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Endometriosis during pregnancy: Risks and effects

Becoming pregnant may be more difficult for women with endometriosis. However, many women with endometriosis do get pregnant and have healthy babies.

This article discusses the effect of pregnancy on endometriosis symptoms. It also considers whether or not having endometriosis during pregnancy increases the risk of complications.

How does pregnancy affect endometriosis symptoms?

Pregnancy has different effects on each woman with endometriosis. Some women may find that becoming pregnant relieves their endometriosis symptoms, as they will no longer be having periods.

Raised levels of the hormone progesterone during pregnancy may also improve symptoms.

Research has found that progestin, which is a synthetic version of progesterone, reduces endometriosis pain for around 90 percent of women. Progestin is a standard treatment for endometriosis.

The body’s natural progesterone may have similar effects to progestin for some women, but not everyone with endometriosis finds that their symptoms improve during pregnancy.

In fact, pregnancy can worsen some women’s endometriosis symptoms. This may be due to the growing uterus putting extra pressure or traction on existing areas of endometriosis.

Another factor that may worsen endometriosis symptoms during pregnancy is a rise in the hormone estrogen, which can encourage more endometriosis lesions to develop.

Even if pregnancy does provide relief, the symptoms of endometriosis are likely to return once a woman’s periods start again after pregnancy, although breast-feeding can delay this further.

A 2018 review states that women should not think of pregnancy as a strategy for managing or treating endometriosis. Pregnancy will not cure endometriosis.

Many people use hormonal therapies to manage endometriosis. These include progestin-only pills, combined pills containing estrogen and progestin, and intrauterine devices (IUDs). These options are not safe to use during pregnancy.

Some people also manage the condition by having keyhole surgeries, or laparoscopies, to remove endometriosis lesions. Surgery is also not possible during pregnancy.

Pregnant women with endometriosis may safely manage their symptoms by:

  • taking over-the-counter (OTC) pain relievers with the approval of a doctor or midwife
  • doing gentle exercise, yoga, or stretching to ease back pain
  • using heating pads or warm baths to ease cramps but not placing them directly on the uterus
  • eating foods rich in fiber to reduce bowel symptoms

What is endometriosis?

Experts estimate that endometriosis affects as many as 10 percent of women of childbearing age.

When a person has endometriosis, cells similar to those that line the uterus grow elsewhere in the body, including:

  • on the outside of the uterus wall
  • on the fallopian tubes
  • behind or on the ovaries
  • on the bladder
  • on the bowel and rectum

Endometriosis can also affect other parts of the body.

Endometriosis lesions respond to the menstrual cycle, meaning that this tissue also thickens and breaks down or bleeds each month. However, it cannot flow out of the vagina, so the blood remains trapped in the body and causes pain, inflammation, and other symptoms.

Endometriosis may also cause pelvic adhesions, where tissues in the pelvis stick together.

When to see a doctor

Many women with endometriosis have a safe pregnancy and birth with help from their doctor.

Although some women experience a reduction in their symptoms during pregnancy and while breast-feeding, others find that their symptoms remain the same or get worse.

It is essential to speak with a doctor about how to manage endometriosis symptoms during pregnancy, as many traditional treatment options are unsafe at this time.

Endometriosis rarely increases the risk of complications during pregnancy and childbirth, but a doctor can provide advice on the best way to manage the condition. Any women who have symptoms of a complication should speak to their doctor.

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