PMS and Flaring

[Magyar]

Hi,

I just wondered if anyone knew anything about the connection between female hormones and microscopic colitis? I find that with supplements and dietary changes things are pretty good. Then, my hormones shift and everything goes haywire during PMS and the week or so after. My doctor mentioned testing me for estrogen metabolism but I can't figure out what she means. She also said some of her patients get better once they hit menopause. This seems odd since most people who get this disease are post-menopausal.

Also, I found that my symptoms were MUCH better when I was breastfeeding. The symptoms came back in full force as soon as I quit (had I known, I wouldn't have stopped!).

I just wish I could figure out a way to make reduce these flares.

Thanks,
Magyar

[tex]

Obviously, I'm not speaking from experience here, but I suspect that your experiences are pretty typical of women in your age group, with MC. I'm guessing that it's the abrupt changes in hormonal activity, that cause most of the problems.

I don't understand why your doctor mentioned testing you for estrogen metabolism, either, because almost all the research done on estrogen metabolism is in connection with predictive indicators for cancer. That's not to say that there might not be clues there, that could possibly be utilized to gain insight into other issues.

If you are interested in trying to improve your estrogen metabolism, you can do that by eating cruciferous vegetables, such as cabbage, cauliflower, and broccoli. According to the article cited below, these vegetables contain unique phytonutrient constituents, which enable them to improve the metabolism of estrogen. Whether or not that will help to eliminate, or diminish, MC flares, is difficult to say, but I believe that those vegetables have been found to be relatively safe, by a majority of the members of this board.

http://www.annieappleseedproject.org/diinforesmet.html

Tex

[Magyar]

Thanks, Tex, for the info.

I've done a little more research online and came across something called intestinal endometriosis. The symptoms definitely correlate with mine. Unfortunately, the only treatment (and even diagnosis method) involves surgery. But, it could explain why my case of MC is so extraordinarily stubborn despite innumberable elimination diets, drugs and supplements.

Magyar

[tex]

Great detective work! I think you may definitely be on to something there, not just for your own case, but for many others with MC, and/or other GI issues. I had never heard of it before, but according to an article in the New England Journal of Medicine, fully 5% of all women have that condition, (not just women with endometriosis). That's an impressive number, if it's accurate.

The symptoms, as you say, are quite similar to the symptoms of MC, except that they vary with the menstrual cycle. I have a hunch that this is much more widespread than is realized. According to the article cited below, it is usually not diagnosed correctly, simply because doctors don't ask the right questions.

It's especially interesting that, unlike ordinary endometriosis, intestinal endometriosis is not primarily limited to pre-menopausal women, and, in fact, in post-menopausal women, it is almost always associated with GI issues

Interestingly, they also showed that the women with Endometriosis had reactive hypoglycemia during a glucose tolerance test.. The blood sugars dropped to an abnormally low level despite having normal insulin levels. This would indicate that women with Endometriosis may be inordinately sensitive to the actions of insulin such that they end up with lower blood sugar levels for a given amount of insulin.

Cristi, if you are reading this, doesn't that fit some of the symptoms that you were having a few months ago, that were confusing the doctors, (along with all the other symptoms that were confusing the doctors)?

Most of what I've mentioned here, can be found at this site, which you've probably already looked at:

http://www.infertilityphysician.com/end ... tinal.html

Thanks for bringing intestional endometriosis to our attention.

Tex

P S According to the article I cited above, proper diagnosis is mostly a matter of the doctor asking the correct questions. As is so often the case, with misdiagnosed issues, you have to know what you are looking for, or you won't find it.

[kate_ce1995]

Well, I forget the statistics, but something like 50 % of women probably have endometriosis in general.

One of the other reasons you may have more problems during your period, is that the prostaglandins that are released as part of that phase to induce smooth walled muscle contractions (i.e. uterine contractions/cramps) also have an impact on the colon. Do you take NSAIDs for cramps? If so, that was my MC trigger and might be causeing your reaction. If not, you aren't getting rid of prostaglandins (NSAIDs are prostaglandin inhibiting, hence the great affect of reducing cramps not just masking the pain).

Hmm. I can't think of a helpful suggestion at the moment, but maybe this will trigger an idea in someone's head.

Katy

[Magyar]

Hi,

Yes, I asked my doctor about the possibility that my body releases excess prostaglandins but the only treatment, as you , Katy, mentioned, is NSAIDs. I used to take a lot of NSAIDs for cramps but I haven't used them for about 4 years. Now, I use Tylenol and a heating pad.

It's confusing to know whether to make an appointment with an OB/GYN or colorectal surgeon. Also, I had a C-section last year and I'm wondering if the doctor would've noticed any endometriosis during it? Probably not, since the incision was very small and the procedure took all of 10 min.

Anyway, I'm going to see how the next few days go as far as this flare is concerned. I was doing pretty well just taking supplements but my cycle really takes a toll on my colon.

Thanks for all the input,
Magyar

[tex]

You're probably right, if the doctor only spent ten minutes on the C-section, he or she probably didn't look around much, while in there. I would suggest that you visit or call the "Release of Records" department at the hospital where the procedure was performed, and request a copy of the operative report, and review it to see if there is any mention of evidence of endometriosis. That office may have some other name in other hospitals, but in the hospital that I go to, it's called "Release of Records", because that's what they do. Copies are usually provided free of charge, to the patient and her/his doctors, but attorneys have to pay a nominal fee.

You would probably be quite surprised to see what is in some operative reports, and endoscopy reports, that the doctors never bother to tell their patients about. In my own case, I found such reports to be real eye-openers, and I wish I had requested them sooner.

Tex

[KissyB]

I have noticed at "that time of the month" my symptoms always seem to be worse as well. I'm not sure of the connection between the two. I guess maybe it is because the areas are so close together.