Can Celiac Disease Delay Your First Period?

There are lots of possible reasons a girl's first period might be delayed. In some, it appears that celiac disease might be one of them, although not all studies have confirmed such a link.

A delayed start of menstruation doesn't absolutely indicate celiac disease, but it could be worth considering as a possibility—especially if a girl has other symptoms of celiac or there's a family history of the condition.

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How Can Celiac Delay Your First Period?

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

"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 most girls).

In the United States, most girls get their first periods by the time they're 13 years—in fact, the average age is closer to 12.25 years.

But girls with undiagnosed celiac disease seem to get a late start, at least in some research reports.

A review of studies published in the journal Gastroenterology and Hepatology From Bed to Bench in 2016 reported that the average age of menarche in girls with celiac disease was around 13.5 years—more than a year compared to girls without.

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 2018 study involving Eastern European women with celiac reported that the average age of first periods of those celiac women was similar to the age for non-celiacs.

How to Know If the Problem Is Celiac

There are several steps you can take if you think undiagnosed 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.

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).

If you're concerned that your late first period might be due to celiac disease, your best bet is to schedule a full physical.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Biro FM, Pajak A, Wolff MS, et al. Age of menarche in a longitudinal US cohort. J Pediatr Adolesc Gynecol. 2018;31(4):339-345. doi: 10.1016/j.jpag.2018.05.002

  3. Biro FM, Pajak A, Wolff MS, et al. Age of menarche in a longitudinal US cohort. J Pediatr Adolesc Gynecol. 2018 Aug;31(4):339-45. doi:10.1016/j.jpag.2018.05.002

  4. Therrien A, Kelly CP, Silvester JA. Celiac disease: extraintestinal manifestations and associated conditions. J Clin Gastroenterol. 2020 Jan;54(1):8-21. doi:10.1097/MCG.0000000000001267

  5. Mičetić-Turk D, Vlaisavljević V, Turk E, Pogačar MS. Onset of menarche is not delayed in Slovenian patients with celiac disease. J Int Med Res. 2019 Feb;47(2):815-22. doi:10.1177/0300060518812623

  6. Walker MD, Zylberberg HM, Green PHR, Katz MS. Endocrine complications of celiac disease: a case report and review of the literature. Endocrine Res. 2019;44(1-2);27-45 doi:10.1080/07435800.2018.1509868 

By Jane Anderson
Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet.