Crohns and amenorrhea

[puggles]

Hi All,

I was diagnosed with Crohns in August 2012. I was put on Pentasa oral tables 1g twice a day. I was also put on mercaptopurine and prednisone to kick start the system. I then weaned off the prednisone and all was well.

In December my period was quite late. It came about 2 weeks later. Then January was late and March this year was the last period i had. We thought it might be due to the mercaptopurine, so in discussions with my GI, we stopped taking it. Prior to this, my periods were like clockwork - and not on the pill. I am 30 years old.

My GP and Dietition think its because i have gone below my ideal weight. I have lost around 50kg over 6 years (healthily and not related to my crohns).

I am very healthy, not underweight and been told to put on weight thinking that would bring back the period - back to the weight i was when i had my last period (5kg more than where i am now). Its possible this is the case and i am trying to eat more but as you can imagine, after you work so hard to lose weight it is a mental battle to try and put it on.

I have seen a gyno who tested everything and ovaries, etc are all fine.
I saw my GI the other day and he said he hadnt heard of Pentasa causing amenorrhea but if i want to, i can change medication. My Crohns is under control and I am hesitant to change, but at the same time also curious if this has caused my absent periods.

Has anyone else had this issue or can provide advice?

Much appreciated to hear your thoughts.

 

[UnXmas]

Hi, there is a close connection between body weight (and fat percentage) and amenorrhea. Amenorrhea can in some cases be due to being too low a weight, not having enough body fat, but it can also be caused by physical stress - even exercising too much can trigger it in some women.

You said you're not underweight, but from your GP and dietician's opinions I'm guessing you're probably at the low end of the healthy weight range? I think it's possible that a person may be at a weight that is less than ideal for that individual while still being within the standard healthy weight range given for a person of that height. So if you are at the low end of healthy, you might want to follow your GP/dietician's advice and gain a bit more.

If you've been thoroughly tested for hormone abnormalities and other gyne problems and nothing's been found, it may be the physical stress of the illness is causing the amenorrhea.

I can't help with your question about Pentasa. I'm not sure about the possibility your meds are behind it - usually if a med has a side effect it will be known about and listed on the leaflet - but I think it's certainly possible that you could experience a reaction to a med that isn't common enough to have been picked up on by the medical community. If there are safe alternatives to Pentasa it may be worth switching to see if your symptoms change.

 

[xmdmom]

Amenorrhea (no periods) in Crohn's is usually due to active disease or low BMI. You said you don't have symptoms. Do you have any lab abnormalities (anemia, low serum protein, elevated crp/ESR) that would suggest active disease even though you are not having symptoms? Is your BMI in the normal range? I checked http://www.rxlist.com/pentasa-side-effects-drug-center.htm and saw that amenorrhea is listed under "The following adverse events, presented by body system, were reported infrequently (ie, less than 1%) during domestic ulcerative colitis and Crohn's disease trials. In many cases, the relationship to PENTASA has not been established."

 

[HannahR]

I have had this same thing happen to me before. When you said that you lost a lot of weight I immediatly knew that that is what is causing it.

I lost a lot of weight as well when my disease starting flaring about a year ago. My periods stopped completely because my overall health was not very good. They started right back up when I started to gain weight back and feel better though.

This also happened to me before when I had lost a lot of weight and I really feel that your body is going to stop some functions when this happens because it is marvelous in switching from one thing to heal the next.
I believe you will notice your periods resuming normally when you have gained weight back and feel very good!

 

[puggles]

Thank you for your responses. The thing is my crohns is under control and i lost the weight because I changed to a healthier lifestyle and started exercising...crohns had nothing to do with the weightloss at all which is why i was wondering if it was the medication. Prior to my periods stopping i had lost 45kg with no issues.

I suppose i will just have to put on some weight and see if it comes back.