Gender-Specific IBD Burden Heavier for Women
Safe conception and pregnancy during treatment, but also at issue: body image, sexuality, cervical cancer risk
Inflammatory bowel disease (IBD), affecting approximately one in 500 people in the United States, occurs about equally in men and women. But gender-specific physiologic and psychological differences can have an impact on patient care and outcomes, especially in females whose issues include pregnancy, reduced fertility, impaired body image and sexuality, higher cervical cancer risk, altered menstrual cycles, and low bone mineral density.
As individualized treatment evolves, sex is one of the patient variables that is increasingly factored into clinical decisions, as noted in a comprehensive 2015 overview by Rosenblatt and Kane outlining concerns facing patients and their healthcare providers. “All teaching institutions now have to document that they have a gender-based curriculum,” Sunanda Kane, MD, of the Mayo Clinic College of Medicine in Rochester, Minn., told MedPage Today.
Recognition of gender issues has expanded considerably since the early observation that smoking aggravated the disease more in women than in men, but the main question for women with IBD, said Kane, “is still pregnancy — what is safe, what is appropriate, and what is reasonable to expect.”
Pregnancy outcomes, on which IBD can have a negative impact, are being tracked in the prospective Registry of Pregnancy Outcomes in Women with IBD Exposed to Immunomodulators and Biologic Therapy. But while the safe treatment of IBD during pregnancy is paramount, several other issues are of particular concern to women with IBD.