Women with untreated celiac disease may hit menopause earlier, and have a higher risk of some pregnancy complications, than women without the disease, suggests a small study.However, if women with celiac disease are diagnosed early, and follow a strict diet as treatment, the findings suggest they won't go through menopause any earlier than disease-free women.
Celiac disease affects "the whole spectrum of the reproductive career of women," said Dr. Shawky Badawy, the head of obstetrics and gynecology at Upstate Medical University in Syracuse, New York.
"It's very interesting that when this disease is diagnosed early and corrected by (a) gluten-free diet, you find that these people improved significantly and their reproductive function improved significantly," added Badawy, who was not involved in the new study.
Combined with other studies that have also shown reproductive problems in women with untreated celiac disease, "it's a really important finding," he told Reuters Health.
In people with celiac disease - about one percent of Americans - the immune system reacts to a protein called gluten, which is found in wheat, barley, and rye. Eating foods with gluten damages the small intestine and keeps it from absorbing nutrients.
The authors of the new study, led by Dr. Carolina Ciacci from Federico II University of Naples, Italy said that nutrient deficiencies, plus lower levels of some key hormones in women with celiac disease, may be the reason for the earlier menopause they observed.
"When people have celiac disease, they have really chronic diarrhea, for example," Badawy said. "With this, they lose much of the necessary amino acids, vitamins, (and) minerals, and all these certainly have their importance in the function of the vital endocrine organs."
Estrogen levels are generally lower in women with celiac disease, said Ciacci. Both reduced body fat and inflammation stemming from the celiac disorder itself can contribute to hormonal disruption, she explained.
The new study included a group of about 100 postmenopausal women. Twenty-five of them had been diagnosed with celiac disease and followed a gluten-free diet for at least 10 years before menopause. Another 33 had celiac disease that wasn't diagnosed until after menopause, and 45 celiac-free women served as a comparison group.
Researchers asked all the women how old they were when they got their first period and when they stopped having periods. They also found out how many times they had been pregnant, about any pregnancy complications -- such as miscarriages or premature births -- they had experienced, and about symptoms they had during menopause, including hot flashes.
On average, women with and without celiac disease had gotten their periods at age 12 or 13. Both women without the disease and those who had followed a gluten-free diet hit menopause around age 50, according to the findings, published in the journal Menopause.
But women with untreated celiac disease went through menopause between age 47 and 48, on average - making their "fertile life span" shorter than other women's.
And while all three groups of women had gotten pregnant an average of two to three times, the combination of miscarriages and premature births was more common in women with untreated celiac disease than in the comparison group - a pattern that also followed, but to a lesser extent, in women with treated celiac disease.
Ciacci's team also noted that women in the untreated celiac group reported more menopause-associated problems, such as hot flashes, irritability, and muscle and joint symptoms than non-celiac women.
They concluded that diagnosing celiac disease early, and preventing some of the nutritional and hormonal differences in celiac women, might delay an otherwise early menopause. It's likely, Ciacci said, that many people go their whole lives with celiac symptoms, but are never diagnosed.
She said that one important way to change that is education of primary care doctors.
"There are big signs" of celiac disease, she told Reuters Health. "One is anemia, or iron deficiency. If you couple that with gastrointestinal symptoms or with fatigue, then you have three symptoms that all together must tell a doctor: check for celiac disease."
But women - who are more at risk for celiac disease than men -- can also be aware of the disease themselves, she added, especially since, if they have symptoms, getting tested can be very simple.
"When a woman has early menopause, she should think of celiac disease. It's probably too late to gain anything about fertility but it's probably important for her quality of life," Ciacci said. "This is the same for people experiencing multiple (spontaneous) abortions or preterm birth -- it's just a blood test."
SOURCE: http://bit.ly/ja9XY2 Menopause, online June 3, 2011.
The 39-year-old Sheik Umar Khan, hailed as a "national hero" by the health ministry, was leading the fight to control an outbreak that has killed 206 people in the West African country
Shanghai food watchdog said it sealed more than 1,000 tonnes of suspected meat products from OSI in China, and a further 100 tonnes of products from a range of its customers.
Children in Syria are at greatest risk as routine immunisation has been disrupted and many health centres are severely damaged after more than three years of conflict
151 people who came into direct contact with the victim were also placed in quarantine.
Viruses that spread through air - such as flu viruses for example - are far more likely to spread swiftly and widely in human populations
TV report that showed workers picking up meat from a factory floor, as well as mixing meat beyond its expiration date with fresh meat
Religious leaders to preach in their churches and mosques for a change of attitude towards the disease
The three people in the latest reported cases had "mild symptoms" and have fully recovered after being treated with antibiotics, the department said, adding that they are no longer contagious.
A state landmark, Mount Rainier last erupted in the 19th century. It is widely expected to erupt again, according to the U.S. National Park Service.
The new vaccine will help save the lives of hundreds of thousands of South Sudanese children.
Food security became a hot topic after record high grain prices in 2008 marked the start of a period of volatility.
An agreement by the court with the advocate general's opinion would have significant repercussions on employers as they could be required to make special adjustments for morbidly obese employees
Steroid-containing inhalers' potential effect on children's growth is a source of worry for parents and doctors
The hole was found near the Bovanentsky gas field, leading to speculation that it could have been caused by an underground explosion.
A team at McGill University developed a pill that cures a form of blindness that usually affects newborns.
Since 2001, new HIV infections have fallen by 38 percent, AIDS-related deaths have fallen by 35 percent since a peak in 2005.