Gastroenterology Learning Network
Aug 5, 2026 · 34 min · 11 segments
Marla Dubinsky, MD, on Lifelong Reproductive Health Care for Women With IBD by Gastroenterology Learning Network
Marla DubinskyGuest
Raymond CrossHost
I don't think she listens to this podcast, thankfully for me, but she is perimenopausal.
And I just want to touch base on hormonal therapy a little bit because I find it very frustrating as a spouse and then listening to my patients who are perimenopausal.
where some of them are like, you just need to get through it and get to the other side.
And if there's some other factor present where we're maybe thinking about clotting, that's more nuanced.
But Do you see that as well, or is it just me observing that here in Maryland, that many women are suffering perimenopausal without treatment?
You know, maybe I don't know if it's if I take IBD specifically, the fear of does it increase flares? You know, there was some discussion that hormonal it's the same conversation, by the way, that I have for patients who are preparing for egg transfer, for example, where there's additional hormone, you know, to stimulate eggs, etc., and preparation for retrieval, that a lot of our patients are told that they may have an exacerbation of their IBD.
Data at DDW presented and data that we also have at Sinai, that yeah, you may have GI symptoms just like somebody who doesn't have IBD, but it's not triggering a flare.
And we even put that in the consensus actually, because there is a lot of myth around the role of hormones impacting your IBD.
So whether or not we're not, and fast forwarding that into the HRT story is, is it possible that there is this discussion, which maybe we need to deconstruct and educate both from our society and educate women and have a focus of that to try and educate the primaries as well as any gyne or reproductive or endocrinologist, for that we are very much in support of women getting HRT if necessary or if the patient agrees that that's what they want to do.
So I think that maybe a little bit of it is this carryover effect from birth control pill.
There was a long time ago where there was a feeling that birth control pills may cause IBD.
And then there was also quite a bit written historically around it increasing flares.
And then that got sort of, I think that debunked, you know, over time, we come to realize that that was not true.
And maybe we need to be more proactive about telling our female patients as part of, you know, we're so busy counseling them on, you know, birth control and then pregnancy and preconception and, and immediately postpartum, we're not focused enough on setting guidance for treating postmenopausal women.
I don't think she listens to this podcast, thankfully for me, but she is perimenopausal.
And I just want to touch base on hormonal therapy a little bit because I find it very frustrating as a spouse and then listening to my patients who are perimenopausal.
where some of them are like, you just need to get through it and get to the other side.
And if there's some other factor present where we're maybe thinking about clotting, that's more nuanced.
But Do you see that as well, or is it just me observing that here in Maryland, that many women are suffering perimenopausal without treatment?
You know, maybe I don't know if it's if I take IBD specifically, the fear of does it increase flares? You know, there was some discussion that hormonal it's the same conversation, by the way, that I have for patients who are preparing for egg transfer, for example, where there's additional hormone, you know, to stimulate eggs, etc., and preparation for retrieval, that a lot of our patients are told that they may have an exacerbation of their IBD.
Data at DDW presented and data that we also have at Sinai, that yeah, you may have GI symptoms just like somebody who doesn't have IBD, but it's not triggering a flare.
And we even put that in the consensus actually, because there is a lot of myth around the role of hormones impacting your IBD.
So whether or not we're not, and fast forwarding that into the HRT story is, is it possible that there is this discussion, which maybe we need to deconstruct and educate both from our society and educate women and have a focus of that to try and educate the primaries as well as any gyne or reproductive or endocrinologist, for that we are very much in support of women getting HRT if necessary or if the patient agrees that that's what they want to do.
So I think that maybe a little bit of it is this carryover effect from birth control pill.
There was a long time ago where there was a feeling that birth control pills may cause IBD.
And then there was also quite a bit written historically around it increasing flares.
And then that got sort of, I think that debunked, you know, over time, we come to realize that that was not true.
And maybe we need to be more proactive about telling our female patients as part of, you know, we're so busy counseling them on, you know, birth control and then pregnancy and preconception and, and immediately postpartum, we're not focused enough on setting guidance for treating postmenopausal women.
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