Pregnancy doesn't 'cure' endometriosis, so where does this advice come from?

December 18, 2017 by Mike Armour, The Conversation
Women have long been told getting pregnant can help with endometriosis. Credit: Unsplash/freestocks.org, CC BY-SA

Many Australian women with endometriosis are reporting they're being advised a reliable treatment or even possible cure for their endometriosis is to "go away and have a baby". This message is consistent with what women from other countries are also being told by a wide range of sources from self-help books to web forums to medical professionals.

Pregnancy as a natural cure for endometriosis appears to date back to the early 20th century. However, even into the 1950s and 1960s, when was commonly recommended as a for endometriosis, this evidence was based mostly on case reports of women whose endometriosis improved during pregnancy. Case reports are often unusual findings and don't necessarily reflect what happens to most people.

Pregnancy as a treatment for endometriosis does not appear in current international guidelines for the management of endometriosis. It's also not mentioned as a treatment by Australian pelvic pain specialists and is classed as a "myth" by reputable endometriosis support sites.

Endometriosis and the lack of a cure

Endometriosis is the presence of tissue similar to the lining of the uterus outside the uterus itself. Accurate estimates of how many women in Australia have endometriosis are hard to find, but a common figure is around one in ten women during their reproductive years.

While during the period is a common symptom of endometriosis, it's so much more than just a "really bad period". There's almost no area of women's lives that is not negatively affected by the condition.

Current medical treatments, often using hormone therapy, are not always effective. And the side effects of many of the hormonal treatments can be particularly unpleasant for women, leading them to stop treatment.

Excision surgery, in which the endometrial lesions are cut away, is the most effective current treatment. But surgery is not something most women enter into lightly, given the cost and risk of undergoing surgery. Unfortunately, even surgery is not always successful with around 50% of women having symptoms reoccur after five years.

When we look at women around the world, it looks like having children does decrease the amount of period pain women have. A significant problem with this is we don't know if these women had endometriosis, and these kinds of studies can't tell us for sure if getting pregnant was responsible for this reduction in period pain.

Pregnancy, pain and the brain

Women with endometriosis, like other , have changes in the way their brains process pain. Nerves, especially in the pelvis, are also more sensitive than in women without chronic pain. The concept of "calming" these hyperactive pain pathways is an important treatment strategy in treating chronic endometriosis pain. Each time menstruation occurs it irritates these sensitive nerves and reinforces these pain pathways.

One way to prevent this reinforcement of pain pathways can be by stopping regular menstruation entirely. This is a key reason women with endometriosis are so often treated with continuous use of hormonal contraceptives.

During pregnancy there's also a suppression of menstruation. So it's possible during pregnancy there will be a reduction in endometriosis-related pain. It's also just as possible pregnancy will make endometriosis-related pain worse, due to extra pressure on these sensitive pelvic nerves. We just don't have the research to be able to answer this.

After giving birth, it's quite possible the pain, if it had decreased, will return. This is especially true once women start having regular periods again, as there's no evidence pregnancy shrinks endometrial lesions or changes pain processing in the long term, both major drivers of endometriosis pain.

Should pregnancy be recommended as a treatment?

Pregnancy might help reduce endometriosis symptoms, if only temporarily. But women with endometriosis often rightly feel upset and offended when advised to have a baby as a treatment strategy.

There are also risks involved, as with endometriosis are more likely to have pre-term births, increased rates of caesarean sections and an increased risk of miscarriage.

Women shouldn't have to bring another human into the world to relieve the of endometriosis. This is why we need to prioritise understanding the cause of , finding effective treatments and eventually a cure.

Explore further: Breastfeeding reduces risk of endometriosis diagnosis

Related Stories

Breastfeeding reduces risk of endometriosis diagnosis

August 30, 2017
Endometriosis is a chronic and incurable gynecologic disorder that affects approximately 10 percent of women in the United States. Its symptoms can be debilitating and include chronic pelvic pain, painful periods and pain ...

Lower-, higher-dose elagolix beneficial for endometriosis

May 22, 2017
(HealthDay)—Lower- and higher-dose elagolix are beneficial for women with endometriosis, according to research published online May 19 in the New England Journal of Medicine to coincide with the 13th World Congress on Endometriosis, ...

Endometriosis increases risk of complications during pregnancy and delivery

September 13, 2017
A new meta-analysis shows that pregnant women with endometriosis are at greater risk for a host of complications during pregnancy and at delivery, including preterm birth and cesarean section. The study was published in the ...

Study suggests that pelvic pain is associated with poorer mental health outcomes in women with endometriosis

December 21, 2015
A new study published in the Journal of Psychosomatic Obstetrics & Gynecology has found that women who suffer from pelvic pain caused by endometriosis may need psychological intervention in order to help improve their mental ...

Survey launched to learn more about Endometriosis

March 8, 2016
Researchers from the University of Liverpool's Institute of Translational Medicine, in collaboration with the Universities of Edinburgh and Oxford, are launching a national survey to further understanding of a common gynaecological ...

Women with endometriosis at higher risk for heart disease

March 29, 2016
Women with endometriosis—especially those 40 or younger—may have a higher risk of heart disease, according to new research published in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

Recommended for you

New technology can keep an eye on babies' movements in the womb

July 19, 2018
A new system for monitoring fetal movements in the womb, developed by Imperial researchers, could make keeping an eye on high-risk pregnancies easier.

Why baby's sex may influence risk of pregnancy-related complicatations

July 12, 2018
The sex of a baby controls the level of small molecules known as metabolites in the pregnant mother's blood, which may explain why risks of some diseases in pregnancy vary depending whether the mother is carrying a boy or ...

Study analyzes opioid overdose risk during and after pregnancy among Massachusetts women

July 11, 2018
A study of women giving birth in Massachusetts found a higher level of opioid use disorder than have studies conducted in other states. In a paper published in the journal Obstetrics & Gynecology, the research team—consisting ...

High blood pressure in pregnancy linked to mother's heart function

July 9, 2018
Pregnant women who develop high blood pressure, or have small babies, may have hearts that pump less blood with each beat.

What you eat while pregnant may affect your baby's gut

July 4, 2018
A mother's diet during pregnancy may have an effect on the composition of her baby's gut microbiome—the community of bacteria living in the gut—and the effect may vary by delivery mode, according to study published in ...

New study reveals time and day women are most likely to give birth

June 15, 2018
A new study has found that the time and day that women give birth can vary significantly depending on how labour starts and the mode of giving birth.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.