title: From menarche to menopause: the fertile life span of celiac women.
abstract: OBJECTIVE
  We evaluated menopause-associated disorders and fertile life span in women with celiac disease (CD) under untreated conditions and after long-term treatment with a gluten-free diet.
  
  
  METHODS
  The participants were 33 women with CD after menopause (untreated CD group), 25 celiac women consuming a gluten-free diet at least 10 years before menopause (treated CD group), and 45 healthy volunteers (control group). The Menopause Rating Scale questionnaire was used to gather information on menopause-associated disorders. The International Physical Activity Questionnaire was used to acquire information on physical activity.
  
  
  RESULTS
  Untreated celiac women had a shorter duration of fertile life span than did the control women because of an older age of menarche and a younger age of menopause (P < 0.01). The scores for hot flushes, muscle/joint problems, and irritability were higher in untreated celiac women than in the control women (higher by 49.4%, 121.4%, and 58.6%, respectively; P < 0.05). In comparison with untreated CD, long-lasting treatment of CD was not associated with a significant difference in the duration of fertile life span, but was only associated with a significant reduction in muscle/joint problems (a reduction of 47.1%; P < 0.05).
  
  
  CONCLUSIONS
  Late menarche and early menopause causes a shorter fertile period in untreated celiac women compared with control women. A gluten-free diet that started at least 10 years before menopause prolongs the fertile life span of celiac women. The perception of intensity of hot flushes and irritability is more severe in untreated celiac women than in controls. Low physical exercise and/or poorer quality of life frequently reported by untreated celiac women might be the cause of reduced discomfort tolerance, thus increasing the subjective perception of menopausal symptoms.
authors.affiliation: Department of Clinical and Experimental Medicine, University Federico II of Naples, Naples, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Santonicola
authors.forename: Paola
authors.initials: P
authors.lastname: Iovino
authors.forename: Carmelina
authors.initials: C
authors.lastname: Cappello
authors.forename: Pietro
authors.initials: P
authors.lastname: Capone
authors.forename: Paolo
authors.initials: P
authors.lastname: Andreozzi
authors.forename: Carolina
authors.initials: C
authors.lastname: Ciacci
mesh_terms: D000368:Aged; D002446:Celiac Disease / Q000178:diet therapy / Q000503:physiopathology*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D055050:Diet, Gluten-Free; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D005298:Fertility; D019584:Hot Flashes / Q000453:epidemiology; D006801:Humans; D008572:Menarche; D008593:Menopause; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires