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Celiac Disease Symptoms in Women

Infertility, Menstrual Problems May Appear Long Before Digestive Symptoms

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Updated March 31, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Women are diagnosed with celiac disease far more frequently than men: Up to 70% of those currently diagnosed with the condition are female, in part because more women than men actually have the condition, and in part because women are more likely to seek a diagnosis for their health problems.

But at the same time, women may be less likely than men to show the best-known symptoms of celiac disease, which include diarrhea, fatigue and weight loss. In fact, women who are diagnosed with celiac disease frequently notice symptoms that are not gastrointestinal in nature prior to experiencing those well-known symptoms.

One large study, for example, found that more than 40% of women first reported "other" celiac symptoms, including menstrual cycle disorders and infertility. Half of those specifically reporting menstrual cycle disorders said their period problems developed before any other symptoms of celiac disease.

Of course, if you have a problem with your period, there are many potential causes beyond celiac disease. But the research indicates that women — especially those at risk for the condition (perhaps because a close family member was diagnosed with celiac) — should keep an eye on more than just digestive symptoms.

Infertility Can Be Sign of Celiac Disease in Women

Celiac disease appears in about 1% of the overall population. However, research studies have found it in up to 8% in women with so-called "unexplained infertility," or infertility that's not due to factors that can be easily identified, such as hormonal problems.

The majority of the women tracked in studies looking at celiac disease as a potential cause for infertility did not have digestive symptoms, leading some researchers to recommend that all women with unexplained infertility be tested for celiac disease, regardless of other symptoms.

Infertility as a symptom in women with celiac disease may be due to nutritional deficiencies, which are common in newly diagnosed celiacs, even those who don't have gastrointestinal symptoms. Infertility also could result somehow from inflammation. Researchers haven't yet pinpointed the exact cause.

More on infertility as a sign of celiac disease in women:
Undiagnosed Celiac Disease Can Lead to Infertility

Pregnancy Problems May Also Indicate Celiac Disease in Women

If you have undiagnosed celiac disease and get pregnant, you're also far more likely than a woman without the condition to experience problems with your pregnancies. Severe anemia, threatened miscarriage, placental abruption, gestational hypertension and intrauterine growth restriction all occur in women with undiagnosed celiac disease much more often than in women who don't have the condition.

Recurrent miscarriages and/or stillbirths also may represent a symptom of celiac disease, and several researchers recommend screening for celiac in women with these problems. In many cases, following the gluten-free diet after diagnosis enables women to carry their babies to term.

Celiac disease also has been implicated in late first periods in young women, missing menstrual periods (amenorrhea), endometriosis, pelvic pain and early menopause, frequently in women with few or no other celiac symptoms.

More on pregnancy problems and menstrual disorders in women with celiac disease:
Celiac Disease Can Cause Pregnancy Problems
Miscarriage More Common Among Women with Celiac Disease
Can Celiac Disease Cause Aamenorrhea or Skipped Periods?
Can Undiagnosed Celiac Disease Cause Delayed Menarche in Young Women?
Do Celiac Women Suffer More From Endometriosis and Pelvic Pain?
Can Celiac Disease Cause Severe Menstrual Cramps?
Celiac Disease and Early Menopause

Anemia, Osteoporosis, Thyroid Disorders All Can Indicate Celiac in Women

Anemia, which is common in women of childbearing age, also appears frequently in women with undiagnosed celiac disease — in one study, 40% of women reported anemia prior to their celiac diagnoses. It's a common enough symptom that some physicians routinely test for celiac when a person suffers from otherwise unexplained anemia. Nutritional deficiencies — specifically, problems absorbing iron — are thought to be the cause.

Undiagnosed celiac disease also significantly raises your risk of osteoporosis — a disease that occurs in women much more frequently than in men. Again, nutritional deficiencies related to problems absorbing nutrients — this time, deficiencies in vitamin D, calcium and magnesium — probably are to blame.

In both cases, the gluten-free diet improves your absorption of the necessary nutrients and often leads to improvements in bone density and a resolution of anemia.

Women also suffer more frequently from thyroid disorders, another set of conditions linked to celiac disease. Up to 7% of people with autoimmune thyroid disease — including Graves' disease and Hashimoto's disease — may have celiac disease, and in some of them the celiac won't cause any other symptoms.

Multiple sclerosis (MS) also occurs far more commonly in women than in men, but in that condition the potential links to celiac disease are less clear — some studies have shown higher rates of celiac in both men and women with multiple sclerosis, while others have not. However, some MS sufferers report improvements in their conditions when they follow the gluten-free diet.

More on other conditions linked with celiac disease in women:
Anemia and Celiac Disease
Osteoporosis and Celiac Disease
Celiac Disease, Thyroid Disease Often Found Together
Celiac Disease and Multiple Sclerosis

Gastrointestinal Symptoms Can Indicate Celiac, Too

It's clear that some non-digestive symptoms of celiac disease in women might register on your radar before digestive symptoms. But don't overlook any digestive symptoms; they also could indicate celiac disease.

For example, women with celiac disease frequently suffer from bloating — in one study, nearly 70% of women reported that "bloated stomach" was one of their first celiac symptoms. About 40% of the women in that same study listed diarrhea as one of their first celiac symptoms, and gastroesophageal reflux disease (GERD) often is found alongside these digestive symptoms.

In addition, women suffer more frequently from irritable bowel syndrome (IBS), and it's not uncommon for doctors to mistake IBS for celiac disease.

It's no coincidence that some consider celiac disease to be a "clinical chameleon" — it can appear with any of more than 100 different symptoms, or, in the case of "silent celiac disease," with no symptoms at all. However, regardless of what symptoms you have, the diagnosis (involving celiac blood tests and an endoscopy) and the treatment (the gluten-free diet) are the same.

Martinelli D. et al. Reproductive Life Disorders in Italian Celiac Women: A Case-Control Study. BMC Gastroenterology. 2010;10:89.

Shah S. et al. Celiac Disease: An Underappreciated Issue in Women's Health. Womens Health (London England). 2010 September; 6(5):753–766.

Tajuddin T. et al. Clinical presentation of adult coeliac disease. Irish Medical Journal. 2011 Jan:104(1):20-2.

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