Birth Control and Crohns

In June my daughter had surgery for a blockage. Before the surgery she would skip periods for two to three months and then have a light period. Since the surgery, she has two week periods followed by maybe a week or two off and then on again for about two weeks. Her iron levels have remained good but this is wearing her down and she is full time in college and working a part time job.

My question is, since I have read that birth control can flare Crohns, what do most people take as far as birth control that will not affect Crohns? Just wanting to get some suggestions before I make her a GYN appointment. I had hoped that she would get on a better cycle but it has been about six months with the same pattern and I am thinking she may need to go on birth control to get her cycles regulated.

Thanks in advance for your opinions.


Margie

Thanks so much for your quick reply. This all sounds reassuring to me.

I think the pill will help, too, but I always want young women to get help figuring out why their menstrual cycles are messed up before they add birth control to the mix.

What you described from before her surgery sounds like anovulatory bleeding, but what do I know? And so many days of bleeding now is not good either. She should track her cycles closely to see how many days she has between periods, which will help everyone understand things better. Have a conversation with her OB/Gyn about doing some baseline hormone tests to see if you can figure out what's going on. She'll probably end up on a pill anyway, but at least you'll have a better understanding of the physiology and/or endocrinology she's dealing with.

I'm not going to advise for/against the use of contraceptives in a patient with Crohn's, but you need to keep this in mind when making your decisions.

On its own, Crohn's disease makes you roughly three times as likely to get deep venous thrombosis or a pulmonary embolism. Oral contraception also increases the likelihood of DVTs and PEs, and if I remember correctly, the effects of both Crohn's disease and contraceptives are synergistic.

As I said, your daughter should make the decision herself, but it's worth knowing the risks and benefits.

Good luck.

I've been on bc pills on and off for 25 years. I've officially had CD for 5 years. I noticed an improvement in my Crohn's when I started taking bc continuously to suppress my periods. My Crohn's is always worse when I have a period.

Sarah

I have always had horrible, continous periods my whole life. The cramps and pain were horrible, heavy perioods as well. I always had a horrible time with diarrhea (more than usual) when my periods arrived.

I take Loestrin FE 24 and I think it's great. It's low-hormone, therefore low-side effect. I started it back in May for ovarian cyst pain, but I haven't had a period since June! How great! No more period/Crohn's problems, just the Crohn's problems.

THE ONLY THING IS . . . birth control can cause yeast infections. People with Crohn's already have a weakened immune system so can get a yeast infection more easily than a healthy person. I have been battling yeast infections for the past three years. I rarely only go up to a few weeks without one- and this was before birth control and my Crohn's diagnosis and budesonide use! I take probiotics capsules daily as well as 1 to 2 chobani greek yogurts for live and active cultures. I know my yeast infections are more recurrent now- cannot attest if it's the BC or budesonide though.

It also changes the flora of your gut. I read a book ("Gut and Psychology Syndrome") that anything that alters gut flora can cause flare-ups of intestinal disorder. The BC causes yeast and disrupts your flora, causing Crohn's flare-ups. I guess it's similar to the way antibiotics shake things up- but an opposite mechanism of action.

Overall- I am very please with Loestrin.

A few weeks ago my GI talked to a gyno about putting me on birth control to keep my periods regulated because during this flare I've gone months without a period(from the Crohn's and weight loss). I'm on a mild form of birth control called Loesterin Fe(sp?). I guess in a month or so we shall see how it works. It hasn't affected my Crohn's. I'm still pretty much the same but since my flare started, when I do have periods, they are so painful and I'm hoping that the pill will ease the pain & regulate my cycle. I've never had a problem with my cycle before Crohn's. I have a lot of gyno problems caused by my Crohn's too so we are hoping the pill will work. My last CT showed inflamation in the rectum/vaginal area. My hormones are just jacked up from this flare, malabsorption etc. I'm young too so I feel the pain!

Hope I helped! (:

I was on the BC pills for years AFTER I had my tubes tied because my periods were so heavy and caused so much grief. I took them continuously for 3 months and then only had to deal with a period 4 times a year. That was great. I did have a lot of break through bleeding though. A few years ago I had an endomeitrial ablation and came off the pills. But I am a good deal older than your daughter.

My younger daughter (just turned 21) does not have CD, but she is the one I worry about, she is always having "issues" and has been to the GI for evaluations, so I think it is just a matter of time. (She is following my, and my mothers pattern, both CDers). Back to the point, she has had period issues since the day she started. Finally her pediatrician sent her to an adolescent clinic at Children's Hospital Boston, where she sees a children's/Adolescent GYN. She was thoroughly checked out and we tried a few different things, but the end result was to take BC for 3 months straight, then have a period, and repeat. She also is suppose to take prescription strength naproxen daily for one week before her period, but she doesn't do that cause it upsets her stomach (Huh, big surprise!). Is there any chance that you can get your daughter into a clinic like this. They really did a great job of setting my daughter at ease and making her comfortable. Since we started seeing them at about age 14, she was really uncomfortable with the whole situation but having doctors who were extremely knowledgeable and knew how to handle kids her age was a huge benefit. It was well worth the trip into the city once a year. She just had her yearly exam and called me on her way home to ask how long I thought she could continue to see her doctor because she just loves her and doesn't want to go to a "big" girl doctor yet.

Addendum to my post:

I forgot to mention I cannot tolerate the 4 days of iron pills from the Loestrin Fe 24 pack! Horrible stuff! My crohn's went crazy when I started taking them, so I just skip those non-hormone pills when I get to that point in my pack. 

Just wanted to point that out for anyone considering taking that type! :)