March is Endometriosis Awareness Month. Endometriosis is a condition, usually painful, that affects an estimated 200 million women worldwide. There is currently no cure for endometriosis. Donate to endometriosis research through The Endometriosis Foundation Of America.
Most women experience a somewhat regular monthly cycle with typical period pain; bloating, cramping, irritability. For some, the monthly visit from Aunt Flo goes far beyond the usual period pain. Endometriosis is often diagnosed based on pain symptoms. The only way to definitively diagnose endometriosis is to undergo an MRI. Unfortunately, endometriosis pain can be debilitating. While some women only experience the pain during their menstrual cycle, others experience consistent chronic agony. In this way, endometriosis can disrupt a woman's life. Doctors have not yet discovered a cure for the condition. In its stead, gynecologists are recommending pregnancy as a treatment for endometriosis!
What Is Endometriosis?
Endometriosis, sometimes called "endo", impacts approximately 200 million people worldwide. Some women with endo don't feel any symptoms; others experience constant debilitating pain. In practical terms, endometriosis happens when the lining of the uterus - the endometrium - grows outside the womb. During a woman's monthly cycle, endometrial tissue behaves just as it would if it were inside the uterus. The tissue thickens, breaks down, and bleeds. Because this all happens outside the womb, the tissue doesn't have an exit. Over time, this cycle creates scar tissue and cysts on the surrounding organs. In extreme cases, endometriosis can actually fuse organs together with scar tissue.
One of the cruelest facts about endometriosis is that it's a progressive disease. Women with endo often report severe pain, especially during their monthly cycle. As time goes on, the severity of endometriosis increases. Those with more involved or advanced cases report dysfunction in their gastrointestinal tract, bladder, and other pelvic organs. Since the condition creates so much inflammation, it can hamper fertility. Many women with endometriosis struggle to conceive or carry a pregnancy to term.
Treatments For Endometriosis
Despite the grave implications for a woman's health, doctors have relatively few possible treatments they can administer. Much of the emphasis for endo treatment involves pain management. Some women can successfully find relief with medication while others struggle despite the use of painkillers. Often doctors will prescribe round-the-clock NSAIDS in an attempt to reduce endometrial inflammation during the menstrual cycle.
Using hormonal contraceptives continuously can prevent the cyclical thickening and bleeding of the endometrial tissue. Some patients require more intensive hormone therapy to create a state of stasis for the endometrium. If these measures don't control the progression or pain of the disease, doctors might recommend surgery to remove the tissue from the pelvis. Conservative surgery involves a laparoscopic investigation and removal of endometrial tissue. While this surgery helps many, it has no guarantee of success and the painful tissue often returns afterward.
Because endometriosis is progressive and can harm fertility, many doctors recommend women with the disease try to achieve pregnancy as early as possible. My own mother-in-law was urged by her physician to get on with building a family. Many women who are able to conceive with endometriosis notice relief during their pregnancy.
Why Does Pregnancy Reduce Endometriosis Symptoms?
To be clear, pregnancy does not cure endometriosis. As of 2019, scientists have not found a cure or a reliable treatment for endo. Still, pregnancy is one way some women choose to "treat" their endo symptoms. Because of the hormonal changes during pregnancy endometrial tissue pauses its cyclical shedding. The effect is usually pain relief, which is definitely welcomed during uncomfortable pregnancies!
Even after delivery, mothers can delay the return of symptoms by breastfeeding. Because breastfeeding hormones can block menstruation, they also stop endometrial tissue from bleeding. Most women report their endometriosis returning after pregnancy and breastfeeding. However, some have noted a reduction in the severity of their symptoms! Of course, this potential relief is one of the reasons doctors urge women with endometriosis to conceive. Even without a promise of pain relief, many women with endo pursue pregnancy in an attempt to preserve their fertility. Since their disease might progress quickly and impair their ability to conceive, these women have opted to bear children while they can.
An estimated 1-in-10 women in the United States suffer from endometriosis, most with significant pain. While doctors have no cure for the disease, they have built their recommendations for treatment on years of experience and study. Research shows that women can slow their endometriosis and reduce pain during pregnancy. Add to that the pressure of a ticking biological clock and it's no surprise that many women with endo pursue pregnancy!