Endometriosis and pregnancy (and breastfeeding)

by Ros Wood

Pregnancy generally leads to an improvement in endometriosis symptoms, particularly during the latter months of pregnancy. However, some women experience a worsening of symptoms, particularly during the first three months.

It is believed that the beneficial effects are due to the high levels of progesterone produced during pregnancy. It is thought that the progesterone suppresses the growth and development of the endometriosis lesions, causing them to become less active. The effects may also be due to the lack of menstruation during pregnancy.

The worsening of symptoms may be due to the rapid growth of the uterus in the early months of pregnancy, which may lead to stretching and pulling of adhesions and tissues that have been scarred by the endometriosis implants. It may also be due to the high levels of oestrogen produced during pregnancy. This may temporarily stimulate the growth of the endometriosis, leading to a worsening of symptoms.

For most women, the beneficial effects of pregnancy are only temporary. Many women will experience a recurrence of their disease and its symptoms within a few years, and some will experience a recurrence soon after resuming their periods.

Breastfeeding

Many women with endometriosis are able to lengthen the remission of their symptoms after pregnancy by breastfeeding their newborn child. Regular breastfeeding inhibits the release of oestrogen by the ovaries, which suppresses ovulation and the growth and development of the endometriosis.

Thank you to the following for reviewing this article prior to its publication:

Juan Garcia Velaso, IVI Madrid, Spain
Andrew Prentice, Consultant Gynaecologist, University of Cambridge, UK
Hugo C Verhoeven, Head of Reproductive Medicine, Med-Plus Krefeld, Germany