Endometriosis and Pregnancy
Endometriosis is a condition where cells similar to those making up the lining of the uterus are found in other parts of the body, commonly the ovaries or fallopian tubes, but it could also occur in other areas.
Despite these cells growing in other areas of the body, they still react in the same way as they would in the uterus. Hormones are naturally released in a woman's body, causing the uterine cells to build up each month and form a thick uterine lining for potential pregnancy and then breaking down and bleeding if a pregnancy does not occur. However, whereas the cells in the womb will leave the body as a period, for the cells in other areas of the body, the blood has no way of leaving and will remain in the body.
This build up of blood can lead to inflammation, pain and the formation of scar tissue. It can also lead to very painful or heavy periods and can be debilitating for some.
Unfortunately, it is extremely common and effects around 1.5 million women in the UK alone. The exact cause is unknown and any women of childbearing age could be affected. There are a number of theories as to why it occurs, and it is assumed that a range of factors normally play a part, including a genetic predisposition and environmental factors.
Endometriosis can lead to:
Chronic pain; during periods, during ovulation or after sex
The pain can include lower abdomen pain, pelvic pain, back pain, leg pain
Heavy and/or prolonged bleeding, bleeding or spotting between periods
Bowel and bladder problems, including bleeding bowel or pain when passing urine
Fatigue/lack of energy
Endometriosis can lead to difficulty in getting pregnant but thanks to surgical treatments and fertility treatments such as IVF, it has become more common for those with the condition to conceive successfully. This is great news and it was previously thought that once a woman with endometriosis became pregnant then their pregnancy would be unaffected by the condition.
However, recent studies have shown a significant link between endometriosis and miscarriage. There were two large studies carried out in 2016 and 2017 which reported up to an 80% increased risk in miscarriage for people with endometriosis. There were no similarities in the way the miscarriages occurred so the link is not yet understood, and of course, miscarriage is common with varying known and unknown causes for all women, but with such significant statistics it is an area that requires further research to better support women and their pregnancies.
There is also growing evidence that endometriosis could lead to an increase in the chances of a woman experiencing difficulties such as: placenta previa, premature rupture of membranes, pre-term birth and the likelihood of requiring a C-section. Again, further research is required in this area, but studies have highlighted the need for early screening and close monitoring throughout pregnancy for women with endometriosis.
It is important to remember that you still have a high chance that your pregnancy will be healthy even if you do suffer from endometriosis, but it is also important to be aware of these potential risks and ensure that your healthcare providers are aware so that they can provide you with the appropriate care and support.
In general, the pain and symptoms of endometriosis improve during pregnancy because there is no monthly cycle. Unfortunately, once the women's periods return then it is likely that the symptoms will also return.