What is Endometriosis Pain? How This Connection Affects Pregnancy

Endometriosis occurs when bits of the endometrium (the tissue that lines the uterus) grow outside the uterus on the ovaries or fallopian tubes. This tissue behaves like regular endometrial tissue which means that it thickens and bleeds along with the endometrium during each menstrual cycle. Endometriosis can be very painful because the tissue grows and bleeds in areas where it cannot easily pass out of the body which leads to swelling. This is a common condition that affects over 11% of women in the US between the ages of 15 and 44. Endometriosis can also affect fertility and pregnancy which is why early diagnosis and treatment is imperative.

Endometriosis Pain: Symptoms and Management

Pelvic pain is one of the primary symptoms of endometriosis and it is often associated with menstrual periods. Endometriosis pain is far more severe than normal menstrual cramping and it can increase over time. This pain is likely to start just before menstruation and lasts through the cycle as well as a couple of days after. Women with endometriosis describe their pelvic pain as a sharp and stabbing pain and unlike menstrual cramps, it does not go away with medication. If you have endometriosis, you may also experience pain during bowel movements or urination while you are on your period. Your uterus and ovaries are near your back so if you have endometriosis, you are also more likely to experience mild to severe back pain. Endometriosis pain can also impact a couple’s s*x life as pain during and after intercourse is a common symptom of this condition.

Pain severity is not an indication of the extent of the condition. This is because some women with mild endometriosis suffer from severe pain while others with advanced endometriosis experience little to no pain. Endometriosis pain management depends on the severity of the condition as well as the level of pain. Exercise and relaxation techniques can help to reduce mild to moderate pain while more severe pain would require prescription painkillers.

How endometriosis affects pregnancy

1. Reduces the chances of conceiving

On average, couples have a 15-20 percent chance of conceiving in any given month. However, studies show that couples affected by endometriosis have a lower chance of success – at just 2-10 percent. There are several ways to increase fertility when you have endometriosis. Your doctor may prescribe fertility medications such as Clomiphene or progestin injections, depending on the severity of your case. Laparoscopy is a surgical option that uses a laser to destroy any endometrial tissue outside of the uterus. Although this is an effective treatment for endometriosis, if there is any tissue left behind, the endometriosis can recur. 

2. Increases the risk of miscarriage

A recent retrospective analysis found that women with endometriosis have a 35.8 percent risk of miscarriage as compared to a 22 percent risk for women who don’t have endometriosis. It is important to note that this increased risk of miscarriage is not limited to severe endometriosis and even includes mild cases of endometriosis. Furthermore, all women ages 35 and older are at a higher risk of miscarriage which means that women with endometriosis who fall in this age bracket have the highest risk of miscarriage compared to younger women. A balanced diet, regular pregnancy exercise plan, healthy body weight and folic acid supplements can help to prevent a miscarriage. Similarly, avoiding cigarettes, second hand smoke and alcohol can also help to lower your risk of miscarriage. 

3. Increases the possibility of preterm birth

Babies that are born before week 37 of gestation are considered preterm or premature. Analysis shows that expectant moms with endometriosis are 1.5 times more likely to deliver preterm babies compared to women who do not have this condition. Babies born prematurely have a higher risk of short-term and long-term health and developmental problems. Their immature respiratory and gastrointestinal systems increases the risk of breathing and digestive issues. They are also at a higher risk if bleeding in the brain which can result in permanent brain damage. Long-term complications of premature birth include an increased risk for cerebral palsy and learning, vision and hearing problems. Preterm babies are also more likely to face behavioral issues, developmental delays and psychological problems.

An early diagnosis is important in order to better understand the condition, as well as to build resilience so that you can cope with the challenges of endometriosis effectively. There is no cure for endometriosis but the symptoms of this condition may be reduced or even absent when you’re pregnant since you do not have periods during this time and because of natural changes to your hormone levels. It is important to remember that a diagnosis of endometriosis does not equal infertility and that the condition can be treated successfully with hormone therapy and surgery.  Although endometriosis poses some risks to your pregnancy, it is possible to have a normal pregnancy, delivery and baby even if you have this condition.