The emotions and experiences of women with endometriosis during and after pregnancy

Infertile women with deep infiltrating endometriosis report relief during and after pregnancy, but symptoms return later, study shows

Key Points

Highlight

• Women with deep infiltrating endometriosis need to be better informed about the importance of resuming hormone treatment after childbirth.

Importance

• Although pregnancy can bring temporary relief from endometriosis symptoms, it remains a special period for women with endometriosis.
• Some patients delay seeking further treatment based on the belief that pregnancy is a cure for endometriosis.

What’s done here

• This is a single-center qualitative study on infertile women with deep infiltrating endometriosis.
• It aimed to assess the emotions of experiences during and after the first in-vitro fertilization (IVF) pregnancy.
• Interviews were conducted using a semi-structured guide on 15 women and the collected data were analyzed using an inductive approach.

Key results

• Discontinuing hormonal treatment for pregnancy often led to increased pain in these patients.
• Endometriosis negatively affected the sexual life of women and planning intercourse despite pain was found to be hard.
• The patients experienced anxiety during IVF treatments due to the social and professional hindrances caused by it.
• Pregnancy provided temporary relief from endometriosis symptoms and improved social and professional life for these women.
• Endometriosis symptoms gradually returned after a time of remission following pregnancy, resulting in disappointment and social/professional constraints.

Lay Summary

It is well-known that endometriosis patients have a high rate of infertility and a hard time getting pregnant compared to women without endometriosis. Despite the belief that pregnancy can alleviate endometriosis symptoms, some studies have shown that women with endometriosis had a recurrence of moderate or severe pain after delivery. However, pregnancy remains a special period for these women due to the difficulties in achieving pregnancy, temporary relief from symptoms, and higher risk of complications.

Researchers from Marseille, France conducted a single-center qualitative study to evaluate the emotions and experiences of infertile women with deep infiltrating endometriosis during and after their first in-vitro fertilization (IVF) pregnancy. The study was published in the journal PLoS One. 

Interviews were conducted using a semi-structured guide on 15 women with deep infiltrating endometriosis, and the collected data were analyzed using an inductive approach. During IVF management, discontinuing hormonal treatment for pregnancy often led to increased pain, causing ambivalence for women desiring a child while needing relief. IVF was also seen as a social and professional hindrance and caused anxiety for women who had to justify their absence. Endometriosis negatively affected sexual life, making it a taboo subject, and planning intercourse despite pain was found to be complicated. On the other hand, partner involvement during IVF treatments strengthened the couples’ cohesion. Regarding symptom resolution during and after pregnancy, the patients reported going through a time of symptom relief during and right after pregnancy. They were able to resume their social and professional lives, enhancing their relationships with their partners. However, some women reported a decline in their sexuality, and the belief that pregnancy was a cure for endometriosis led some to delay seeking further treatment.

The endometriosis symptoms for the women interviewed were reported to be gradually returned after a time of remission following pregnancy, resulting in disappointment and social/professional constraints. Some stated that they regretted not resuming hormonal treatment after pregnancy despite healthcare professionals' advice.

The authors discuss that the women's experiences changed when their symptoms resurged after some time, which led to negative emotions such as disappointment and resignation. They highlight the need to better inform patients about the importance of resuming hormone treatment after childbirth.

It is concluded that there is still limited data available on the effect of pregnancy on endometriosis and the persistence of the myth of pregnancy as a treatment or principle of management of endometriosis among health professionals treating the disease and more studies are needed to fully understand the influence of pregnancy regarding endometriosis symptoms in the long term.

Research Source: https://pubmed.ncbi.nlm.nih.gov/36327260/