Can celiac disease cause infertility?

  Celiac disease is not a positive celiac disease
  Celiac disease is a frequent and common disease in women. The literature reports that its prevalence is as high as 40% to 60% in married and fertile women. The female cervix is divided into an inner and an outer opening. The epithelium of the inner orifice is a slender, mucus-secreting red columnar cell, while the outer orifice is covered by a grayish-yellow squamous epithelium. Under the influence of certain factors, the squamous epithelium of the external opening of the cervix becomes covered by the columnar epithelium and cervical erosion is formed. When the erosion surface is observed under colposcopy, it is actually intact columnar epithelium, which is observed as red erosion-like to the naked eye because the columnar epithelium is a single layer with a red interstitium underneath.
  This shows that cervical erosion is not true erosion, but only feels intuitively like erosion compared to a normal smooth cervix. This change is related to the displacement of the junction between the squamous and columnar epithelium of the cervix. Colposcopic observation of cervical “erosion” is a squamous-columnar junction transformation zone. Many women are so afraid of this disease, in large part because they are frightened by the word “celiac”.
  Celiac disease is mostly asymptomatic
  Many women are accidentally found to have celiac disease during a normal physical exam when they had no previous symptoms. Why is this? This is because cervical erosion itself is not an inflammatory condition, i.e. it is not an epithelial loss and inflammatory reaction in the pathological sense, but an ectopic cervical columnar epithelium, which is one of the physiological changes of the cervix and not a pathological change. When there is no pathogenic microbial infection, that is, when there is no combined inflammation, patients with cervical erosion may have no clinical symptoms or may only show increased discharge. Some patients may present with bloody leucorrhea or bleeding after sexual intercourse.
  Of course, there are some patients with more severe symptoms, and in addition to abnormal leucorrhea, they may also have symptoms such as backache, vulvar and vaginal itching. However, this is not due to celiac disease itself, but mostly due to a combined inflammatory infection.
  Sexual life is not a direct cause of celiac disease
  Some people believe that celiac disease is caused by sex, so once they are diagnosed with celiac disease, they are quite reluctant to have sex. In fact, this view is wrong. At present, the real etiology of celiac disease is still unclear. It is generally believed that mechanical stimulation or injury after marriage, such as childbirth, abortion or too frequent sexual intercourse, can cause varying degrees of destruction of the squamous epithelium of the cervix, which reduces the local resistance of the cervix and predisposes to cervical inflammation. However, it is clinically found that women who do not have sex still have cervical erosion, sometimes even severe erosion. This shows that sexual life is not the culprit of cervical erosion. At the same time, experts remind unmarried, or non-sexual women, if they have persistent leucorrhea, or with changes in color and texture, they should also visit a gynecological clinic in time to identify the cause and treat it in time.
  Celiac disease does not necessarily lead to infertility
  In the past, it was believed that cervical erosion was often accompanied by inflammation, and inflammatory cells can engulf sperm, as well as cause changes in the nature of cervical mucus, thus preventing sperm from penetrating the cervical mucus to reach the uterine cavity. As the sperm cannot reach the uterine cavity, they naturally cannot meet the egg and conception cannot take place. However, it is now found that more young women have cervical erosion that is only an alteration of the cervical epithelial cell type and is not accompanied by an inflammatory infection and therefore does not lead to infertility.
  For women who are ready to get pregnant, if celiac disease is not accompanied by any symptoms, fertility specialists recommend that they should actively try to get pregnant without rushing to do much treatment for celiac disease. If it is accompanied by excessive leucorrhea or yellowish leucorrhea that has caused discomfort, it can be treated with appropriate medication and pregnancy can be attempted after the symptoms have improved.
  Celiac disease is not related to cancer
  Many women with cervical erosion are worried about cervical cancer, believing that the heavier and longer the cervical erosion, the more likely cervical cancer will occur. Theoretically, cervical erosion is a physiological change caused by the replacement of the squamous epithelium of the cervix by the columnar epithelium, rather than true erosion. Cervical cancer, on the other hand, is an abnormal change in the squamous epithelium of the cervix, mainly due to human papillomavirus (HPV) infection. The causes and pathogenesis of the two are different, as are the pathological changes. Therefore, simple cervical erosion, if not combined with HPV infection, does not lead to the development of cervical cancer.
