Can ulcerative colitis treatment affect fertility?

Question

Hello doctor,

I am a 27-year-old female, recently diagnosed with ulcerative colitis after a colonoscopy. I have been experiencing bloody diarrhea, abdominal cramps, and urgency for several months. My hemoglobin has dropped to 9.8 g/dL. I am scared that this will be lifelong.

Can dietary changes really help?
I also read that medicines such as steroids can affect fertility. Should I be worried since I want to have children in the future?
How do women manage ulcerative colitis in the long term?

Please help.

Thank you in advance.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

I can imagine how overwhelming this new diagnosis feels for you. Let me reassure you: ulcerative colitis (UC – a chronic inflammatory condition of the large intestine/colon) is a lifelong condition, but with the right treatment and lifestyle adjustments, most women live full, active, and healthy lives, including having children.

Role of diet: Food does not “cause” UC, but it can influence flare-ups (episodes when symptoms get worse).

During active disease (flare): Choose low-fiber, soft, easy-to-digest foods, such as white rice, bananas, boiled chicken, and yogurt.
Avoid: Caffeine, alcohol, spicy and fatty foods, raw vegetables, and high-lactose dairy products if they worsen symptoms.
Once remission is achieved (periods when symptoms settle): You can slowly reintroduce more foods and learn your personal triggers.

Treatment and fertility

Steroids (such as Prednisone): Medicines used for short periods during flare-ups to reduce inflammation. They are not meant for continuous long-term therapy. These drugs do not affect long-term fertility.
Steroids in pregnancy: Considered safe in the second and third trimester if needed.
Long-term control: Usually managed with Mesalazine, given as suppositories, enemas, or tablets, depending on the location of the disease in the colon.
For severe disease not responding to standard drugs, biologics (advanced medicines that target specific parts of the immune system) may be considered.

Fertility and family planning

Most women with UC can conceive and carry a healthy pregnancy.
The key is to achieve remission before conception, as active disease carries more risks for pregnancy than the medications themselves.

Long-term monitoring

UC slightly increases the risk of colon cancer, but the risk remains low with good disease control.
Colonoscopy (a camera test to look inside the colon) for surveillance is usually advised after 8 to 10 years of disease, and then every one to three years, depending on the findings.

UC is a chronic condition, but most women manage it well with the right balance of medication, diet, and regular follow-up. You are not alone; many patients live healthy, happy lives, raise families, and achieve long periods of remission.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.