How Wheat or Gluten Affects Periods

For women with gluten sensitivity (celiac disease or non-celiac gluten sensitivity), even trace amounts of gluten can drive or worsen endometriosis, adenomyosis, amenorrhea, migraines, and thyroid disease.

For women with FODMAP sensitivity (as opposed to gluten sensitivity), a full serving of wheat or other FODMAP food can cause digestive bloating and potentially worsen premenstrual mood symptoms and polycystic ovary syndrome (PCOS). Small amounts of wheat are usually fine.

When trying to decide whether to strictly avoid gluten, the first step is to understand the difference between FODMAP sensitivity and gluten sensitivity. In short, if wheat causes digestive bloating, it’s likely to be a problem with FODMAPs. If wheat worsens brain fog, psoriasis, autoimmunity, or migraines, it’s likely to be a problem with gluten.

FODMAP sensitivity causes digestive bloating

FODMAPs are short-chain, fermentable carbohydrates that can cause irritable bowel syndrome (IBS). FODMAP-containing foods include wheat, milk, legumes, certain vegetables, and fruit. The term FODMAP is an acronym invented by researchers at Monash University in Australia and stands for fermentable oligo-, di-, and monosaccharides and polyols.

👉🏽Tip: Spelt is easier to digest than wheat because it’s low in FODMAPs. But spelt does contain gluten.

Untreated, FODMAP sensitivity can contribute to problems with the microbiome, impair estrogen clearance, and activate mast cells — all leading to inflammation that can worsen period problems such as premenstrual mood symptoms and PCOS.

The solution is to 1) temporarily cut back on FODMAPs and 2) work on the underlying cause of FODMAP sensitivity, such as stomach acid medication, underactive thyroid, and small intestinal bacterial overgrowth (SIBO).

With SIBO and a FODMAP sensitivity, it’s usually enough to just temporarily reduce wheat and other FODMAPS, without needing to strictly avoid wheat or any other food.

The effect of gluten on the menstrual cycle.

Gluten sensitivity can drive or worsen immune dysfunction

Gluten, on the other hand, is not a carbohydrate and often does not cause digestive symptoms. (If bloating is your main symptom, refer to the FODMAP section above.)

Instead, gluten is a protein that can cause deep-seated immune dysfunction, even in trace amounts. But only in people with gluten sensitivity.

👉🏽 Tip: Wheat, spelt, rye, barley, and possibly oats contain gluten. Rice, corn, millet, quinoa, or potatoes do not contain gluten.

Gluten sensitivity can take the form of either celiac disease or non-celiac gluten sensitivity. Of the two, celiac disease is more severe and can be diagnosed with a blood test (celiac serology) followed by an intestinal biopsy. It’s important to have the blood test before eliminating gluten from your diet because avoiding gluten can cause you to test negative even if you have celiac disease.

Non-celiac gluten sensitivity (NCGS), on the other hand, cannot be diagnosed (or ruled out) by the celiac serology blood test.

How to assess for non-celiac gluten sensitivity

First, consider whether you or anyone in your family has any of the symptoms of non-celiac gluten sensitivity:

  • depression
  • brain fog
  • psoriasis
  • infertility
  • migraines
  • osteoporosis
  • autoimmune disease.

Hashimoto’s autoimmune thyroid disease, in particular, is strongly linked to gluten. A family history of thyroid disease (or other gluten symptoms) is a good indicator that you could benefit from a trial of a gluten-free diet.

Next, speak to your doctor about the “celiac gene” or “celiac genotype” blood test, known as HLA-DQ2 and HLA-DQ8. If you test positive for a celiac gene, you have a 4 percent chance of developing celiac disease but a much higher risk of developing other autoimmune conditions such as autoimmune thyroid disease. Testing positive for a celiac gene is another good indicator that you could benefit from a trial of a gluten-free diet.

Finally, you could just try strictly avoiding gluten for at least eight weeks and see how you feel. Strictly avoiding means avoiding even trace gluten, which is different from just reducing wheat as you can do with FODMAPs. For conditions associated with gluten sensitivity (endometriosis, autoimmune thyroid disease, and migraines), there is no such thing as partially gluten-free.

