny-sounding term, but bowel rest can help reduce severe Crohn’s symptoms. It involves drinking a liquid that contains necessary nutrients for your body and nothing else.

You may need to stay on bowel rest for a few weeks to several months, depending on your symptoms. Since this liquid diet doesn’t require any work from your intestines, it gives them an opportunity to take a break and heal.

In very severe cases, doctors may put you on bowel rest via an intravenous (IV) or feeding tube. This isn’t common and is typically reserved for serious cases that haven’t responded to other Crohn’s medications.

It’s best to touch base with your doctor regularly when you have Crohn’s. Since the disease has no cure, you want to stay on top of your treatment to avoid flares as best you can.

If any of your symptoms suddenly get worse, try to call a doctor as soon as you can. You also want to make an appointment right away if you have persistent vomiting, symptoms of a fistula or intestinal blockage, or high fever.

Along with Crohn’s comes a variety of symptoms, some of which are complete opposites of one another.

It can cause weight gain or weight loss. Heavier periods, or no period. You may have no trouble getting pregnant, or have problems with fertility. This can make Crohn’s extra confusing to deal with.

Luckily, if you avoid triggers and stay on top of your treatment, Crohn’s symptoms can be manageable. Symptoms may even disappear entirely as you achieve remission.