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Microscopic colitis progression showed links with smoking, celiac disease, and a potential protective role of bilateral oophorectomy. 

A study published in June 2025 issue of BMC Gastroenterology on microscopic colitis (MC) was marked by non-bloody, watery diarrhea, primarily affecting older women, with limited data available on hormonal risk factors.  

Researchers conducted a retrospective study to examine whether hormonal factors disrupting sex hormone balance influenced the disease course of MC.  

They distributed a questionnaire to 384 women with MC (mean age 64 years, range 35–90) across 5 Swedish centers. The survey collected demographic details, including age at diagnosis, disease duration, and treatment history. It also gathered information on polycystic ovary syndrome, endometriosis, and bilateral oophorectomy. Data on previous or ongoing hormone therapy and in vitro fertilization (IVF) were included to assess their relation to disease progression.  

The results showed that the association with smoking was confirmed. The odds ratio (OR) for celiac disease and oral contraceptive use was higher in relation to disease course, though not significant for oral contraceptives. Hormone replacement therapy was linked to a lower OR, but this was also non-significant. Bilateral oophorectomy showed a significantly reduced OR (0.41, CI 0.19–0.86, P= 0.019). No other evaluated factors demonstrated a notable effect on the course of MC.  

Investigators concluded that smoking and celiac disease were linked to a more active disease course, while bilateral oophorectomy appeared protective, supporting a possible role of hormonal balance in MC. 

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-04083-8