Likely to require strictly gluten-freeUnlikely to require strictly gluten-free
endometriosis and adenomyosispolycystic ovary syndrome (PCOS)
autoimmune thyroid diseasehypothalamic amenorrhea (HA)
migrainespremenstrual mood symptoms

How wheat affects periods

In summary, periods can be affected by FODMAP sensitivity and/or gluten sensitivity (including non-celiac gluten sensitivity).

Some cases of amenorrhea (lack of periods) are caused by celiac disease or non-celiac gluten sensitivity which is why every woman with unexplained amenorrhea should be screened for celiac disease. In that case, strictly avoiding gluten is the main treatment. However, most cases of amenorrhea are caused by undereating and have nothing to do with gluten.  

Migraines can be worsened by gluten sensitivity because an inflammatory reaction to gluten can lead to antibodies against the enzyme glutamate decarboxylase (GAD), resulting in high glutamate and low GABA. Most (but not all) women with migraines can benefit from strictly avoiding gluten. Read Natural treatment of hormonal migraines.

Hashimoto’s autoimmune thyroid disease is strongly linked with gluten sensitivity. Untreated, thyroid disease can contribute to heavy periods. Almost without exception, testing positive for “thyroid antibodies” means you should strictly avoid gluten. 

Most types of PCOS do not require avoidance of either FODMAPs or gluten. The inflammatory type of PCOS can require temporary avoidance of FODMAPs and only sometimes the strict avoidance of gluten. 

Finally, endometriosis and adenomyosis are usually worsened or driven by gluten sensitivity. That’s because (according to reproductive immunologist Dr Jeffrey Braverman), most women with endometriosis have the celiac genotype (the genes associated with gluten sensitivity). So strictly gluten-free can be an important part of treatment for endometriosis. Read Immune treatment for endometriosis.

20 thoughts on “How Wheat or Gluten Affects Periods”

  1. Blood tests (coeliac serology) are used to screen for coeliac disease. Coeliac serology measures antibody levels in the blood which are typically elevated in people with untreated coeliac disease, due to the body’s reaction to gluten.

    Importantly, a diagnosis of coeliac disease SHOULD NOT be made on the basis of a blood test alone. A positive blood test needs to be followed by a small bowel biopsy to confirm the diagnosis.

    From https://www.coeliac.org.au/s/coeliac-disease/diagnosis

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  2. does Greave caused by gluten sensitivity? interestingly, I just noticed when eating cracker, even just one can cause a hot flush, wonder why?

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  3. Another great article, Lara! I’ve read both your books and am genuinely grateful.

    Could it be both, gluten and fodmap sensitivity? I’m 40 and my main diagnoses is endo although my personal main issue is bloating for the last few years. They both started about the same time. I am not celiac but the gene was found. I have tried eliminating gluten and dairy before in my life without any success but noticed lighter and nearly pain free periods in the last 2 months. Then i had a vacay in Italy where bread and dairy is a staple, and voila, painful period is back. Will go off again and see how i feel next month. Not figured out yet how to go low FODMAP though, seems like a lot of restrictions to my already fragile nervous system 🙁

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  4. Thanks for your ongoing research and sharing of your knowledge. Your blog has changed my life in a great way!!

    I’m 30 now, but had very heavy, painful & irregular periods since menarche at 11. After becoming a midwife, I realised my periods were not normal.

    For years, I tried acupuncture, natural remedies, the COCP & then finally had surgery, where endometriosis/adenomyosis was addressed, as well as a Mirena inserted.

    The heavy periods responded well to the Mirena, however the pain remained.

    Then, I found your blog.

    I stopped eating gluten and all dairy & had my first EVER PAIN-FREE PERIOD!

    While I was off gluten and dairy, I had no pain.

    I moved to another country for a year, where gluten was extremely hard to avoid (no food labelling requirements) & was very ill until I strictly avoided gluten and dairy again.

    After that, I was tested for the Coeliac genes, which I don’t have.

    Just wanted to share my story, because I know my body reacts to gluten, even though I don’t have the Coeliac genes.

    Hope others find relief through the sharing of knowledge too!

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  5. Thank you for the article! I went off gluten because I was worried I could have some sensitivity due to my mom having celiacs and I also have hypothyroidism.

