IBD: Issues With Menstruation and Contraception. Menstrual Cycle and Bowel-Pattern Fluctuations Bowel-pattern fluctuation is common during the menstrual.

Slides:



Advertisements
Similar presentations
General Conclusions: Special Considerations for Women With IBD Women have more severe symptoms, more disease concerns than men Women have more severe symptoms,
Advertisements

Menopause in Women With IBD. Menopause Natural menopause results from gradual decline in number of estradiol-producing ovarian follicles Natural menopause.
Conception and Fertility in Women With IBD. Effects of IBD on Fertility Women Women –UC: normal fertility rate overall (92.2%) 1,2 IPAA reduces fertilityIPAA.
CHRONIC PELVIC PAIN ENDOMETRIOSIS
CANCER The Nature of Cancer Types of Cancer Extent and Trend of Cancer Risk Factors Sociocultural, socioeconmic and environmental determinants High Risk.
Boris Delić Mentor: A. Žmegač Horvat.  several different hormonal methods, according to:  1. the type of hormone  2. the amount of hormone  3. the.
Understanding real research 3. Assessment of risk.
SIDE EFFECTS OF GUTKHA (TOBACCO) Carcinogenic The most serious side effect associated with prolonged gutkha use is an increased risk of cancer. The National.
Update In Contraception 2014: New Options, New Controversies Women’s Health Initiative August 19, 2014 Cleve Ziegler, M.D.
Endometriosis and Cancer…Is there a Causal Link? Paula Payton Masters Project 2/22/06 Advisor: Prof Eileen VanDyke.
What women can do to stay healthy Valerie Beral University of Oxford THE MILLION WOMEN STUDY.
ORAL CONTRACEPTION (OC) - OVER THE COUNTER (OTC)? Arie Yeshaya, M.D. Pediatric Adolescent Clinic Schneider Children’s Hospital and Department of Obstetrics.
List three discomforts that may accompany menstruation.
DRUG INTERACTIONS with SMOKING. Drugs that may have a decreased effect due to induction of CYP1A2: Caffeine Fluvoxamine Olanzapine Tacrine Theophylline.
Dysmenorrhea By Dr. Ali Abd El Monsif Thabet. Definition Pain related to menstruation that may occur just before or during menses. Types There are different.
Hormonal and Surgical Contraception
Emergency Contraception. Emergency contraceptive pills (ECPs) provide a short, high dose of combined estrogen and progestin, or progestin alone and are.
Combined Oral Contraceptive Pills (COCs)
Premenstrual Syndrome ( PMS) Biological/Psychosocial???
Sex, Menopause, and Aging
Biomarkers of ovarian cancer and cysts Reproductive Block 1 Lecture By: Reem Sallam, MD, MSc, PhD.
Breast Cancer Risk Factors
Abstract: According to United States Health Surveys 10 to 15% of Americans are “alcoholic.” That is “a chronic disorder characterized by dependence on.
Menstrual Cycle 9 th Grade Health. Menstrual Cycle The cycle begins when an______starts to mature in one of the ______________. Egg Ovaries.
Hormonal Replacement Therapy for postmenopausal females: To give or not to give? Amna B. Buttar, MD, MS Assistant Professor of Clinical Medicine Indiana.
Ovarian Cancer Research in Allied Health Erin Brewer.
MENOPAUSE DR. AMEL EL-SAYED, FRCSC Assistant Professor & Consultant King Saud University King Khalid University Hospital.
Disorders of the Female Reproductive System Vaginitis Common medical condition This is a vaginal infection or irritation Symptoms are similar in all.
Risk factors and Epidemiology of Endometrial and Ovarian Cancer By: Tammy, Merissa, and Heather For: Nursing 519 Unit 6.
Breast Cancer Risk with Menopausal Hormone Use Jackie Bouillon Advisor: Dr. Robert Hadley Spring 2007.
Personal Risk Factors Gender being a woman is the main risk factor for developing breast cancer (100 times more common in women) Age occurrence increase.
Magnesium, Menstrual Migraines, & PMS By: Tori Couch.
Venous thromboembolic disease
Stages of the Menstrual Cycle  Days 1-4: Uterine lining is shed during menstruation  Days 5-13: An egg matures in one of the ovaries and the uterine.
ENDOMETRIOSIS. Definition Is a condition in which tissues similar to normal endometrium in structure and function are found in sites other than the lining.
Hello, my friends ! I am going to discuss about the effect of smoking…
Reduced Lung Cancer Mortality Risk Among Breast Cancer Patients Treated With Anti- Estrogens Rapiti E et al. SABCS 2009;Abstract 35.
Hormonal Contraceptives. 2 A. Hormonal Contraceptives 1.Combined Oral Contraceptive Pills (COCPs) – Contain both estrogen and progesterone 2.Progestin.
Hormonal Birth Control and the Ovarian Cycle Cara Beth Rogers Tanja Mehlo.
By: Anthony, Sophia, Jessica, Terrance, and Sierra.
Oral contraceptives.
1 Yize R. Wang, MD, PhD, John R. Cangemi, MD, Edward V. Loftus Jr, MD and Michael F. Picco, MD, PhD Am J Gastroenterol 2013;108:444–449 F1 김혁 / Prof. 김효종.
GUT 2012;61:1533–1537. R4 Kim Dong Hyun / Fellow Kim Jung Wook Higher Predicted Vitamin D Status Is Associated With Reduced Risk of Crohn’s Disease.
ON THE PILL JANETH SOTO GATEWAY COMMUNITY COLLEGE.
High frequency of early colorectal cancer in inflammatory bowel disease M W M D Lutgens, F P Vleggaar, M E I Schipper, P C F Stokkers, C J van der Woude,
Hello, my friends ! I am going to discuss about the effect of smoking…
Combined Oral Contraceptives
Cumulative Probability of Developing Colon Cancer in UC Patients
MENOPAUSE.
Breast Cancer By : Ethar AL-Yousif.
Endometrial cancer on the rise in older women (August 2014)
Contraception 1.
Choosing a contraception that’s right for u
July 28, 2010 Cervical Dysplasia in Immune Suppressed Women Jill Gaidos Nancy Hardt Faris Hashim.
Choosing a contraception that’s right for u
Mental and physical risks and effects of induced abortion on women
Subjective quality of vision recorded by the patient during a typical menstrual cycle superimposed on a graph of levels of the principal female hormones.
PREGNANCY AND ITS HORMONAL CONTROL.
Sedentary time was higher in non-alcoholic fatty liver disease (NAFLD) than healthy controls with fewer sedentary to active transitions (data reported.
Ratio of relative risks of heart disease and stroke associated with higher blood pressure, smoking, type I and II diabetes, and higher cholesterol in women.
Eligibility criteria for inclusion as an expert Delphi panellist
Smoothed colorectal cancer mortality rate (per 100 000 person-years) in the screening and control arm over follow-up time, and ratio of the mortality rates.
HRs of NAFLD with or without obesity for incident gastric cancer and colorectal cancer. HRs of NAFLD with or without obesity for incident gastric cancer.
Risk factors for postoperative infection after lower gastrointestinal surgery in patients with inflammatory bowel disease: Findings from a large epidemiological.
The impact of the addition of a faecal immunochemical test (FIT) for haemoglobin as an adjunct to clinical assessment on the pathway of patients presenting.
Proposed algorithm for the management of patients with acute-on-chronic liver failure (ACLF) or decompensated cirrhosis. Proposed algorithm for the management.
Odds ratio (95% confidence intervals) of reporting respiratory symptoms in patients with treated hypothyroidism or inflammatory bowel disease (IBD) compared.
(A) Trends in colorectal cancer incidence and mortality in males (M) and females (F) by country (group 1: increasing or stable incidence and mortality).
Presentation transcript:

