One of the biggest struggles we have in gynecology and obstetrics is understanding how fertility and diet interact. If you are having digestive issues and trying for pregnancy, it may be time to come and evaluate.
Sometimes women worry about issues they may have seen in social media, like someone who got a flu shot and miscarried. Flu shots are not associated with miscarriage according to a new study in Obstetrics and Gynecology in the September 2023 issue.
Often women will have minor digestive symptoms that may be the clue to more significant issues. Diagnosing the cause of bloating and diet adjustment is often part of the diagnosis as well as the cure. This is true if you are on a contraceptive and trying to find the right birth control pill if yo are trying for a baby, and infertility patient or a woman with gynecologic issues. If bloating and gas occur just when on your menstrual period, then the treatment is identical to the treatment of menstrual cramps, as the bloating may be due to the prostaglandin release that causes cramps. Menstrual cramp bloating is hormonal have nothing to do with the diet.
The same for women who have their bloating during ovulation, or as a consequence of other pelvic conditions such as endometriosis. However, if the symptoms worsen with certain foods, do not follow any hormonal pattern, or are cured by avoidance of the offending foods; then the condition is unlikely to be gynecologic, and you should consider both food allergy testing and modulating your diet and even considering a gluten free diet to see if this is the cause of the symptoms.
Women with celiac disease have an incurable, but controllable digestive condition which can cause, among other issues, some bloating. Newest data shows that gluten insensitive women are 3.5 times more likely to be infertile. Women with untreated celiac and severe forms of gluten intolerance show later age of first period and menarche, earlier menopauses, more problems with menstrual cycle including cases of amenorrhea and skipped menstrual periods, recurrent miscarriage, spontaneous abortion, preterm delivery, and low birth weight. In males untreated celiac disease can reduce sperm counts and reduced sperm motility through an unknown mechanism.
Many women who fall short of the disease formal diagnosis however are unable to easily digest gluten. The nutritional havoc introduced by the digestion problems could lead to some of the same fertility and pregnancy issues that women with celiac have.. This is not an uncommon disorder, and 1/200 women may in fact be affected. For women who cannot digest gluten they both feel better and have less bloating if they do avoid gluten in their diet. Most gluten that is in one’s diet is encountered in wheat, but other grains like rye and barley have gluten too.
The actual disease Celiac disease is due to an autoimmune reaction to gluten proteins, including gliadin in wheat, secalin in rye and hordien in barley. Those with the most intense form of the condition will also have a problem with oats.
To avoid gluten look for the GF certified gluten-free label. If it doesn’t have such a label, then you cannot be sure there aren’t sources of gluten in the food. In fact, there are foods, that are almost gluten free, but do have a few parts per million that might affect someone extremely sensitive. Women can be fooled into complacency as the disease can be in remission over periods of time. If you feel that you may be affected by the condition, speak to your gyno about when and if you should have testing or adjust your diet, and perhaps those baby plans will come true after all!
