Crohn’s disease inflames the gastrointestinal (GI) tract and causes symptoms like diarrhea, gas, and nausea. It can also affect other aspects of your health, including your menstrual periods.

Most people are diagnosed with Crohn’s disease during their reproductive years, typically before age 35, according to the Crohn’s & Colitis Foundation. Inflammation from Crohn’s disease can affect the way your body makes the hormones that control your menstrual cycle.

Teenagers diagnosed with Crohn’s disease may start their periods later than their peers. Taking steroids to treat Crohn’s can also delay a person’s first period.

Some people with Crohn’s disease find that their periods become irregular or painful. Crohn’s symptoms like diarrhea, gas, nausea, and belly pain may also get more intense before and during your periods.

Here are six things you can do to manage Crohn’s disease around the time of your periods.

Birth control methods like the pill, implant, patch, and ring contain the hormones estrogen and progestin. Along with preventing pregnancy, they typically make periods lighter and less painful. Birth control might also relieve Crohn’s symptoms during your period.

Hormonal birth control methods are safe overall, but they do have risks like blood clots, heart attack, and stroke. Ask your doctor whether they’re safe for you, especially if you:

  • are over age 35
  • smoke
  • have other risks for heart disease

Stress is typical when you live with a chronic condition like Crohn’s disease. But too much stress can aggravate your Crohn’s symptoms and make your periods even more irregular.

Try relaxation techniques like:

  • deep breathing
  • yoga
  • meditation

Do things that make you happy and help you unwind, like hanging out with friends or listening to music.

If you feel overwhelmed, ask your doctor to recommend a therapist or counselor. A mental health professional can suggest additional ways to help you cope with the stress of living with Crohn’s disease.

One way to relieve period and Crohn’s discomfort is by taking medication. Prescription medications, such as antispasmodics, ease belly cramps from Crohn’s inflammation and gas. Corticosteroids can also be prescribed to bring down inflammation, but they could make your periods even more irregular.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and aspirin relieve period pain but can be harmful for people with Crohn’s disease. NSAIDs can damage the GI tract even more and cause a Crohn’s flare-up. Acetaminophen (Tylenol) is the safer pain reliever choice for people with Crohn’s disease.

Your body uses iron to make hemoglobin, a protein that helps your red blood cells carry oxygen to your tissues. During heavy periods, you lose iron, which could lead to anemia. Because of this, there’s a risk that people with heavy periods could develop anemia.

Add more iron to your diet by eating iron-rich foods such as:

  • spinach and other dark green leafy vegetables
  • fortified breakfast cereals
  • beans
  • tofu
  • beef

If you have low iron, ask your doctor about taking a supplement, such as vitamin B12, which may help prevent anemia.

Not everyone feels like exercising in the middle of a Crohn’s flare or during their heaviest period days. But exercise can ease stress by promoting the release of feel-good chemicals called endorphins.

Yoga is a good exercise for relieving period cramps and Crohn’s symptoms like gas and bloating. You might try poses like Cobra, Cat-Cow, and Fish.

It can sometimes be hard to talk about symptoms like diarrhea, gas, and your periods, but your doctor can only help when they know what’s going on. Find a healthcare professional you trust so that you’ll feel more comfortable being open with them.

See your doctor if you find that your Crohn’s symptoms get worse around the time of your period. The overlap between Crohn’s disease and your menstrual cycle may require you to see two different specialists — a gastroenterologist and a gynecologist.

Your gynecologist can check you for other conditions that cause similar symptoms, like endometriosis. Women with endometriosis are at higher risk for Crohn’s disease.

Once you know what’s going on, you can get treatments to manage symptoms of both Crohn’s disease and difficult periods.

Crohn’s disease can affect your menstrual cycle. Your periods may be more irregular and more painful than they were before your diagnosis. Crohn’s symptoms like diarrhea, gas, and nausea can also get worse during your periods.

Birth control, medication, and stress-relieving techniques can make your periods more manageable. Over time, as you find a treatment plan that works for your Crohn’s, your periods should become more regular and less painful.