Will Getting Pregnant Make My Pain Go Away?

Yes, but it will likely return after giving birth, new study suggests.

Key Points

Highlights:

Becoming pregnant might make some of the pain symptoms of endometriosis go away but these usually come back for most women following childbirth.

Importance:

This finding is important because doctors may wrongly advise women with endometriosis to become pregnant for their symptoms to disappear.

What's done here:

Researchers analyzed 131 women with endometriosis before they became pregnant and two years after they gave birth.

Key results:

• 37% of women had recurrent endometriosis within two years after giving birth.
• 84% of women had at least one pain symptom recur two years after giving birth. 
• There was a statistically significant improvement in women’s psychological status and quality of life but not in their sexual functioning two years after giving birth

Limitations:

• This is a retrospective study and so may contain some inaccuracies. For example, the authors report that the clinical and anatomical information about the women at the time of the first surgery was frequently incomplete.
• The women that were included in the study had been treated for endometriosis in many different ways making it difficult to compare them before they became pregnant and after they gave birth.
• The results might be biassed as only women who returned to the clinic after giving birth were included in the study and there may be many reasons why some women did not return, which cannot be known. 
• The women included in the study may have breastfed their babies for different amounts of time and this could have an impact on the findings of the second visit. 

Lay Summary

Pregnancy can relieve the symptoms of endometriosis, according to a new study published in the European Journal of Obstetrics & Gynecology and Reproductive Biology. However, for most women, the pain usually returns like in the case of hormonal therapy.

This is an important finding because most women with endometriosis are advised by their doctor to become pregnant as soon as possible. However, this can be very stressful for patients especially if they are not ready to start a family. 

“Overall, pregnancy is associated with a substantial improvement of pain symptoms but cannot be viewed as a definitive cure of the disease,” wrote Dr. Daniela Alberico and the co-authors of the study that analyzed 131 women.

All women had had at least one endometriosis surgery and moderate to severe pelvic pain symptoms before becoming pregnant. This included menstrual cramps, pain during intercourse, pelvic pain not caused by menstruation, and painful defecation. All women had had at least one child.

The researchers assessed the women before they became pregnant and two years after they gave birth. At each visit, they assessed the women clinically and by transvaginal ultrasound sonography. They also asked them to fill a number of questionnaires including the Short Form-12 questionnaire (SF-12), the Hospital Anxiety and Depression scale (HADS) and the Female Sexual Function Index (FSFI) to assess their pain, quality of life, psychological status, and sexual functioning respectively. 

The found that the symptoms of endometriosis recurred in around a third of the women (37 percent) two years after giving birth. These women required medical treatment or surgery to treat their condition. Most women (84 percent) had at least one pain symptom two years after giving birth. 

The results also showed that there was a statistically significant improvement in women’s psychological status and quality of life after giving birth but no improvements in their sexual functioning, 

The authors noted that the psychological benefits of parenthood may contribute to these improvements as does the hormonal changes that occur in a woman’s body as a result of pregnancy.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/30308401