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Remicade and menstrual cycle

It's been 3 days since my first Remicade treatment and i began my period yesterday. The period cramps and bloating is worse than ever. Has anyone notice their menstrual symptoms amplified since beginning Remicade?
I've not noticed any connection with the remicade, but sometimes (about every 3 months) the week before I start my period I feel like I am going into a flare, even when my crohn's is in remission. I get really bad cramps and stomach pains, very bad diarrhea and even sometimes feel achy. If I give in to cravings and eat chocolate, I get bloated very bad. Chocolate is the devil for me.
I've noticed in the past my periods getting incredibly bad once I started the remicade. My Doctor mentioned its just my body's way of trying to be normal again, so for about the 1st year all my periods were pretty bad but then things started to level out.

Hope this was helpful


Staff member
Hey SoOoO CoNfuSeD. I'm going to copy and paste a couple of posts by Judith from my thread as I noticed that Humira had messed with the birth control I take (Junel, not supposed to have a period yet with Humira I did. So far I haven't had one with Remicade but I've only just started it).

"In fact, the role of TNF in the Ovulation, the Menstrual Cycle, and Pregnancy is not fully understood. So far, researchers have shown TNF plays a Major role in each aspect of female reproduction.

TNF Blockers have been shown to cause Menorrhagia (painful, heavy periods) in some women. There is not a lot of data on this subject but treatment with estrogen / progesterone appears to help with some symptoms."

"I have not been able to find any significant warnings regarding oral contraceptive failure and Remicade therapy. There have been minimally increased rates (.01% increase) of oral contraceptive failure during use of TNF blockers and 100% of these cases occurred during the first month of therapy.

This may be one reason for the increased rates:

7.5 Cytochrome P450 Substrates
The formation of CYP450 enzymes may be suppressed by increased levels of cytokines (e.g., TNFα, IL-1, IL-6, IL-10, IFN) during chronic inflammation. Therefore, it is expected that for a molecule that antagonizes cytokine activity, such as infliximab, the formation of CYP450 enzymes could be normalized. Upon initiation or discontinuation of REMICADE in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed. http://www.remicade.com/hcp/prescribing-information

Cytochrome p450 induction is one of the major causes of oral contraceptive failure during antibiotic therapy.

However if you compare oral contraceptive failure rates in the general population (0.3% - 9%), an increased risk of 0.01% is quite low.

But, is still an increased risk and all of the information is not in yet.

Your risk of oral contraceptive failure increases with vomiting/diarrhea (decreased absorption of the drug), antibiotic use, and use of other medications that increase Cytochrome p450.

I would consider using a backup method of birth control the first month."
Ref Oral Contraceptives, my nurse practitioner recommended that I take it continually instead of 3 weeks on and 1 week off as per normal as she thought it would be more effective for me to take it that way. I take Alesse. She also mentioned the "back up" method part; not that it's been an issue, my one fistula seems to have branched into my labia, so sex is pretty much out of the question for now (hopefully Remicade heals things up).
Thanks for the great info Crabby... and everyone else for sharing their experiences. It seems, the cramps and bloating for just really bad the first day. At least it wasn't horrible all week. Good luck Alliruns, i too am dealing with fistulas and i for one know that besides being painful, it isn't all that sexy... hope ur remicade heals it up fast.