Family planning

Endometriosis and family planning: what you need to know

Endometriosis is a condition in which the tissue that normally lines the inside of the uterus, called the endometrium, grows outside of the uterus. According to a 2011 studythe condition affects more than 11% of American women between the ages of 15 and 44 – during their childbearing years.

Endometriosis can be associated with chronic pelvic pain, heavy periods and infertility. Although there is no cure for the disease, various treatment strategies are available to help reduce symptoms and prevent disease progression.

Treatment of endometriosis is often done with the aim of preserving fertility. Even if having a baby isn’t on your radar yet, there may be things to consider if you want to get pregnant in the future.

Hormonal contraceptives are commonly used to prevent pregnancy, whether you have endometriosis or not. It is available as a pill, injection, ring, patch, or intrauterine device (IUD).

Hormonal birth control works by altering your hormone levels to prevent ovulation. Ovulation occurs when an egg is released from your ovaries. If no egg is released, it cannot be fertilized by sperm.

This type of birth control can also help manage the symptoms of endometriosis and preserve fertility.

Hormonal birth control helps reduce levels of hormones, including estrogen, which stimulate the growth of endometriosis. By lowering estrogen levels, hormonal birth control can help alleviate bothersome symptoms and minimize disease progression that could lead to future fertility problems.

Hormonal birth control is also used to lighten or skip periods. This can help reduce pain from endometriosis.

On 30 to 50 percent of people with endometriosis experience fertility problems. Sometimes endometriosis is not even diagnosed until a person undergoes investigations for infertility.

A laparoscopy is a surgical procedure where a small telescopic camera is placed in the abdomen. It is the gold standard for diagnosing endometriosis, although endometriosis implants can be treated and removed with this technique.

A laparoscopy can show the extent of the endometriosis and the amount of lesions and scar tissue. The more endometriosis there is, the more likely it is to affect fertility.

Endometriosis can impact fertility in several ways:

  • Scar tissue or adhesions can cause anatomical distortion and affect the function of the fallopian tubes and ovaries.
  • Endometriomas, or ovarian cysts from endometriosis, can impact egg quality and ovulation.
  • Increased inflammation can impact fertility.
  • Endometriosis can decrease implantation rates in the uterus.

Endometriosis treatment can help with fertility. Here are some treatment options that can be used for endometriosis-related infertility:

  • Laparoscopic surgery. Adhesions and scar tissue can alter the structure of the reproductive organs. With this procedure, the anatomy can be restored and the affected tissues can be removed or treated. For some people, it can improve fertility.
  • Medications. Hormonal contraceptives are often used before trying to get pregnant. Medications can help prevent disease progression and manage symptoms. If you are trying to get pregnant, medications can be used to stimulate egg growth and ovulation if needed.
  • Assisted Reproductive Technology (ART). Options may include intrauterine insemination (IUI) or in vitro fertilization (IVF). IVF may be needed with more serious disease. Several factors must be taken into account when deciding if ART is the right choice for someone.

Limited research is available on how pregnancy affects endometriosis, and the results are mixed.

A Report on studies 2018 showed that 15 to 50% of the lesions disappeared and that 34 to 64.7% diminished with pregnancy. However, the examination also revealed that between 8.8 and 39% of the lesions grew larger during pregnancy. The results also showed that around 25% of the lesions did not change during pregnancy.

Thus, the effects of pregnancy on people living with endometriosis can vary widely. For some, not having a period can mean a break from symptoms. For others, there may be no change in symptoms, or symptoms may increase during pregnancy.

Pain during pregnancy is more common when certain areas are affected by endometriosis. Injuries to the umbilical region (navel) or rectum are more likely to cause pain. As the uterus expands during pregnancy, there may be additional pressure on these areas.

Endometriosis can increase the odds placenta previa during pregnancy. Placenta previa occurs when the placenta is very close to the cervix or covers the cervix.

If it’s early in pregnancy, the placenta has time to move away from the cervix. If the placenta still covers the cervix later in pregnancy, you may need extra monitoring. Most cases of placental previa lead to a planned caesarean section, also known as cesarean section.

However, complications of endometriosis during pregnancy are rare. There can be it’s not necessary for extra monitoring during pregnancy if you have endometriosis.

Methods of delivery may play a role in future symptoms of endometriosis after pregnancy.

Research suggests that vaginal births are associated with lower rates recurrence of endometriosis. Many people experience a pause in their symptoms for a while after a vaginal birth.

If you are breast-feeding or breast-feeding, it may further delay the return of your period, which may help ease symptoms.

The postpartum period can be overwhelming and exhausting. Don’t forget to take care of yourself too. Be sure to follow up with your own healthcare team and discuss future plans for managing your endometriosis.

Endometriosis usually affects people of childbearing age. This can cause pain, heavier periods, and sometimes fertility problems.

Endometriosis is incurable, but treatment can help manage symptoms and preserve fertility. Treatment approaches can change if a person is trying to conceive or planning to get pregnant in the future.