    I was off it for about 8 years and had regular periods, but I wanted to try to incorporate it back bc of going mostly vegan. I couldn’t last more than two weeks because I didn’t feel right, plus I started my period more than two weeks before it was due which never has happened.

    Strange what can happen from gluten!

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  6. Is sugar bad for your period?
    Like chocolate,desserts and cakes?
    I have low blood pressure and am British 8 stone in weight, I am always tired too.
    I kind of need sugar for my low blood pressure don’t i?

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  7. Period migraines and taking too many painkillers.
    When I get period cramps i take soluble paracetamol caffeine codine tablets, between four and six for a few days but they don’t always help, i just can’t handle the pain………I end up getting headaches and one really bad migraine each time I have a period.
    I wonder if taking too many strong painkillers for days gives me headaches and a migraine.Is that possible?

    Could dairy and certain foods I am eating also be a problem?

    Does caffeine affect period migraines? I don’t have caffeine usually except in painkillers……….

    Would changes could I make please?

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  8. Hello Lara ,

    I have had normal period when I was in India , but after moving to US 7 years back , my period has never been the same. My doctor told me I have PCOS just on the basis of ultrasound. I am very confident that I don’t have insulin resistance because when I got that done during my pregnancy, it was on the lower side of the normal range. I don’t have hair loss problem at all. I have facial hair on my chin.

    Here in US they suggested taking birth control , which I took for one and half year but I don’t want to take it anymore. I decided not to take birth control back in 2017 after which I got pregnant and had my baby. I really don’t know what’s going on. I did not get my periods now for 3 months. Any suggestions from you will be helpful. Do you do online consultations ?

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  9. Hi Lara, thanks for the interesting article. Just so you know, according to the Monash University who develeloped the FODMAP diet, Spelt does in fact contain FODMAPs and should be consumed in careful portion sizes.

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  10. Fabulous article thank you! As ever so clear and simple to read 🙂 As a naturopath I refer clients all the time to your website and book for further education. Thank you

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  11. Thank you for spreading awareness on this issue. I had unexplained secondary infertility. Thankfully, I did have another baby but had many health problems after the pregnancy such as migraine and prolonged period pain. A whole five years later, I was diagnosed with endometriosis through surgery. Another 4 years later was diagnosed with celiac disease only after another family member was diagnosed. My point here is without doctors connecting the dots, it is very hard to find an answer to seemingly unrelated health issues. I am feeling amazing now, am off continuous birth control and currently managing the endo pain so much better. All from a strict gluten free diet! Hope this helps someone out there as I had absolutely no clue about celiac disease and its relation to many health problems.

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    • Thanks so much for sharing your story. It is important that more women know about the potential effect of gluten on infertility, migraines, and endometriosis.

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  12. Thank you for this article. Very interesting about wheat intolerance not being linked to digestive issues, rather the migraine, depression, brain fog, and osteoporosis etc. fodmaps being the bloating. Fits with my own experience too.

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  13. Not about gluten, but I’ve been listening to your book and have a question. Is a mild to moderate amount of darker coarser hair growing on your chin/neck just a variation of normal in your early 30’s as a woman? My cycle is normal, and I had blood tests done at various parts of my cycle to check my hormones and thyroid but everything came back normal. I just pluck away every day-12-20 of them maybe-not super obvious if you don’t look close-but it just bugs me. My naturopathic dr said it’s just “ideopathic hirsutism”. I also have androgenetic Alopecia-dr said it was also “ideopathic” but all the visuals are there, even if my labs come back normal. I’ve come to terms with the Alopecia. Just not sure if there’s anything I can do with the facial hair part. Thanks!

    Reply
  14. I have neurodermatitis (atopic eczema) but it only flares up once every 2-3 years. I don’t experience any of the other symptoms mentioned in the article. Could it be gluten or is that very unlikely?

    Reply
    • Eczema can relate to gluten but not usually.

      There are lots of other potential factors with eczema including genetics (of course), but also gut and skin microbiome, and possible sensitivities to salicylates, dairy, or eggs. But unless you also have other issues, a flare every few years may not be worth making big changes for.

      Reply

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