Last Updated on July 8, 2023 by Steven Root


Ulcerative colitis, a chronic inflammatory bowel disease (IBD), affects millions of people worldwide. While the condition does not discriminate based on gender, some Ulcerative Colitis symptoms in females are unique. These distinctive symptoms and complications can be attributed to factors such as anatomical differences, hormonal fluctuations, and the reproductive cycle

In this article, we will delve deeper into these specific aspects, highlighting symptoms that can manifest in females and discussing the associated risks and challenges. It is important to remember that while the symptoms discussed are gender-specific, most can also occur in males, albeit less frequently. Early detection and appropriate treatment can aid in managing these symptoms and improving overall quality of life (1).

Ulcerative Colitis Symptoms In Females Include

Apart from the common symptoms that can occur irrespective of gender, such as abdominal pain, bloody diarrhea, and fatigue, females with ulcerative colitis can experience unique symptoms. The influence of hormones and the female reproductive system creates a distinctive medical landscape.

Females can experience fluctuations in the severity of their symptoms related to their menstrual cycles, increased risk of conditions like anemia and osteoporosis, and complications during pregnancy. Moreover, certain medications used to treat this condition might have specific side effects in females. It’s essential for women to be aware of these specific manifestations and to engage in ongoing communication with their healthcare providers for optimal disease management.

We’ll unpack each of these in more detail below.

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For many women, their menstrual cycle and hormonal fluctuations can exacerbate the symptoms of ulcerative colitis. A study published in the journal “Inflammatory Bowel Diseases” found that nearly half of the participating women reported a worsening of their IBD symptoms during menstruation.

Symptoms such as diarrhea, abdominal pain, and fatigue were more pronounced during this time. The reasons behind this are not entirely clear, but it is speculated that hormonal changes can increase intestinal motility. Additionally, inflammation in the colon may respond to hormonal fluctuations, leading to symptom escalation during certain stages of the menstrual cycle (2).


Red pills symbolizing anemia - one of the common ulcerative colitis symptoms in females

Anemia, specifically iron-deficiency anemia, is a common complication in individuals suffering from ulcerative colitis. The chronic inflammation of the colon leads to blood loss through the feces, while decreased nutrient absorption further contributes to a deficiency in essential nutrients like iron.

Females are at a higher risk of anemia due to menstrual blood loss. Symptoms of anemia can include extreme fatigue, weakness, pale skin, shortness of breath, and chest pain. The fatigue caused by anemia can be severe and can further impair daily functioning, adding to the burden of the disease. If a woman with ulcerative colitis experiences these symptoms, it’s important to consult with a healthcare provider, who may recommend iron supplements or even an iron infusion to rectify the issue. (3)


Pregnancy presents unique challenges for women with ulcerative colitis. The disease does not typically affect fertility, but women with active disease may find it more difficult to become pregnant. Moreover, active disease during pregnancy can increase the risk of adverse pregnancy outcomes such as preterm birth, low birth weight, and even neonatal death.

However, many women with ulcerative colitis have successful pregnancies. Disease management before and during pregnancy is crucial to reduce these risks. Women planning for pregnancy should discuss this with their healthcare provider to manage the disease effectively and improve pregnancy outcomes. (4)


Ulcerative Colitis Symptoms in Females - Osteoporosis

The link between ulcerative colitis and osteoporosis is well-established. Chronic inflammation and the long-term use of certain medications such as corticosteroids can lead to decreased bone density and an increased risk of fractures, a condition known as osteoporosis.

This risk is particularly relevant for postmenopausal women, who are already at a higher risk of osteoporosis due to hormonal changes. Bone health is an essential aspect of long-term disease management in females with ulcerative colitis. Regular monitoring, adequate calcium, vitamin D and vitamin K intake, and appropriate physical activity can help maintain bone health. (5)

Yeast Infections

Females with ulcerative colitis, particularly those on immunosuppressive medications, are at an increased risk of yeast infections. The disease and some medications can alter the gut microbiome, potentially leading to an overgrowth of the yeast Candida in the body.

This overgrowth can result in a yeast infection, which can cause itching, burning, and discharge. Women who notice these symptoms should seek medical advice, as these infections are generally easily treatable. Maintaining a balanced diet that is low in processed high sugar foods, and probiotic use may help maintain a healthy gut microbiome, potentially reducing the risk of these infections. (6)

Hereditary risks for your child

Ulcerative colitis has a genetic component, and children of parents with the condition are at an increased risk of developing it. However, it is essential to note that the overall risk remains relatively low.

A review published in the Annals of Gastroenterology showed that IBD can be inherited in approximately 8-12% of cases, with Crohn’s disease showing a stronger genetic link than ulcerative colitis.

However, it should be noted that the risk for twins and for couples who both have IBD, the risk is much higher. (7)

Medication risks for women

While medication plays a vital role in managing ulcerative colitis, some drugs can have gender-specific side effects. Certain immunosuppressants, for example, can have effects on fertility and can potentially harm a fetus.

Women of childbearing age should discuss these risks with their healthcare provider to make an informed decision regarding their treatment. It’s essential to balance the necessity of disease control against the potential risks of medication. (8)

Body Image Issues

Body image issues for women with ulcerative colitis

Ulcerative colitis can result in visible symptoms such as weight loss, bloating, and in some cases, surgery scars from procedures like colectomy. These visible changes can lead to body image issues and impact mental health.

Women, in general, may be more susceptible to these issues due to societal pressures around appearance. It’s important to acknowledge these challenges and seek psychological support when needed. Peer support groups can also be beneficial, providing a platform to share experiences and coping strategies. (9)

When to see a doctor

Females with ulcerative colitis should maintain regular contact with their healthcare provider, reporting any new or worsening symptoms. Early intervention can prevent complications, improve prognosis, and enhance quality of life.

If a woman notices any symptoms mentioned above, such as worsening symptoms during menstruation, signs of anemia, difficulty getting pregnant, or signs of a yeast infection, she should seek medical advice promptly.


In closing:

  • Ulcerative colitis presents unique challenges and symptoms for females, including impacts on menstruation, increased risks of anemia, osteoporosis, and complications during pregnancy.
  • Women may face unique medication risks and body image issues due to the disease.
  • Timely medical attention and proactive management strategies are vital for dealing with this chronic condition effectively.
  • Understanding and recognizing these gender-specific symptoms can lead to improved care and better outcomes for women with ulcerative colitis.