Barley And Wheat And Rye, Oh My! Women And Celiac Disease

Celiac Disease is an autoimmune disorder which causes an adverse reaction to gluten (a composite protein found in wheat, barley and rye). Gluten is found in anything that includes these grains, including: cakes, most types of bread, pasta, breakfast cereals, and even sauces and ready-meals. In other words, it can be tough to be a celiac.

It's not an uncommon condition, either, with one in one-hundred people thought to suffer with the disorder (although this may be an underestimate, as many cases of Celiac Disease are misdiagnosed as Irritable Bowel Syndrome). There is no cure for Celiac Disease, which is treatable only with a strict, lifelong gluten-free diet.

Did you know that between sixty and seventy percent of celiacs are women?

It's true.

Note: Symptoms Vary

Not every Celiac Disease sufferer will have every symptom. Adult celiacs often have milder gastrointestinal symptoms. Some may not have gastrointestinal symptoms at all.

Part of the reason for this lies in the bowel. Over time, consumption of gluten in the gluten-sensitive individual leads to clogging to the villi (the finger-like growths that line the healthy intestine), preventing the digestion of nutrients. Over time, malabsorption and malnutrition may cause many of the symptoms outlined here. In the early days of the disease, the villi are not clogged, meaning that nutrients can still be digested and symptoms may be less severe.

What Celiac Symptoms Can Everyone Experience?

Gastrointestinal symptoms: Many Celiacs suffer gastrointestinal symptoms, particularly as the disease progresses. These symptoms (which include diarrhea, bloating, fatty stools and foul-smelling flatulence) are largely due to malabsorption. When you have Celiac Disease, the villi become clogged, preventing the absoption of nutrients. The fats you consume remain trapped in your intestine, and are broken down into fatty acids. Fatty acids promote the secretion of water, which causes the diarrhea.

Weight loss: At one time, weight loss was thought to always occur with Celiac Disease, due to the malabsorption of nutrients. We now know, however, that Celiac Disease sufferers often consume huge quantities of food to compensate for the nutrients they're lacking, which may mean they remain the same weight or even gain some weight.

Bruising: The malabsoption of vitamin K leads to bruising and excessive bleeding, as the ability to clot is reduced. If you notice that you seem to be bruising after a mild knock, or taking longer to heal after a cut, talk to your doctor.

Osteoporosis: The malabsorption of Calcium and vitamin D can make you susceptible to fragile bones and breakages.

Anemia: The malabsorption of iron, vitamin B12 and folate can cause anemia, leading to breathlessness, tingling extremities (fingers and toes), fatigue, heart palpitations, and confusion.

Muscle weakness: Due to the malabsorption of magnesium and potassium, untreated celiacs frequently suffer with muscle weakness, muscle cramps, and a tingling sensation in the limbs.

READ Celiac Disease Vs. Non-Celiac Gluten Sensitivity

So, there we have the symptoms that everyone can suffer. But what symptoms are specific to women?

Women With Celiac Disease

Celiac Symptoms Specific To Women

Women with Celiac Disease have their own set of symptoms. These symptoms may be experienced alongside the symptoms outlined previously, or they may arrive without any other symptoms. So, if you experience these symptoms, don't dismiss it as something gynecological. Consider Celiac Disease.

Menstrual difficulties: If you're a celiac, you may experience a variety of menstrual problems, including: irregular menstruation, dysmenorrhea (painful menstruation), and amenorrhea (absent menstruation).

Fertility problems: A celiac woman may be diagnosed with unexplained infertility (that is to say, infertility not caused by endometriosis, polycystic ovarian syndrome, fibroids, or anything else gynecological). You may find it difficult or impossible to become pregnant, with many women trying to conceive for years. Celiac Disease is the cause in as many as four to eight percent of cases of undiagnosed infertility in women.

Pregnancy and Childbirth problems: Sadly, the difficulties celiac women face don't end when they conceive. An undiagnosed, or untreated celiac woman is more likely to experience miscarriage or stillbirth than her non-celiac counterpart. She is also more likely to require a cesarean delivery should she be able to carry the pregnancy to term.

Early menopause: An undiagnosed, untreated celiac woman is more likely to have an early menopause than her non-celiac counterpart.

Why do untreated celiac women experience fertility pronlems?

No-one's quite sure. Some think the malabsorption of folate, and other nutrients that are essential in pregnancy, is to blame. However, it has been noted that not every infertile woman with newly-diagnosed Celiac Disease is currently experiencing malnutrition. Some people think the nature of the autoimmune disorder itself (where the body attacks healthy tissue) may be at fault.

I don't really have any symptoms and I really love pasta. Do I have to give up gluten?

You can experience malnutrition and malabsorption, which (rather than making you pale, interesting and slender) will actually cause devastating osteoporosis (bone density loss leading to brittle bones), vitamin D deficiency (which could cause Osteomalacia, or painful bones), vitamin B12 and folate anemia (which causes extreme fatigue, muscle weakness, depression and mental confusion), and iron deficiency anemia (which can cause shortness or breath and heart palpitations).

Even more serious is the uncommon risk that you may develop cancer of the digestive tract. One in two-hundred people with Celiac Disease will develop bowel cancer within ten years of diagnosis.

Can I get pregnant if I'm a celiac?

The bad news if that, if you have untreated Celiac Disease, you have a higher risk of infertility and miscarriage. The good news is that diagnosis and treatment with a strict gluten-free diet can restore your health and, with it, your fertility.

Warren and Greenblatt (2010) tell the story of a thirty-five year old woman who was diagnosed with Celiac Disease after trying for a baby for sixteen months. She later became pregnant after only ten months on a gluten-free diet, giving birth to a health baby after having a perfectly normal pregnancy.

What do I do if I think I have Celiac Disease?

Do you think you might have Celiac Disease? If you do, see your primary care physician. It may be necessary to refer you to a gastroenterologist. Celiac Disease is usually diagnosed though a colonoscopy (an examination where your intestine is pumped full of air, and a small flexible camera is inserted into your rectum).

READ What Is Non-Celiac Gluten Sensitivity?