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From menarche to menopause: the fertile life span of celiac women

Santonicola, Antonella MD1; Iovino, Paola MD2,3; Cappello, Carmelina MD3; Capone, Pietro MD1; Andreozzi, Paolo MD1; Ciacci, Carolina MD1,2

doi: 10.1097/gme.0b013e3182188421
Original Articles

Objective: We evaluated menopause-associated disorders and fertile life span in women with celiac disease (CD) under untreated conditions and after long-term treatment with a gluten-free diet.

Methods: The participants were 33 women with CD after menopause (untreated CD group), 25 celiac women consuming a gluten-free diet at least 10 years before menopause (treated CD group), and 45 healthy volunteers (control group). The Menopause Rating Scale questionnaire was used to gather information on menopause-associated disorders. The International Physical Activity Questionnaire was used to acquire information on physical activity.

Results: Untreated celiac women had a shorter duration of fertile life span than did the control women because of an older age of menarche and a younger age of menopause (P < 0.01). The scores for hot flushes, muscle/joint problems, and irritability were higher in untreated celiac women than in the control women (higher by 49.4%, 121.4%, and 58.6%, respectively; P < 0.05). In comparison with untreated CD, long-lasting treatment of CD was not associated with a significant difference in the duration of fertile life span, but was only associated with a significant reduction in muscle/joint problems (a reduction of 47.1%; P < 0.05).

Conclusions: Late menarche and early menopause causes a shorter fertile period in untreated celiac women compared with control women. A gluten-free diet that started at least 10 years before menopause prolongs the fertile life span of celiac women. The perception of intensity of hot flushes and irritability is more severe in untreated celiac women than in controls. Low physical exercise and/or poorer quality of life frequently reported by untreated celiac women might be the cause of reduced discomfort tolerance, thus increasing the subjective perception of menopausal symptoms.

The fertile lifespan of untreated celiac women is short because of late menarche and early menopause. A gluten-free diet delays the onset of menopause.

From the 1Department of Clinical and Experimental Medicine, University Federico II of Naples, Naples; 2Department of Clinical Sciences, University of Salerno, Salermo; and 3Department of Surgery, University Federico II of Naples, Naples, Italy.

Received January 13, 2011; revised and accepted March 3, 2011.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Carolina Ciacci, MD, Department of Clinical and Experimental Medicine, Federico II University of Naples, Via Sergio Pansini, 5, Naples 80131, Italy. E-mail:

©2011The North American Menopause Society