Can gluten affect periods?
Gluten sensitivity is common amongst the general population. Many people experience a range of symptoms after eating gluten containing foods. The most common and obvious symptoms are tummy upsets; such as bloating, diarrhoea, constipation and excessive/smelly gas. The less obvious symptoms are fatigue, nutrient deficiencies, brain fog, skin rash, migraines and worsening of period pain. Gluten is a protein found in grains. Celiac disease is an autoimmune disease that is initiated by the consumption of gluten. It affects 1.5% of the population- with an estimated 80% of them remaining undiagnosed (1). Those with celiac disease must adhere to a strict gluten free diet, as consuming even a small crumb of gluten initiates an inflammatory immune response and causes damage to the gut lining (1). Non-celiac gluten sensitivity is less severe, but far more common, and still causes immune activation, inflammation and damage to the gut lining (2).
GLUTEN CONTAINING GRAINS
Wheat
Spelt
Rye
Triticale
Barley
Oats
GLUTEN FREE GRAINS
Rice
Quinoa
Sorghum
Buckwheat
Teff
Corn
Millet
So how does gluten affect periods?
We need sufficient nutrients to produce hormones for healthy menstrual cycles and pain free periods. We also need our detoxification pathways to be working to clear out any excess hormones, to ensure hormonal balance. Untreated gluten sensitivity can damage the gut lining and result in severe nutrient malabsorption. It can also affect the microbiome which is imperative for clearing out excess oestrogen. An imbalance of oestrogen levels is a common driver of heavy and painful periods.
Symptoms of endometriosis and adenomyosis are commonly driven or worsened by consuming gluten. If you are sensitive to gluten, consuming it causes an inflammatory response and endometriosis is an inflammatory condition (read more on endo here).
75% of women with endometriosis see a significant reduction in pain when following a gluten free diet (4).
Some may benefit from going gluten free due to sensitivity to FODMAPS
FODMAPS are types of carbohydrates, if you are sensitive to FODMAPS, the gut doesn’t absorb them. Remember, gluten is a protein which is different to FODMAPS, some gluten grains, such as wheat, contain FODMAPS. FODMAPS generally cause bloating and can worsen PMS. If FODMAPs are an issue for you, going low FODMAP may lessen symptoms of endometriosis and PCOS as they often overlap. FODMAP sensitivity usually only causes gut symptoms (bloating, excess/smelly gas, diarrhoea, constipation). If consuming gluten causes other symptoms (brain fog, migraines skin rash) it is more likely to be gluten sensitivity or wheat allergy, not a FODMAP issue. The Low FODMAP diet is complex and should be done under the guidance of a qualified practitioner.
When you have one autoimmune disease, you have a much higher risk of developing 1-2 other autoimmune diseases, such as Hashimoto's thyroid disease for example. Hashimoto’s causes an under active thyroid and is also linked to gluten sensitivity.
Going gluten free has been shown to benefit women with autoimmune thyroid disease (5).
The thyroid is involved in regulating healthy menstrual cycles, low thyroid function can cause irregular and/or heavy periods. Infertility is also a concern- studies have shown almost half of women with Hashimoto’s disease to have issues getting pregnant (5).
Gluten and Fertility?
Unexplained infertility and miscarriage are some of those less obvious signs of celiac disease (1). Gluten sensitivity and infertility may be explained due to nutrient deficiencies or a dysregulated immune system (6). Pregnancy is not viable with insufficient nutrients. Because non celiac gluten sensitivity can do similar damage to the gut lining as celiac disease, it is important to rule this out with a trusted practitioner if you are experiencing unexplained infertility. Celiac disease can be diagnosed with a blood test then followed by an intestinal biopsy. However, non-celiac gluten sensitivity cannot be diagnosed by a blood test. You can test for the celiac gene (HLA-DQ2 and HLA-DQ8) but it does not mean you have celiac- However, it is likely that you could be sensitive and could benefit from going gluten free.
Women whose periods are missing, AKA amenorrhea, will also struggle to fall pregnant- you need to ovulate to fall pregnant, right? Some women with amenorrhea may also benefit from getting tested for gluten sensitivity.
Should I go gluten free?
If you experience heavy painful periods, such as in conditions like endometriosis and adenomyosis you may see a benefit in going gluten free.
Restricting gluten if you have an underactive thyroid may also be beneficial.
Those who have PCOS may not see a benefit of going gluten free, however, some may see results going low FODMAP.
Those experiencing unexplained fertility and miscarriages should get screened for celiac disease and may gain from implementing a gluten free diet.
Everything is individual.
When will I start seeing results after going gluten free?
The repair process will depend on how severe the gut damage is, and influence how quickly you see results. You may start to feel significantly better after a couple of days following gluten restriction; however, your gut needs a lot longer than a few days to repair. Because gluten sensitivity is an immune response, consuming gluten triggers antibody release which is what damages the gut lining. Antibodies attack gluten and in the process it damages the gut lining, leading to intestinal permeability and further inflammation. Once following a gluten free diet, the body stops making antibodies. The antibodies start to clear out, and after 2 months their damaging effects start to decline. However, it can take up to 4 months for the antibodies to be completely cleared from the body (7). So what does this exactly mean? Adhering to a strict gluten free diet for at least 4 months will allow for your gut lining to repair and minimise the effects of gluten. Even eating small amounts can induce antibody production and cause inflammation and gut damage.
All in all, going gluten free may be beneficial in many hormonal and period problems.
Always get advice from your healthcare practitioner.
