A Cohort Study of the Age at Menopause in Female Patients With and Without Inflammatory Bowel Disease

Abstract

Introduction Menopause, defined by the complete cessation of menstrual cycles for 12 consecutive months, may occur at a younger age in women who have concomitant immune dysregulation. Our aim was to determine whether women with inflammatory bowel disease (IBD) experience an earlier onset of menopause compared to women without IBD. Methods This was a retrospective cohort study using resources of the Rochester Epidemiology Project, a collaboration between clinics, hospitals and medical facilities in Olmsted County, Minnesota. From these people, women who were diagnosed with IBD between 1970 and 2010 comprised the case cohort while the reference cohort included women with no diagnosis of IBD. Data including age, body mass index (BMI), ethnicity, smoking status, age at onset of menopause and current use of hormone therapy was collected. Patients with history of hysterectomy or oophorectomy were excluded. Wilcoxon rank-sum test for numeric variables and Fisher’s exact test for categorical variables was used to analyze the data. Results A total of 171 women met criteria for inclusion (83 cases and 88 controls). Mean age of menopause in women with IBD was 50.0 years compared to 51.5 years in women with no IBD (p=.006). There was no difference in BMI of women with and without IBD (28.7 kg/m 2 versus 28.2 kg/m 2; p=0.9), respectively. There were more former smokers (33.7%) and current (6%) smokers in the IBD group (p=0.009) compared to the non-IBD group. Conclusions IBD is associated with an earlier onset of menopause. Although it is unclear if this mean difference of 1.5 years is clinically relevant, it is known that early menopause is associated with an increased risk of osteoporosis and cardiovascular disease. Further research on the possible mechanisms is needed.

Dietary Habits and Nutrient Deficiencies in a Cohort of European Crohn’s Disease Adult Patients

“…The reduced intake of minerals (calcium, potassium, phosphorus, magnesium) that we have highlighted can have various negative effects on IBD patients, such as the increase in the PRAL values of their diet or the increased calciuria. The increased excretion of calcium in the urine, over time, may worsen osteoporosis which, in women with IBDs, appears to be a more serious condition [ 24 ]. The decreased iron intake seems to be related to the non-heme form, present in plants, given the lower consumption of vegetables observed in CD patients.…”

Female reproductive tract-organ axes

“…Ovarian functions, including ovulation and lutein body formation, are precisely controlled by pituitary hormones but are also affected by intestinal functions, including the microbiota. For example, IBD can be a risk factor for ovarian dysfunction, including premature ovarian failure ( 123 ). Furthermore, patients with polycystic ovary syndrome (PCOS), which is often accompanied by hyperandrogenism, showed reduced diversity and different phylogenetic compositions of the gut microbiota ( 124 , 125 ).…”