Celiac disease and endometriosis are separate medical conditions that can cause chronic pelvic pain. They have a high rate of co-occurrence or comorbidity, meaning you can experience both at the same time.

Celiac disease is an autoimmune condition in which gluten, a protein in certain grains like wheat, causes an immune reaction that damages your small intestine’s lining. As damage builds up, celiac disease affects digestion and how well your body absorbs nutrients.

Endometriosis is a reproductive disorder that occurs when bundles of tissue similar to your uterine lining (your endometrium) grow outside your uterus. Endometriosis often affects different organs and structures in your pelvis.

Celiac disease and endometriosis are inflammatory conditions. They’re both potential causes of chronic pelvic pain (CPP), and they can occur simultaneously.

Research hasn’t shown a direct cause-and-effect relationship between endometriosis and celiac disease. The exact relationship between the two conditions isn’t clear, but receiving a diagnosis of celiac disease may increase your chances of receiving a diagnosis of endometriosis.

A 2023 study found that people with celiac disease were 6 times more likely than others to receive a diagnosis of a reproductive disorder, regardless of race, age, or body mass. For endometriosis, specifically, the risk doubled for people living with celiac disease.

Experts theorize celiac disease and endometriosis may frequently occur together for several reasons.

Certain reproductive changes, like infertility and amenorrhea (missed periods), are extraintestinal symptoms of celiac disease. Extraintestinal symptoms are those that affect body systems outside your digestive tract. Celiac disease can change reproductive function by affecting the absorption of certain nutrients essential to hormone regulation.

This change in function can contribute to experiences like delayed onset of menstruation and early menopause, for example, and some experts believe the hormone disruption may contribute to processes in endometriosis.

Reproductive conditions like endometriosis may also share overlapping genetic risk factors with celiac disease and an inflammatory connection, where chronic inflammation from one condition naturally increases the risk of the other.

Get involved

If you have celiac disease, endometriosis, or both and want to help scientists better understand how these conditions interact — you can participate in a clinical trial or study.

You can learn more about ongoing studies at ClinicalTrials.gov, but talk with your primary healthcare professional first.

As inflammatory conditions in your pelvis, endometriosis and celiac disease can share many overlapping symptoms, such as:

Does celiac disease affect fertility?

Celiac disease can affect fertility for some people.

Hormonal imbalances can disrupt your natural reproductive cycle, and autoantibodies from celiac disease can interfereTrusted Source with blood vessel formation in your uterine lining, making it difficult for eggs to implant or survive in your endometrium.

Endometriosis and celiac disease are separate conditions with their own management strategies. Treating them together requires a multidisciplinary approach with individual and overlapping therapies.

Celiac disease is primarily manageable through gluten avoidance. There’s no conclusive evidenceTrusted Source that a gluten-free diet can significantly improve endometriosis symptoms, but reducing body-wide inflammation from celiac disease through diet may indirectly help improve symptoms of endometriosis.

Your doctor may also recommend pain management for both conditions, like taking nonsteroidal anti-inflammatory drugs, though not all pain relievers are suitable for conditions affecting your digestive tract.

For those with celiac disease, even medications need to be gluten-free.

Lifestyle changes are also a shared feature of treating celiac disease and endometriosis. For example, stress management and regular exercise can help reduce inflammation in your body, which compounds symptoms. Prioritizing healthy habits like getting quality sleep, staying hydrated, and stopping smoking also helps your body function and feel good when living with a chronic condition.

In addition to shared management strategies, your doctor can create a comprehensive treatment plan for endometriosis. Endometriosis occurs across a spectrum of symptom presentation and severity. Depending on your symptoms, your doctor may recommend surgical procedures, hormone therapy, or both.

Celiac disease and endometriosis are separate medical conditions that have a high rate of comorbidity. While more research is necessary to understand their relationship, hormone imbalances and systemic inflammation may help explain the link.

If you’ve received diagnoses of endometriosis and celiac disease, you may experience overlapping symptoms like CPP, bloating, and bowel discomfort. Your doctor can recommend a gluten-free diet and endometriosis-specific therapies to treat these conditions when they occur simultaneously.