Endometriosis, Fertility, And Pregnancy: Information, Resources & More
Did you know endometriosis is the second most common gynecological condition in the UK, with around 1.5 million people currently diagnosed?
Endometriosis affects 1 in 10 women, and yet research shows it takes an average of 7 years from the onset of symptoms for women to receive the correct diagnosis. It's still surprising that it can take so long for women to reach an endometriosis diagnosis and get the support they need, but that's largely because symptoms, experiences, and severity can vary so widely from person to person. But that's why we need to talk about it more.
March is Endometriosis Awareness Month and this year Endometriosis UK are calling it Endometriosis Action Month where the mission is not only to raise awareness but also launch key actions and campaigns to secure better diagnosis and care.
To start the conversation, we’re sharing what endometriosis is and how it impacts fertility and pregnancy.
Let's start with the basics: what is endometriosis?
It's a condition that causes tissue commonly present in the lining of the womb to grow in other places - such as the ovaries or fallopian tubes. Each month, these cells react in the same way as those in the womb; building up and breaking down and bleeding, but the blood has no place to go. This commonly causes inflammation and pain in your pelvic region, lower back, or stomach that intensifies during your periods.
Speaking of periods... women with endometriosis often have heavy and irregular flows. Now, we all experience some form of PMS but the pain associated with endometriosis is often strong enough to stop you from completing your normal daily activities, and can worsen when having sex, urinating, and during bowel movements.
What does endometriosis mean for fertility?
Unfortunately, this answer is not always clear-cut. Endometriosis doesn’t necessarily cause infertility but it is associated with fertility problems. As with many gynecological and endocrine (hormonal) conditions that can impact your chances of conceiving, the way that endometriosis impacts fertility can vary greatly from person to person. And, like so many conditions related to women's health, it's... complex.
It’s currently estimated that 60-70% of women with endometriosis can get pregnant spontaneously. Generally, endometriosis is associated with a slightly longer time to conception, and this usually increases with the severity of the endometriosis. This is because increased severity is associated with greater amounts of scar tissue, and that's what causes pain. And the more scar tissue you have, the higher the chance of your egg being trapped in your ovaries or unable to move down the fallopian tube and into your uterus.
However, that doesn't mean you will struggle to conceive with an endometriosis diagnosis. Only around 50% of women with endometriosis report difficulty conceiving, and even women with the most severe form of the condition can still get pregnant and give birth to happy, healthy babies! Research has shown that most women with mild endometriosis have similar fertility rates to women without the condition.
Are there any treatments for endometriosis and if so, what are they?
Although there is not yet a cure for endometriosis, treatments are often prescribed to slow its progression, relieve pain, improve fertility, and prevent the condition from returning.
Hormonal treatments such as the Combined Oral Contraceptive Pill are often used to ease pain and control symptoms, however, if you're actively trying to conceive, contraceptives won't be your best bet.
There are surgical interventions available to alleviate symptoms and possibly improve your chances of getting pregnant - and it typically involves the removal of cysts, adhesions, and nodules formed by the misplaced tissue growth associated with endometriosis.
As with all things related to your health, it's best to consult your healthcare professional on the best route to care when you're TTC and trying to manage endometriosis.
What will happen if I have endometriosis and I become pregnant?
Again, it's... hard to predict. Unfortunately, research around endometriosis and pregnancy is fairly limited.
For some women, pregnancy temporarily alleviates the symptoms of endometriosis as it puts a stop to those painful periods and heavy menstrual bleeding. Other women don't notice an improvement of symptoms, and sometimes symptoms worsen as the uterus expands to accommodate the growing baby, stretching misplaced scar tissue.
Will endometriosis impact my chances of carrying a pregnancy to term?
It's important to know that most endometriosis pregnancies progress almost identically to those of women who do not suffer from the disorder.
There is debate around whether complications in the later stage of pregnancy complications are increased due to endometriosis or not. But again, there’s not enough research to substantiate any evidence.