  However, women with cervical erosion should be reminded that during gynecological examination, cervical exfoliation cytology should be performed to initially exclude the possibility of cervical cancer. It is difficult to distinguish early cervical cancer from cervical erosion by gynecological examination alone. If possible, HPV testing should be performed along with cervical exfoliation cytology to exclude the possibility of cervical cancer and precancerous lesions.
  Is vaginal douching helpful in treating celiac disease?
  The surface of the female vaginal mucosa is squamous epithelium, which is affected by female sex hormones and undergoes a cycle of shedding, which has a protective effect. At the same time, the squamous epithelium secretes glycogen, which is broken down into lactic acid by Lactobacillus parasiticus in the vagina, thus maintaining an acidic environment in the vagina and inhibiting the growth and reproduction of bacteria. Under normal circumstances, women are not advised to do excessive vaginal douching, which is not beneficial in maintaining the acidic environment of the vagina, but can lead to dysbiosis, which can lead to vaginal inflammation.
  Celiac disease is not caused by bacterial infection. If you apply antiseptic, antiseptic, anti-itch and anti-inflammatory lotions to douche the vagina, it may destroy the protective barrier of the vagina itself, which is not beneficial to celiac disease and may cause secondary vaginal infections. Therefore, if celiac disease is not accompanied by vaginal inflammation, the application of local vaginal douches is not advocated.
  Can celiac disease be cured?
  Currently, the most widely used treatment for celiac disease in China is physiotherapy. It is often believed that physiotherapy can cure celiac disease at once. In fact, in the absence of a clear cause, it is impossible to completely cure cervical erosion, regardless of the conservative treatment. Clinically, it is often encountered that after physiotherapy treatment of cervical erosion, the erosion area becomes smooth (columnar epithelium is replaced by squamous epithelium), but after a period of time, cervical erosion reappears.
  The reason for this is that the principle of microwave, ironing, laser or freezing methods is to destroy the columnar epithelium on the erosion surface, causing it to necrotize, crust off and new squamous epithelium to grow in to “cure” it. If the real cause of the disease is not removed, celiac disease may occur again.
  Should celiac disease be treated or not?
  In recent years, there have been some new ideas in the academic community about the management of cervical erosion. When there is no pathogenic microbial infection, cervical erosion may have no clinical symptoms or may manifest only as increased discharge and does not require treatment.
  (1) <30 years old, for simple, superficial erosion is mostly physiological changes, no special treatment is necessary.
  (2) >30 years old, or granular erosions, asymmetric erosions, with contact bleeding and different cervical hardness, should be screened for cervical lesions in three steps, except cervical lesions.
  (3) Granular or papillary erosions that are combined with inflammatory symptoms such as increased leucorrhea and vulvovaginal pruritus should be treated. Physiotherapy is often advocated in cases where cervical cancer is excluded.
  (4) There are many physiotherapy methods, but the treatment principles are the same and the efficacy is similar. The key is to master the correct indications, standardize the operation and pay attention to the peri-treatment period.
  Does physiotherapy have any effect on future pregnancy and delivery?
  Physical treatments such as laser may cause slight damage to the cervix and may affect the dilatability of the cervix during future delivery. It is best to go to the hospital for a check-up before you plan to get pregnant. If cervical erosion does not affect pregnancy or is not combined with acute infection you can get pregnant first and wait for the laser treatment after delivery. However, if your condition requires it, you should still follow your doctor’s advice and actively cooperate with the treatment.
  In principle, physiotherapy only destroys a layer of cells on the surface of the cervix, and through damage repair, the columnar epithelial cells are transformed into squamous epithelial cells, thus treating cervical erosion, and therefore physiotherapy will not lead to narrowing of the cervical opening, let alone infertility.

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