Endometriosis and Pregnancy: Risks, Treatments & Essential Info

Endometriosis and pregnancy aren’t always the best of friends.

Even if you’ve avoided the other extremely un-fun symptoms of this condition (extra-heavy periods, extra-painful period cramps, pain after sex…), you might still find it impacts your fertility.

But, many women with endometriosis do go on to get pregnant and give birth to healthy babies.

Some just need more time; others need treatment.

Either way, there is definitely hope.

So, let’s talk more about the relationship between pregnancy and endometriosis.

In this article: 📝

What is endometriosis?

Endometriosis (AKA endo) occurs when the tissue lining your uterus (the endometrium) doesn’t stay in your uterus, like it’s supposed to.

Instead, patches of it start growing beyond the uterus, to its surrounding areas such as your ovaries, fallopian tubes, bowels, bladder, and behind your uterus.

Symptoms of endometriosis vary from woman to woman, but they tend to hit the hardest during your period, like:

• Painful, heavy or irregular periods
• Pain in your abdomen
• Pain when peeing or pooping
• Pain during or after sex
• Feeling nauseated

And there are some people out there with both endometriosis and PCOS (polycystic ovary syndrome), so some symptoms can be even more exacerbated.

It’s estimated that more than 11% of women in the US aged 15–44 have endometriosis, and it’s most common to get it when you’re in your 30s or 40s. [1]

The only way to diagnose it for sure is to look inside your body using a laparoscope (a long, thin tube with a camera on it).

Medical experts still aren’t sure what causes the condition.

As it runs in families, they think there might be a genetic cause.

But it could also be an issue with blood flow during your period, your immune system, or your hormones.

👉 Get all the info: What is Endometriosis?

Can you have a baby naturally with endometriosis?

Yes, there’s a very good chance you can.

Cards on the table: if your dream is to get pregnant and endometriosis is a part of your life, you may face some extra challenges.

You see, it’s thought that around half of women who experience reproductive struggles have endometriosis.

But it might be that it’s undiagnosed endometriosis, so there could be thousands, or hundreds of thousands of women who have endometriosis while trying to get pregnant.

How does endometriosis affect getting pregnant?

It’s not always clear why endometriosis makes it harder for some women with the condition to have a baby.

With severe endometriosis, it’s possible that the rogue endometrium patches may have damaged your ovaries or blocked access to the fallopian tubes.

This then prevents that crucial meeting between sperm and egg.

Or, with milder endometriosis, it’s thought that the condition might cause inflammation that can damage an egg or sperm cell inside your body.

But more research is required to give women with endometriosis the answers they need.

Embryologist Navya Muralidhar breaks it down: “With endometriosis, there are 4 stages. Stages 1 and 2 are of the milder type, and it may be easier to become pregnant naturally. However, with the advanced stage 3 and 4 types, pregnancy rates are seen to be higher post-surgery to remove scar tissue or endometriotic cysts.”. [2]

How can you improve your chance of conceiving with endometriosis?

Some potential treatments may increase your chances of getting pregnant with endometriosis.

Treatments that may help you have a baby when you have endometriosis include:

• Medications, including progestins, help boost the level of pregnancy hormones in your body.
• Surgery to remove the patches of tissue.
• Fertility treatments, like in-vitro fertilization (IVF) and intrauterine insemination (IUI).

If you have endometriosis (or you suspect you have it) and you’re struggling to conceive, make an appointment with your doctor.

They’ll be able to assess your fertility, work out if there are any other health issues to consider, and discuss your options with you.

Can endometriosis cause positive pregnancy test?

While it’s true that some medical conditions can cause a false-positive pregnancy test, endometriosis is not one of these conditions.

But if you think you may have pregnancy symptoms, like a missed period, with no other explanation, it can be worth visiting your doctor.

What is the best age to get pregnant with endometriosis?

The “best age” to get pregnant, regardless of medical conditions, is always up for debate.

What might be best for your egg maturity could also not be best for the rest of your body, mental state, or circumstances.

But very generally speaking, it’s often easier to get pregnant in your 20s compared to your 30s and 40s.

And Endometriosis UK suggests that people with endometriosis’ fertility “rapidly declines after the age of 38”, so it seems that it’s pretty similar to those without endo. [3]

What are endometriosis pregnancy rates?

So what are the chances of getting pregnant with endometriosis?

