The Overlooked Connection Between Celiac Disease and Endometriosis: What Every Woman Should Know

At Cultivate, we specialize in supporting women through complex, often misunderstood conditions like endometriosis. But one topic that doesn't get nearly enough attention is the potential connection between celiac disease—an autoimmune response to gluten—and endometriosis, a chronic inflammatory condition that affects 1 in 10 women.

While these two conditions might seem unrelated at first glance, research and clinical experience suggest that they may share more in common than we once thought. Understanding this connection can offer powerful insight and relief for women living with persistent pelvic pain, digestive issues, or unexplained infertility.

Let’s dive in.

What Is Endometriosis?

Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside the uterus—on the ovaries, fallopian tubes, bladder, or intestines. These growths respond to hormonal changes and can cause severe pain, heavy periods, bloating, digestive symptoms, and even fertility struggles.

It's a condition we see often in our clinic. And while acupuncture and Traditional Chinese Medicine offer incredible tools to help manage the pain and inflammation associated with endo, healing also requires us to look at the whole body, including the gut.

What Is Celiac Disease?

Celiac disease is an autoimmune disorder where the ingestion of gluten (a protein found in wheat, barley, and rye) triggers the immune system to attack the small intestine. This can lead to malabsorption of nutrients, inflammation, and a wide range of systemic symptoms—from fatigue and brain fog to hormonal imbalances and infertility.

Importantly, celiac can present differently in women, often masquerading as gynecological issues or IBS-like symptoms. Sound familiar?

The Inflammation Link

At the root of both celiac disease and endometriosis is inflammation.

• In endometriosis, inflammation drives the growth of lesions and contributes to chronic pelvic pain.

• In celiac disease, gluten exposure causes an autoimmune reaction that inflames the gut lining and disrupts the immune system.

Studies have shown that women with endometriosis are significantly more likely to have celiac disease than the general population. One 2011 study published in Human Reproduction found that gluten sensitivity may be an overlooked contributing factor in chronic pelvic pain, especially when other treatments aren’t working.

If you're dealing with both digestive discomfort and endometriosis symptoms, it’s worth considering whether gluten could be playing a role.

Symptoms That Overlap

It’s not uncommon for our patients to describe:

• Bloating and abdominal pain

• Constipation or diarrhea

• Fatigue

• Painful periods

• Unexplained infertility

These are hallmark symptoms of both endometriosis and celiac disease—and they often coexist.

Could Gluten Be Making Endometriosis Worse?

Even in women without full-blown celiac disease, non-celiac gluten sensitivity (NCGS) can still trigger inflammation and immune responses that exacerbate endometriosis symptoms. For some, gluten acts as a pro-inflammatory food, contributing to a flare-up of pelvic pain, hormone imbalance, or fatigue.

We’ve seen firsthand in our clinic how removing gluten—even for a trial period—can lead to significant improvements in symptoms like:

• Pelvic pain and cramping

• Digestive discomfort

• Brain fog and fatigue

• Mood swings or anxiety

The Gut-Hormone Connection

Gut health and hormone balance are deeply intertwined. A damaged or inflamed gut (like in celiac disease) can lead to:

• Poor estrogen metabolism, making it harder for your body to eliminate excess estrogen

• Nutrient deficiencies, especially iron, zinc, B vitamins, and magnesium—all vital for reproductive health

• Leaky gut, which increases systemic inflammation and contributes to immune dysfunction

Supporting your gut can be a foundational part of healing from endometriosis—and identifying hidden triggers like gluten is part of that process.

What You Can Do: Cultivating a Healing Approach

If you're living with endometriosis and suspect a gluten sensitivity or autoimmune trigger, here are some supportive steps you can take:

1. Get Tested
   Ask your provider about testing for celiac disease. Even if it comes back negative, you may still benefit from a gluten-free diet if you're sensitive.

2. Try a Gluten-Free Trial
   Consider removing gluten from your diet for 4–6 weeks and tracking your symptoms. Many women notice reduced bloating, fewer flares, and clearer cycles.

3. Focus on Gut Repair
   Healing the gut lining through nourishing foods, herbal medicine, and acupuncture can help reduce systemic inflammation.

4. Use Acupuncture to Reduce Inflammation and Pain
   Acupuncture can regulate the immune system, calm inflammation, and support hormone balance. It’s a powerful tool for managing both endometriosis and autoimmune conditions like celiac disease.

5. Tune Into Your Body
   Your body is wise. If certain foods consistently make you feel worse—trust that. Listening to your symptoms is the first step to healing.

You Are Not Alone

At Cultivate, we honor the complexity of endometriosis—and the whole woman experiencing it. You deserve more than just symptom suppression. You deserve answers, relief, and a clear path forward.

If you’re curious whether gluten could be affecting your symptoms, or you're ready to take a more holistic approach to managing endo, we’re here to support you.

Ready to explore acupuncture for endometriosis or digestive health?
Book your initial consultation and begin your healing journey.

1. et al. (2011) – Risk of endometriosis in 11,000 women with celiac disease
   This Swedish nationwide cohort found that women with celiac disease had a significantly higher risk (HR=1.39) of being diagnosed with endometriosis compared to matched controls Verywell Health+15Oxford Academic+15ResearchGate+15.

2. Marziali et al. (2012) – Gluten-free diet as a management strategy for painful endometriosis-related symptoms
   In a one-year observational trial, ~75% of participants reported significant reductions in pelvic pain, menstrual discomfort, and improved mental wellbeing on a gluten-free diet Jmig+5thedietologist.com.au+5iCareBetter+5.

3. JAMA Network Open (2025 International Survey) – Dietary impact on endometriosis pain
   A large global survey of 2,599 women showed that ~45% who removed gluten (and dairy) from their diet reported a notable drop in pain levels ScienceDirect+9The Guardian+9EatingWell+9.

4. Frontiers in Nutrition (2023 review) – Dietary associations in endometriosis with reference to gluten
   A narrative review found symptom overlap between endometriosis and gluten-related disorders. It noted symptom relief from gluten avoidance—but highlighted weak study designs and possible placebo/nocebo effects Healthline.

5. Healthline (2024) – Understanding the link between celiac disease and endometriosis
   This medical overview confirms higher co-occurrence of the two conditions and theorizes shared genetic, inflammatory, and hormonal pathways Jmig+15Healthline+15iCareBetter+15.