Wondering about wheat and menstrual health? Wheat or gluten is not usually a problem for periods but can affect certain women’s health conditions such as endometriosis, adenomyosis, unexplained amenorrhea, migraines, and thyroid disease.
The first step in assessing possible wheat sensitivity is to know the difference between 1) FODMAPs and digestive bloating, and 2) gluten and immune dysfunction.
FODMAPs can cause digestive bloating
FODMAPs are a type of carbohydrate that can cause digestive bloating and lead to the diagnosis of irritable bowel syndrome (IBS). The term FODMAP is an acronym invented by researchers at Monash University in Australia. It stands for fermentable oligo-, di-, and monosaccharides and polyols which are short-chain carbohydrates that can be difficult to absorb from the small intestine. Foods with a high FODMAP content include wheat, legumes, certain vegetables, and fruit.
👉🏽Tip: Spelt is a cousin of wheat and a popular wheat substitute. Spelt contains gluten but not FODMAPs — so it is easier to digest than wheat.
Untreated, a 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.
The solution is usually to temporarily cut back on FODMAPs while at the same time address the underlying cause of a FODMAP-sensitivity, which can include stomach acid medication, underactive thyroid, and small intestinal bacterial overgrowth (SIBO).
With SIBO and a FODMAP-sensitivity, you usually don’t need to strictly avoid wheat or any food.
Gluten can cause immune dysfunction
Gluten is not a carbohydrate like FODMAPs and does not cause digestive bloating; if bloating is your main symptom, refer to the FODMAP section above.
Gluten is a protein that can cause immune dysfunction, but only if you’re sensitive to it.
👉🏽 Tip: Wheat, spelt, rye, barley, and possibly oats contain gluten. Rice, corn, millet, quinoa, or potatoes do not contain gluten.
The difference between Celiac disease and NCGS
Gluten-sensitivity can take the form of either celiac disease or non-celiac gluten sensitivity (NCGS). Of the two, celiac disease is more severe and can be quite easily diagnosed with a blood test. For a celiac test to be accurate, you need to have consumed some gluten within the past few weeks. That’s why it’s important to test for celiac disease before you eliminate gluten from your diet.
Non-celiac gluten sensitivity (NCGS) is more common than celiac disease and, unfortunately, cannot be diagnosed by a standard celiac blood test.
As stated, gluten-sensitivity does not usually cause digestive symptoms but instead can cause non-digestive symptoms such as:
- brain fog
- autoimmune disease.
How to know if you have gluten sensitivity
To know if gluten is a problem, first consider whether you or anyone in your family has any of the conditions listed above, especially Hashimoto’s autoimmune thyroid disease, which is strongly linked with gluten.
You can also speak to your doctor about a blood test for the “celiac gene” or “celiac genotype,” which are a couple of chromosomal mutations, known as HLA-DQ2 and HLA-DQ8. Testing positive for a celiac gene does not mean that you actually do have a problem with gluten-sensitivity or coeliac disease—only that you could have a problem. For example, testing positive for the gene means about a 4 percent chance that you will eventually go on to develop celiac disease but a higher risk of other autoimmune conditions such as autoimmune thyroid disease.
It can be worth knowing if you have the celiac gene not just so you know if gluten could be a problem but also to know if it definitely is not a problem. If you test negative for the coeliac gene, you probably don’t have to worry about gluten sensitivity.
Beyond symptoms and testing, the easiest way to know if you have gluten sensitivity is to try strictly avoiding it for at least eight weeks and see how you feel. “Strictly avoiding” means avoiding even trace gluten, which is quite different from just reducing wheat as you can do with FODMAPs. There’s no such thing as partially gluten-free.
In summary, if wheat causes digestive bloating, it’s likely to be a problem with FODMAPs. If wheat causes brain fog, psoriasis, autoimmunity, or migraines, it’s more likely to be a problem with gluten.
How wheat affects periods
Acne can be made worse by SIBO, low stomach acid, and FODMAP malabsorption. In most cases, however, acne is affected far more by sugar and cow’s dairy.
Amenorrhea (lack of periods) can be the result of celiac disease or gluten sensitivity which is why every woman with unexplained amenorrhea should be screened for celiac disease. Of course, there are several other reasons for amenorrhea, such as undereating, which have nothing to do with gluten.
The inflammatory type of PCOS can be the result of FODMAP-sensitivity, gluten, or dairy sensitivity.
Finally, endometriosis and adenomyosis can be improved by strictly avoiding gluten. According to reproductive immunologist Dr Jeffrey Braverman, most women with endometriosis have the celiac genotype. Read Immune treatment for endometriosis.