As you might know, miscarriage occurs in around 1 in 5 pregnancies, regardless of whether a woman has endometriosis or not. If you have endometriosis, research shows that the likelihood of miscarrying increases to 1in 4. However, it’s important to understand that studies around endometriosis and miscarriage are often inconclusive and results vary greatly - so more research is definitely needed.
Are there any other risk factors of having endometriosis and falling pregnant?
Findings suggest that women with endometriosis are 33% more likely to give birth prematurely, which is typically associated with lower birth weights for baby and a greater incidence of developmental issues.
There is also an increased risk of a condition called placenta previa where the placenta attaches to the bottom of the uterus at the opening of the cervix instead of at the top or side of the uterus. Your doctor or midwife will be monitoring for this throughout your pregnancy and will help you manage it accordingly, ensuring a safe and healthy experience for you and baby.
What will happen after I give birth if I have endometriosis?
Whether or not pain is alleviated or aggravated over the course of your pregnancy, shortly after you’ve given birth to your baby symptoms of endometriosis typically return in line with your periods restarting.
But breastfeeding can make things interesting. Studies show that regularly breastfeeding your newborn can lengthen the "remission period" after pregnancy and reduce endometriosis-related pain as it inhibits the release of estrogen by the ovaries, suppressing ovulation and halting the development of your endometriosis.
How can I take control of an endometriosis diagnosis?
We know that an endometriosis diagnosis can feel like a life sentence, but once you know that's what you're dealing with there are a number of ways that you can take back control of your body and ease your pain.
There are some short-term methods of pain relief such as using heat pads on your stomach or taking a warm bath when symptoms are particularly bad, and some women have found acupuncture to be helpful with pain relief as well. More interestingly, research has pointed to the importance of diet and exercise in alleviating symptoms of endometriosis.
1. Food and diet
Studies have suggested avoiding trans fat in fried, processed, and fast foods, as well as avoiding red meat, gluten, caffeine, and alcohol can help lessen the pain and growth of endometriosis. Instead, here are some foods to love:
Fibrous foods such as fruit, vegetables, legumes, and whole grains
Essential fatty acids like salmon, sardines, herring, trout, walnuts, chia, and flax seeds
Iron-rich foods such as dark leafy greens, broccoli, beans, fortified grains, nuts, and seeds
Antioxidant-rich foods found in colorful fruits and vegetables, such as oranges, berries, dark chocolate, spinach, and beets
Consider supplementing your diet with zinc, vitamins A, C, and E -- but be sure to talk to your doctor before beginning any supplementation plan, especially if you're TTC, pregnant, or breastfeeding
2. Exercise
Some women find that high-impact exercises and traditional core routines (like sit-ups and crunches) exacerbate abdominal pain, especially while on your period. If you find certain workouts heighten your pain, please be sure to skip them. We always preach listening to your body above all else!
However, if you feel able to, maintaining a regular exercise routine can really help manage endometriosis symptoms, as we also know that regular exercise is proven to:
Boost your mood
Ease pain and inflammation
Reduce stress
Improve sleep quality
Try yoga and bodyweight exercises that relax, lengthen, and strengthen your pelvic floor, abdominal wall, and hip flexors.
3. Symptom tracking
Lastly, it's important to engage in frequent and careful monitoring and tracking of your symptoms. This is true if you have not been diagnosed with endometriosis but suspect you may have the condition, and it's true if you are managing endometriosis through your conception journey and during pregnancy to check for any of the possible complications.
Key takeaway: you can have a healthy, happy pregnancy with endometriosis
Being diagnosed with endometriosis often feels like adding another level of unpredictability to the complex and, at times, scary world of motherhood. But we want you to understand that, even with the risks we've discussed here, there are countless examples of women with endometriosis who have been able to conceive naturally and give birth to healthy babies, and there are treatment plans that can help if you are struggling.
The most important thing is to check in with your doctor to get diagnosed quickly, don't be afraid to speak up about your symptoms, and know that the entire Baby2Body community of mamas and mamas-to-be are behind you.
Additional resources and support
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US:
Australia:
New Zealand:
Find more country-specific support here.
Have a question or need some help finding support? Let us know in the comments.
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