Inflammatory bowel disease (IBD) can cause various symptoms in females not typically seen in males. These may include painful menstruation, fertility issues, anemia, and pain during sex.

IBD describes different conditions that cause inflammation and damage to the gastrointestinal (GI) tract. The two most common forms include ulcerative colitis and Crohn’s disease. Depending on which area of the GI tract it affects, IBD can lead to a variety of symptoms.

In addition to symptoms, such as stomach cramping and persistent diarrhea, IBD can affect other areas of a person’s health. Females may develop health issues, such as painful menstruation, fertility issues, and pain during sex, among others.

This article reviews some of the possible IBD symptoms a female may experience, as well as information on treating the condition.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Was this helpful?
Female watering plants in a windowShare on Pinterest
Serena Burroughs/Stocksy United

An older study from 2014 found that of over 120 people with IBD, 25% experienced changes in their menstrual cycle. Of those, about 40% experienced more pain than before diagnosis, and around 31% experienced changes in the duration of their menstrual cycle.

More recently, a 2023 review found that few studies look specifically at IBD and the menstrual cycle. The most commonly reported issue involves irregular menstrual cycles, which can include worse bleeding and prolonged durations.

It also noted that some studies discussed increased pain, among other symptoms, due to IBD.

Learn about inflammatory bowel disease (IBD).

Iron deficiency is a common issue in people living with IBD. This can lead to anemia.

According to a 2021 review, iron-deficiency anemia is the most common complication of IBD. It occurs most frequently due to poor iron absorption in inflamed tissue, inadequate intake, and blood loss. However, the review also states that scientists cannot determine the exact causes of anemia due to the nature of IBD.

Some studies suggest that age may increase a person’s risk of developing anemia with IBD. The studies note that in people who were hospitalized and newly diagnosed with IBD, those 18 to 25 years old and under 65 years old showed an increased risk of developing anemia.

Read more about iron-deficiency anemia.

According to a 2023 review, previous studies reported roughly equal infertility rates between the general population and those living with IBD. However, they also noted that psychological issues, as well as mechanical issues due to IBD-associated surgeries, may interfere with fertility in some cases.

A study from 2021 noted that additional studies are needed to understand the connection between infertility and IBD fully. They added that mechanical issues due to treatment, the use of certain medications for IBD, and psychological issues may all increase the chances of a person having fertility issues.

Learn more about infertility.

Sexual dysfunction is a common issue that females experience due to IBD.

According to a 2022 review, pain during intercourse is one of three of the most common types of sexual dysfunction females experience due to IBD. Other types of sexual dysfunction include:

  • impaired arousal
  • trouble orgasming
  • reduced sexual desire

The researchers suggest that healthcare professionals should take time to discuss and review sexual health issues with people diagnosed with IBD as part of routine care.

Read more about sexual dysfunction in females.

IBD has links to the development of osteoporosis.

According to a 2023 study, about 7.3% of people with IBD develop osteoporosis. The study authors noted their results were lower than some other studies, which reported over 30% of people developing osteoporosis after diagnosis with IBD.

The researchers noted several risk factors for developing osteoporosis in those with IBD, including:

  • low vitamin D levels
  • male gender with IBD
  • history of fractures
  • having ulcerative colitis (UC)
  • physical activity other than cycling, jogging, gymnastics, or swimming
  • exacerbated course of the condition
  • infrequent physical activity
  • an extensive range of inflammation in the intestine (pancolitis) among people with UC
  • abnormalities of certain bone turnover markers

They also noted that some studies report being female with IBD as having a protective effect against osteoporosis.

Learn more about osteoporosis.

According to a 2023 review of studies, researchers found that about 20 to 30% of people living with IBD develop anxiety, a mood disorder, or both. The rate also increases during times of increased disease activity.

Another study from 2021 noted that IBD and psychological distress can contribute to the development of each other. The authors also stated that increased stress can lead to worsening IBD symptoms, similar to how IBD can lead to the development of mental health conditions.

A person living with IBD may want to request a regular screening for depression or anxiety. They may also want to speak with a healthcare professional if they notice changes in their mood, sleep habits, or other changes that could indicate depression.

Learn more about mental health.

Common symptoms associated with IBD include:

A person experiencing these symptoms should contact a healthcare professional for an evaluation.

Some other symptoms a healthcare professional may find during an initial visit for diagnosis can include:

  • pale skin
  • anal fistulas, abscesses, or rectal prolapse (Cronh’s disease)
  • blood on rectal exam with an unknown source
  • signs of anxiety
  • dehydration
  • fever
  • tachycardia (fast heartbeat)

If symptoms worsen or new ones appear, a person should contact a healthcare professional to review treatments.

Learn the difference between IBD and irritable bowel syndrome (IBS).

There is no medical cure for IBD. Instead, treatment goals typically involve achieving remission or reduced or non-existent disease activity.

Treatments can vary between people according to the type of IBD they have. Some common treatments can include medications, surgery, or a combination.

Each treatment has potential benefits and risks. A person should discuss the pros and cons of different treatments with their healthcare professional to help determine the most effective options for them.

In addition to medical treatment, certain lifestyle changes, such as diet and regular exercise, may help manage symptoms.

Read about treatments for ulcerative colitis and Crohn’s disease.

What is the main cause of inflammatory bowel disease?

The exact cause of IBD is unknown. Theories suggest that a genetic component and an inappropriate immune response to a trigger may lead to its development in many people.

What can be mistaken for IBD?

Several different conditions can cause similar symptoms to IBD. These can include intestinal parasites, different types of colitis, and various other conditions, such as IBS and celiac disease. Typically, healthcare professionals will take steps to rule out other underlying causes before making a diagnosis of IBD.

IBD resources

Visit our dedicated hub for more research-backed information and in-depth resources on inflammatory bowel disease (IBD).

Was this helpful?

IBD can cause several symptoms in females that are less common in males, including painful menstruation, mental health issues, pain with sex, and fertility issues. Females are also likely to experience many of the typical symptoms of IBD, which can include diarrhea, abdominal pain, or blood in their stool.

A person with IBD should speak with a healthcare professional if symptoms worsen or new ones develop. A healthcare professional can help adjust treatment to manage symptoms more effectively.