IBD: Issues With Menstruation and Contraception

Menstrual Cycle and Bowel-Pattern Fluctuations Bowel-pattern fluctuation is common during the menstrual cycle Bowel-pattern fluctuation is common during the menstrual cycle IBD symptoms may increase during the menstrual cycle IBD symptoms may increase during the menstrual cycle Suppression of menses via hormonal contraceptive methods may be considered in presence of debilitating symptoms Suppression of menses via hormonal contraceptive methods may be considered in presence of debilitating symptoms

Potential IBD-Related Menstrual Symptoms Most frequently reported symptoms Most frequently reported symptoms –Pelvic pain 52% –Lower back pain 36% –Diarrhea 26% –Irritability 23% –Headache 20% Incidence of any menstrual symptoms significantly higher for IBD patients than for healthy controls (P .01) Incidence of any menstrual symptoms significantly higher for IBD patients than for healthy controls (P .01) Kane SV, et al. Am J Gastroenterol. 1998;93:

IBD: Issues With Menstruation There is a trend for patients with CD to be affected by IBD symptoms during menstruation to a greater extent than are patients with UC There is a trend for patients with CD to be affected by IBD symptoms during menstruation to a greater extent than are patients with UC CD patients experienced diarrhea significantly more often than did controls (P=.004) CD patients experienced diarrhea significantly more often than did controls (P=.004) Kane SV, et al. Am J Gastroenterol. 1998;93:

OCs and IBD Risk Controversial data Controversial data Increased incidence of CD with use of OCs? Increased incidence of CD with use of OCs? OCs related to flare of CD activity? OCs related to flare of CD activity? Newer OCs with lower estrogen content associated with decreasing incidence of CD in women? Newer OCs with lower estrogen content associated with decreasing incidence of CD in women?

CD Flare and OCs Adapted from Cosnes J, et al. Gut. 1999;45: with permission from BMJ Publishing Group. Days After Inclusion Patients With Flare (%) OC use No OC use

OCs and IBD Risk Baltimore F:M incidence for year age group Olmstead F:M incidence for year age group US OC use (  5 million) Adapted from Alic M. Gut. 2000;46:140 with permission from BMJ Publishing Group. F:M Incidence Ratio

Contraindications for OCs History of thromboembolic disease History of thromboembolic disease Active obstructive liver disease with elevated liver enzymes Active obstructive liver disease with elevated liver enzymes Breast cancer Breast cancer Smokers over the age of 35 Smokers over the age of 35 Pregnancy Pregnancy

IBD and Contraception: Conclusions OCs should have lower estrogen content (eg,  35 µg) OCs should have lower estrogen content (eg,  35 µg) Avoid for women with known hypercoagulability Avoid for women with known hypercoagulability Avoid for women with IBD-associated liver disease Avoid for women with IBD-associated liver disease Avoid for women with IBD who smoke Avoid for women with IBD who smoke