Newsflash! Trust your gut: HRT and ulcerative colitis

Posted by Liz on Apr 20, 2012 in estrogen, HRT | 2 comments

Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation and sores in the lining of the large intestine. The disease affects men and women in equal numbers and risk is higher among Caucasians and Jews. Yet, although it most commonly develops between the ages of 15 and 30, ulcerative colitis has a brand new bag, so to speak: women in menopause taking hormone replacement therapy (HRT). Yikes! Another nail in that HRT coffin. And this time, both combination hormone therapy (i.e. estrogen plus progesterone) and estrogen only appear to play a role.

Investigators will be reporting study findings (which are derived from following more than 108,000 postmenopausal women enrolled in the Nurses Health Study) at the American Gastrointestinal Association’s Annual meeting next month. Information on this group of women was updated every two years for 32 years, including menopausal status, use of hormones and medical diagnoses. The findings? Compared to women who never used hormones, women who did, regardless of type, had a 1.7 times greater risk for developing ulcerative colitis. Notably, this risk increased with longer duration of hormone use and decreased the longer the time period since stopping hormones. In fact, risk declined by almost 25% in women who had discontinued hormones for five or more years.

It was once believed that stress caused ulcerative colitis but experts now hypothesize that it’s triggered by a virus or bacteria that attacks the immune system, or is hereditary. So where do hormones come into play? Apparently, estrogen may play a role in controlling how the lining of the intestine functions to keep out toxins but let in nutrients, electrolytes and water as well as inflammation. Replacing estrogen with hormone therapy may act to create an imbalance that sends the system into overdrive but researchers are still not clear how and why.

Meanwhile? Hormone replacement therapy may increase your risk for developing ulcerative colitis as you age. You should always trust your gut. What is it telling you about HRT?