Can Celiac Disease Delay Your First Period?

teenage girl talking to doctor
Celiac disease can delay your first period. Tetra Images/Getty Images

Question: Can undiagnosed celiac disease delay your first period?

Answer: Yes, it appears celiac disease can do that in some girls, although all studies haven't found such a link. Also, there are lots of possible reasons for your first period to be later than it is in your friends, so a delay (especially a short one) certainly doesn't mean you absolutely have celiac.

However, celiac disease is one possibility if you don't get your first period on time, especially if you've got other symptoms or there's a family history of the condition.

Read on for the details.

So How Can Celiac Delay Your First Period?

Let's get the technical stuff out of the way:

"Menarche" means the actual date of a girl's first period, not when you first hit puberty. Puberty in girls actually starts about two to two-and-a-half years before menarche — at around age 10-and-a-half.

In the U.S., most girls get their first periods by the time they're 13 years, nine months old — in fact, the average age is closer to 12-and-a-half.

But girls with undiagnosed celiac disease seem to get a late start, at least in some research reports. For example, in one study, girls who were later diagnosed with celiac disease started their periods at a significantly older age than their non-celiac peers — 13.6 years, compared to 12.7 years for girls who didn't have celiac. Another study found an even later average age of menarche for celiac girls: 16.16 years.

Some researchers blame malnutrition from untreated celiac disease or malabsorption of important nutrients for delayed menarche, while others say that gluten itself could be having some unknown effect on girls, possibly involving their hormones.

However, other researchers haven't found a definitive link between late first periods and celiac disease. For example, a major study involving Italian women with celiac reported that the average age of first periods of those celiac women was similar to the age for non-celiacs.

How Do I Know If the Problem Is Celiac or Not?

There are several steps you can take if you think celiac disease might be delaying your (or your daughter's) first period.

First, check out this guide to delayed puberty to see if there's really a problem. If there aren't obvious signs of puberty by around age 14, you might want to investigate further.

If you have a family history of celiac disease or celiac disease symptoms, you might want to consider asking for celiac blood tests. You might be thinking that most celiac symptoms are digestive in nature, but that's not true at all — in children and teens, especially, constant irritability can be a sign (although I admit it's hard to tell what irritability is weird and what's normal with a teenager!).

Delayed puberty can be caused by a wide range of conditions, including thyroid disorders or chronic diseases such as diabetes (both of which also are closely linked with celiac disease, of course). If you're concerned that your late first period might be due to celiac disease, your best bet is to schedule a full physical.

Sources:

D. Martinelli et al. Reproductive life disorders in Italian celiac women. A case-control study. BMC Gastroenterology. 2010 Aug 6; 10:89.

J. Rujner. [Age at menarche in girls with celiac disease]. Ginekologica Polska. 1999 May;70(5):359-62.

C. Sferlazzas et al. Menarcheal age in celiac disease may not be delayed and may be irrespective of age at diagnosis and dietary management. Journal of Endocrinological Investigation. 2008 May; 31(5):432-5.

K.S. Sher et al. Female fertility, obstetric and gynaecological history in coeliac disease: a case control study. Acta Paediatrica supplement. 1996 May;412:76-7.

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