As Navya says, “Studies mention how medical treatment does not really improve spontaneous pregnancy rates, but surgery may be beneficial in minimal to invasive endometriosis. Spontaneous pregnancy rates in women with mild endometriosis is about 33% and lessens as it progresses to higher stages. But post operation or laparoscopic surgery, pregnancy rates varied from 30-67% for women with mild to severe endometriosis.”. [4,5]

How does endometriosis affect pregnancy?

Now for a particularly tough bit.

If you become pregnant with endometriosis, you do have an increased risk of pregnancy loss.

Can endometriosis cause miscarriage?

Maybe, but we’re not entirely sure.

While it’s not exactly a case of cause and effect, it’s been shown that women with endometriosis have an above-average chance of experiencing a miscarriage.

The same is true of endometriosis and ectopic pregnancy (where the fertilized egg implants somewhere that isn’t your uterus).

According to Navya, “there’s also the risk of placenta praevia, where the placenta attaches lower down in the womb than usual.”. [6]

Later in pregnancy, you might also have a slightly increased risk of preeclampsia and preterm birth.

But your doctor will watch you carefully so they can manage any issues that arise.

A little bit of good news.

What are pregnancy symptoms with endometriosis?

What does pregnancy feel like with endometriosis?

Well, as your periods stop during pregnancy, that means many women get relief from the pain during that time.

Unfortunately, the symptoms can return once your periods start again.

And as for other pregnancy symptoms with endometriosis?

They can be pretty similar to pregnancy symptoms for people without endo. [7]

Many of our endo Peanut mamas have reported:

• Cramping (side note: it’s worth visiting a doctor if you’re worried while experiencing cramping during pregnancy)
• Some light pregnancy bleeding
• Lightning crotch (sharp pains around your groin)
• Round ligament pain (stretching pains around your abdomen as your uterus expands)
• Back pain
• Leg pain or cramping
• Nausea
• Bloating
• More frequent trips to the bathroom

And if you’re experiencing any of these more pain-related or cramp-like endometriosis pregnancy symptoms, there’s one thing that our Peanut mamas have found helps ease the pain: a microwaveable wheat bag.

Is pregnancy with endometriosis high risk?

Yes, usually, endometriosis means a high-risk pregnancy.

This is because some of the more recent figures suggest that the chances of a tubal pregnancy (when the fertilized egg gets stuck before it gets to the uterus) are almost tripled, and chances of pregnancy loss are almost doubled for people with endometriosis. [8]

However, that’s not to say that endometriosis and pregnancy are a recipe for loss ‒ many of our mamas on Peanut have endometriosis and have had healthy babies.

🤔 Dig deeper: What is Considered a High-Risk Pregnancy?

How can I prevent miscarriage with endometriosis?

As with most cases of pregnancy loss, there’s usually nothing you can do to prevent it, even with endometriosis.

Unfortunately, there aren’t enough studies on endometriosis and pregnancy, so doctors don’t really know the reason why the chances of pregnancy loss are increased with endo. [9]

And not knowing the link between pregnancy loss and endometriosis means that they can’t pinpoint what you can do to prevent it.

Does pregnancy cure endometriosis?

Here’s where things get even more muddied.

We don’t actually know whether endometriosis symptoms are improved with or after pregnancy.

While some studies suggest that pregnancy can help reduce the effects of endo, “thanks to the increased levels of progesterone which suppresses endometrial growth”, as Navya explains. [10]

And others say it can be a temporary relief from the symptoms, as periods have stopped. [11,12,13,14]

And some people with endometriosis who are also pregnant sometimes still get the endo symptoms, even throughout pregnancy.

So there’s no single answer here.

Does endometriosis get worse after having a baby?

Typically, endometriosis during pregnancy can mean that the symptoms of endo are lessened, while periods are on their own version of maternity leave.

But even if these symptoms do disappear during pregnancy, they’re still very likely to come back once your periods return, postpartum or after breastfeeding.

So it might not be that endometriosis gets worse after having a baby, but that you’ve had some temporary relief from the symptoms, so now getting them full-force while looking after a baby and recovering can feel worse.

We know that living with endometriosis can be a challenge at the best of times.

Even without the heartache of struggling to conceive or being pregnant.

But, there’s still hope that a baby is in your future, with the right treatment – or perhaps a few extra months of trying.

In the meantime, sharing your hopes and heartache with other women on the same journey can help.

You’re absolutely not alone.