Increased Autoimmune and Celiac Disease Risk in Women with Primary Ovarian Insufficiency

Celiac.com 04/08/2025 - Primary ovarian insufficiency is a condition where the ovaries stop functioning properly before the age of 40, often leading to infertility and hormone imbalances. Autoimmune diseases, where the body's immune system mistakenly attacks its own tissues, have been found to be common in women with this condition. Researchers aimed to investigate whether women with primary ovarian insufficiency and their family members had a higher likelihood of developing autoimmune diseases, including celiac disease.

Study Approach and Data Collection

This study analyzed electronic health records from two major healthcare systems in Utah, covering data from 1995 to 2022. Researchers identified 610 women diagnosed with primary ovarian insufficiency and reviewed their medical charts for accuracy. Using genealogy databases, they also identified first-, second-, and third-degree relatives of these women. The presence of autoimmune diseases was determined by reviewing medical records, and the risk levels were compared to the general population.

Key Findings: High Prevalence of Autoimmune Diseases in Women with Primary Ovarian Insufficiency

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The study revealed that 25% of women with primary ovarian insufficiency had at least one autoimmune disease. Several autoimmune conditions were significantly more common in these women compared to the general population:

• Celiac disease – 7.5 times more likely
• Autoimmune hypothyroidism – 6.9 times more likely
• Adrenal insufficiency – 4.7 times more likely
• Type 1 diabetes – 4.1 times more likely
• Rheumatoid arthritis – 5.7 times more likely
• Psoriasis – 3.9 times more likely
• Systemic lupus erythematosus – 4.4 times more likely
• Vitiligo – 15.3 times more likely

Despite the strong connection between primary ovarian insufficiency and autoimmune diseases, the study did not find an increased risk of these conditions among the family members of affected women. This suggests that factors beyond genetics, such as hormonal or environmental triggers, may contribute to the development of autoimmune diseases in women with primary ovarian insufficiency.

Endocrine Autoimmune Diseases and Their Impact

Many of the autoimmune diseases observed in women with primary ovarian insufficiency are linked to endocrine system dysfunction.

Thyroid disease, particularly hypothyroidism, was the most common autoimmune condition in these women, affecting nearly 20% of them. This aligns with previous research linking ovarian and thyroid function.

Adrenal insufficiency, another hormonal disorder, was also significantly increased. This condition, which affects the body's ability to produce essential hormones, often occurs alongside other autoimmune conditions.

Type 1 diabetes, which results from an immune attack on insulin-producing cells, was also more common in women with primary ovarian insufficiency. Researchers noted that many of these women also had thyroid disorders, a combination that has been linked to autoimmune syndromes affecting multiple glands.

Non-Endocrine Autoimmune Diseases: The Connection to Celiac Disease

Beyond hormonal disorders, women with primary ovarian insufficiency were also at increased risk for several non-endocrine autoimmune diseases, including rheumatoid arthritis, lupus, vitiligo, psoriasis, and celiac disease.

The link between celiac disease and primary ovarian insufficiency is particularly notable. Celiac disease is an autoimmune disorder in which the ingestion of gluten triggers damage to the small intestine. The study found that women with primary ovarian insufficiency were 7.5 times more likely to have celiac disease than the general population. This connection suggests that women with ovarian insufficiency should be screened for celiac disease, especially if they experience symptoms such as digestive issues, nutrient deficiencies, or unexplained infertility.

Why Family Members Were Not at Increased Risk

While women with primary ovarian insufficiency were more likely to have autoimmune diseases, their relatives did not share this increased risk. This finding indicates that genetics alone may not be the primary driver of autoimmune disease in these women. Instead, environmental exposures, hormonal changes, or immune system dysregulation could play a key role. Researchers also suggested that differences in sex hormone levels, particularly estrogen and androgen, might influence autoimmune disease development, as these hormones are known to impact immune function.

What This Means for People with Celiac Disease

For individuals with celiac disease, this study highlights an important association between autoimmune conditions and reproductive health. Women diagnosed with celiac disease, especially those experiencing irregular periods or early menopause, should discuss ovarian function with their doctors. Similarly, women diagnosed with primary ovarian insufficiency should consider screening for celiac disease and other autoimmune conditions.

The study also underscores the importance of early diagnosis and intervention. Since autoimmune diseases often cluster together, recognizing and managing one condition can help prevent complications from others. Women with primary ovarian insufficiency may benefit from regular screenings for autoimmune diseases, including celiac disease, thyroid disorders, and adrenal insufficiency.

Conclusion: A Call for Greater Awareness and Screening

This research reinforces the strong connection between primary ovarian insufficiency and autoimmune diseases, including celiac disease. While the exact mechanisms remain unclear, the findings suggest that women with ovarian insufficiency should be monitored for autoimmune conditions. Increased awareness and proactive screening can help manage these diseases earlier, improving overall health and quality of life for affected individuals.

For those with celiac disease, this study is a reminder of the wider impact autoimmune diseases can have on the body, particularly on reproductive health. Understanding these connections can lead to better medical care, earlier diagnoses, and more effective management strategies for those living with celiac disease and other autoimmune conditions.

Read more at: academic.oup.com