Rates of Women’s Health Disorders Among Those with Celiac Disease

Celiac Disease Women's HealthWomen with celiac disease had statistically higher odds of experiencing ovarian dysfunction, irregular menstruation, infertility and other women’s health disorders, according to Rama Nanah, MD. Presented at the ACG Annual Scientific Meeting; Oct. 20-25, 2023 in Vancouver, British Columbia.

  • Kate Burba, https://www.healio.com 1

“Celiac is more prevalent in women, and presentations are shifting away from classical malabsorption towards nonclassical and extra-intestinal manifestations,” Rama Nanah, MD, a clinical hospitalist at Cleveland Clinic, told Healio. “One area of these extra-intestinal symptoms is women’s health disorders. Prior research reported delayed menarche and early menopause in women with celiac disease, but the information remains limited, particularly in North America.”

In a retrospective analysis, Nanah and colleagues evaluated nationwide rates of women’s health disorders among 9,368 women with celiac disease compared with 25 million outpatient women without celiac disease. Researchers noted women with celiac disease were predominantly white (83% vs. 47%) and had a lower mean BMI (24.6 vs. 26.1).

According to results presented at the ACG Annual Scientific Meeting, women with celiac disease had statistically significantly higher odds of primary ovarian failure (0.96% vs. 0.16%; OR = 6.25; 95% CI, 4.89-7.41), which included ovarian dysfunction (4.4% vs. 1.25%; OR = 3.64; 95% CI, 3.3-4.02) and polycystic ovarian syndrome (3.3% vs. 1%; OR = 3.2; 95% CI, 2.94-3.68).

  • “Our study found higher overall rates of women’s health disorders in women with celiac disease compared to non-celiac at all hormonal stages of life,” Nanah said.

Women with celiac disease also were more likely to experience irregular menstruation (15.5% vs. 6.9%; OR = 2.45; 95% CI, 2.32-2.6) dysmenorrhea (10.9% vs. 4.24%; OR = 2.76; 95% CI, 2.58-2.94), menopausal and peri-menopausal disorder (4.3% vs. 1.56%; OR = 2.85; 95% CI, 2.58-3.15), endometriosis (2.3% vs. 0.93%; OR = 2.53; 95% CI, 2.21-2.9), infertility (1.44% vs. 0.85%; OR = 1.69; 95% CI, 1.43-2.01) and absent or rare menstruation (4.6% vs 2%; OR = 2.34; 95% CI, 2.13-2.58).

Nanah noted that these findings remained significant among groups matched for age, race and BMI.

  • “By raising awareness of these higher rates of women’s health disorders in women with celiac disease, we hope this will provide a call to gastroenterologists to think of this association and evaluate patients accordingly, including referral to and partnership with our OB/GYN colleagues to care for these women,” Nanah told Healio. “Early diagnosis and management are crucial for these patients to minimize complications and take advantage of their fertile lifespan should they be interested in a family.”

Source: Nanah R, et al. Women’s health disorders in a celiac disease population – A nationwide cohort analysis. Presented at: ACG Annual Scientific Meeting; Oct. 20-25, 2023; Vancouver, British Columbia (hybrid meeting).

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