The Connection Between Celiac Disease and Reproductive Health
When you think of the effects of celiac disease, digestive system, namely the intestines, probably come to mind. Yet symptoms of celiac disease, can present in many different ways, including your reproductive health. For example, if you have undiagnosed and/or untreated celiac disease, you may be more likely to experience infertility. While research is limited and results of studies are mixed, here’s why and how gluten intolerance could impact fertility.
Gluten intake in individuals with celiac disease may impact reproductive health in two specific ways: 1) nutrient deficiencies caused by intestinal damage; 2) autoimmune and inflammatory processes that may impact the reproduction process.
Let’s take a closer look at the ways untreated celiac disease can affect reproductive health.
Gluten and Female Reproductive Health
Celiac disease appears to have a potential impact on reproductive health issues early on in a female’s development. The 2010 article titled “Reproductive changes associated with celiac disease,” published in the World Journal of Gastroenterology, outlined the results of several fertility studies. The findings showed that some females with undiagnosed and untreated celiac disease either started menstruating later or experienced amenorrhea, a lack of menstruation. Celiac disease was also linked to early menopause.
One analysis of multiple studies concluded that women with infertility have a 3.5 times higher chance of also having celiac disease and those with “unexplained infertility” had a 6 times higher chance of having untreated celiac disease.
While there is more research on women’s fertility and celiac disease than men’s fertility, some research that exists to date does show some connection between the autoimmune disease and infertility for both women and men (see Gluten and Male Reproductive Health section below for more).
Gluten and Pregnancy
Some studies have shown that undiagnosed celiac disease and its autoimmune response may lead to difficulty getting pregnant, recurrent miscarriages, and, if a pregnancy is carried to full term, premature births and low birth weight.
A 2016 review points out that up to 50% of women with untreated celiac disease had at least one miscarriage or a poor pregnancy outcome. A 2018 study in Denmark of over 12,500 women found that those who had undiagnosed celiac disease had an increased risk of miscarriage.
In some cases, going on a gluten-free diet resolved fertility issues in women. In those cases where it did not have an effect, other undiagnosed disorders or health issues may have been at play. The 2018 study showed that women with celiac disease who had been diagnosed and treated did not experience higher rates of pregnancy loss.
In our article Pregnancy and Celiac Disease, we outlined some of the nutrients important to maintaining a healthy pregnancy: iron, folic acid, and omega 3 fatty acids. Undiagnosed celiac disease can interfere with the proper absorption of these key nutrients, regardless of pregnancy. While pregnant, celiac disease and related nutrient deficiencies could affect the placenta and fetus.
People with gluten sensitivity and those with celiac disease may experience similar symptoms, but there is very little research on the effects of non-celiac gluten sensitivity (NCGS) on fertility.
Gluten and Male Reproductive Health
Women are not the only ones whose fertility is potentially affected by untreated celiac disease. While the studies related to male reproductive health and gluten are limited, researchers theorize that undiagnosed or untreated celiac disease may impact male fertility through one or both of the mechanisms that affect female fertility: reduced nutrient absorption and the inflammatory aspects of the autoimmune process in celiac disease.
In limited studies, gonadal dysfunction in patients with celiac disease — the sex glands where sperm is produced — was observed. Gluten intolerance may alter sperm formation and movement (morphology and motility) as well as affect sperm count. In one study, after men were given a celiac disease diagnosis, going on a gluten-free diet improved sperm condition and count but had no effect on sperm movement.
Another study of over 7,000 men with celiac disease found that men with celiac disease seem to have normal fertility rates, both before and after diagnosis.
While there is no definitive answer on the relationship between celiac disease and fertility at this time, the existing research taken as a whole does indicate that, at least in some cases, celiac disease may be a contributing factor to infertility.
Getting Diagnosed and Going Gluten-Free
If you are experiencing issues related to your reproductive health, including infertility, you may want to get tested for celiac disease, particularly if you have a family history of celiac disease or other autoimmune disorders. If you believe you could be a candidate for celiac disease testing, talk with your doctor. If you have been diagnosed with celiac disease and are strictly adhering to a gluten-free diet, you may see a positive change in your reproductive health.
The information on this website is for educational purposes only. Consult your healthcare team when considering this information.
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