*Division of Gastroenterology and Hepatology, and †Department of Biostatics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; ‡Division of Gastroenterology, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island; §Division of Reproductive Endocrinology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; ‖Department of Pediatric Gastroenterology, Rhode Island Hospital, Providence, Rhode Island; ¶Division of Community Health, Centers for Disease Control and Prevention, Atlanta, Georgia; **Crohn's and Colitis Foundation of America, New York, New York; and ††Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine, Mount Sinai, New York, New York.
Inflamm Bowel Dis. 2014 Mar;20(3):534-40. doi: 10.1097/01.MIB.0000441347.94451.cf.
The effect of the inflammatory bowel diseases (IBD) on menstrual function is largely unknown. The aims of this study were to determine whether changes in menstrual function occur in the year before IBD diagnosis or in the initial years after diagnosis.
Women aged 18 years and older in the Ocean State Crohn's and Colitis Area Registry with at least 2 years of follow-up were eligible for this study. All patients were enrolled within 6 months of IBD diagnosis and followed prospectively. Menstrual cycle characteristics were retrospectively assessed. To assess for changes over time, general linear models for correlated data were used for continuous outcomes, and generalized estimating equations were used for discrete outcomes.
One hundred twenty-one patients were studied. Twenty-five percent of patients experienced a change in cycle interval in the year before IBD diagnosis and 21% experienced a change in the duration of flow. Among women with dysmenorrhea, 40% experienced a change in the intensity of their menstrual pain and 31% experienced a change in its duration. Overall cycle regularity increased over time. Quality of life was significantly lower in women without regular cycles across all time points.
Changes in menstrual function occur frequently in the year before IBD diagnosis; therefore, screening for menstrual irregularities should be considered in women with newly diagnosed IBD. Patients can be reassured that cycles typically become more regular over time.
炎症性肠病（IBD）对月经功能的影响在很大程度上尚不清楚。本研究旨在确定月经功能的变化是否发生在 IBD 诊断前 1 年或诊断后最初几年。
符合条件的研究对象为 Ocean State Crohn's 和 Colitis Area Registry 中年龄在 18 岁及以上且随访时间至少 2 年的女性。所有患者均在 IBD 诊断后 6 个月内入组并进行前瞻性随访。回顾性评估月经周期特征。为评估随时间的变化，使用相关数据的一般线性模型评估连续结果，使用广义估计方程评估离散结果。
共研究了 121 名患者。25%的患者在 IBD 诊断前 1 年经历了周期间隔的变化，21%经历了流量持续时间的变化。在痛经患者中，40%的患者经历了月经疼痛强度的变化，31%经历了疼痛持续时间的变化。整体周期规律性随时间增加。在所有时间点，无规律周期的女性生活质量显著较低。
在 IBD 诊断前 1 年经常发生月经功能变化；因此，应考虑对新诊断为 IBD 的女性进行月经不规则筛查。可以让患者放心的是，随着时间的推移，周期通常会变得更加规律。
