Menopausal hormone therapy is a risk factor for microscopic colitis: findings from a nationwide, matched case–control study

We read with interest the paper by Ha et al,1 which explores the intricate relationship between the gut microbiome, host genetics and MASLD, highlighting how gut dysbiosis and immune interactions contribute to chronic inflammation, a mechanism potentially relevant to other inflammatory conditions such as microscopic colitis (MC). MC predominantly affects postmenopausal women, with current incidence rates2 3 comparable to those of ulcerative colitis and Crohn’s disease.4 This female predominance and typical postmenopausal onset suggests that hormonal factors may play a role in its development.