Myth or Reality: Does Pregnancy Cure Endometriosis?

According to statistics, endometriosis affects one in ten women of childbearing age. There is ongoing research on whether pregnancy cures endometriosis. Some healthcare professionals propose pregnancy as a solution to endometriosis. To understand the reasoning behind this idea, it's important to know what endometriosis is, the myth surrounding it, and the reality.

Endometriosis?

Endometriosis is a chronic systemic proinflammatory condition characterized by the growth of tissue similar to the endometrium (simple columnar epithelium) outside the uterus, causing dyspareunia, dysmenorrhea, and occasionally infertility.

The word endometriosis is derived from Greek: “endo” meaning within, “metra” meaning uterus, and “osis” meaning disease. A sustained inflammation within the pelvis and affected structures occurs due to the recruitment of pro-inflammatory cytokines and a shift in circulating immune cell populations. Chronic pelvic pain is the most common clinical symptom, though the concept remains somewhat vague.

Additional Symptoms Include:

• Pain during menstruation

• Pain before or after sex

• Pain during urination or defecation

• Pain in the sacral region of the spine

• Pain radiating to the back

• Heavy bleeding during or between periods

• Trouble getting pregnant (infertility)

• Spotting before periods

Patients May Also Experience:

• Bloating

• Nausea

• Dizziness

• Low-grade fever

• Anxiety or depression

• Chronic fatigue

• Hypoglycemia

• Susceptibility to infections

• Allergies

The origin of endometriosis remains unknown, and various theories attempt to explain it. ⁽¹⁾

One theory suggests that during menstruation, some tissue backs up through the Fallopian tubes into the abdomen, a form of reverse menstruation, where exfoliated endometrial cells attach and grow. The most common site of endometrial tissue found outside the uterine cavity is the peritoneum. Other common locations include the ovaries, fallopian tubes, uterosacral ligaments, cervix, bladder, vagina, gastrointestinal tract, and abdominal wall. Less frequent locations include the pleura, spleen, pericardium, and central nervous system. ⁽²⁾

Endometriosis is a chronic disease that presents socioeconomic, medical, and public health challenges, significantly impacting patients' quality of life. ⁽¹⁾

Why Does the Myth Persist?

Looking into the past, in the 5th century BC, Hippocrates believed that women had “wandering wombs” that caused “hysteria” and that they could only be cured through sex and procreation.

In 1921, Sampson first described the regression of endometriotic lesions during pregnancy, highlighting it in the article "Benefits of Pregnancy on Endometriosis."

He stated that progesterone levels rise during pregnancy, altering the hormonal environment in a way that suggests the regression of endometriotic lesions. Based on this evidence, progesterone treatment developed as a therapeutic approach to endometriosis and remains in use today. (3)

In 2018, according to the American College of Obstetricians and Gynecologists (ACOG) guidelines, there was a lack of clinical evidence regarding endometriosis and women's health. The Vital Health blog described how, in 2018, some obstetricians and gynecologists still suggested, “Pregnancy is the cure for endometriosis,” despite this being patently untrue. The myth persisted.

Looking into Facts and Reality

In Sampson's study, conditions arose where complications, including intra-abdominal bleeding due to the rupture of endometriotic lesions, occurred during pregnancy.

Risk factors for endometriosis include:

• Early menarche: Experiencing the first menstrual cycle before the age of 11 is associated with an increased risk of endometriosis.

• Short menstrual cycles: Cycles lasting fewer than 27 days are linked to a higher risk of endometriosis, regardless of bleeding duration or volume.

• Low BMI (Body Mass Index)

• Age 25-29

• Fewer pregnancies or births

• Endometriosis is more commonly diagnosed in infertile women.

• Daily alcohol consumption (around 10g per day). (1)

The reason behind myth persistence?

Looking into the past, in the 5th century BC, Hippocrates believed that women had “wandering wombs” that caused “hysteria”, only by having sex and procreation with a man, believed that they would get cured.

In 1921, Sampson first described the regression of endometriotic lesions during pregnancy highlighted in the article, "Benefits of Pregnancy on Endometriosis"

He stated that progesterone levels also rise in pregnancy resulting in changes in the hormonal environment that have suggested regression of endometriotic lesions. Based on the supportive evidence, progesterone treatment developed as a therapeutic approach to endometriosis even today. ⁽³⁾

In 2018, according to current American College of Obstetrics and Gynecology endometriosis guidelines, there is a lack of clinical evidence regarding endometriosis and women's health in clinical fitting. In 2018, obstetricians and gynaecologists suggested “Pregnancy is the cure to endometriosis,” which is patently untrue. The myth didn't break but continued.

Looking into Facts and the Reality

In Sampson's study, there were conditions depicting a lot of complications causing intra-abdominal bleeding due to the rupture of endometriotic lesions in pregnancy.

We will look into the risk factors of endometriosis, including: 

• Early menarche: The first cycle of the reproductive age below the age of 11 is associated with endometriosis.

• The risk of endometriosis is higher in cases of short cycles, i.e. lasting less than 27 days, this is unrelated to the number of bleeding days and the menstrual volume.

• Low BMI (Body Mass Index) 

• Age 25-29

• Smaller number of births

• Endometriosis is more often diagnosed in infertile women.

• Daily consumption of alcohol ( amount around 10g per day).⁽¹⁾

MedBound Times connected with Dr. M. Jyotshna Priyanka, MBBS, Gynecologist and Obstetrician to share her opinion about the facts behind the question “Does pregnancy cure endometriosis?”

In her words “Pregnancy plateaus endometriosis. During pregnancy, the domination of progesterone, prolactin, and estrogen suppresses the clinical findings of endometriosis which reverts after pregnancy. So Pregnancy is Just a halt for Endometriosis but not a cure.

Based on evidence from previous studies, some molecular and cellular level modification of disease occurs during pregnancy which can potentially have longstanding benefits, not only in reversing the adverse effects on pregnancy outcomes but also in symptom management and disease progression following birth."

Considering the present data and the myths, Maddie Massy, M. Phil, Immunology, shared her thought that a myth persists among healthcare professionals that pregnancy cures endometriosis.

She suggested her evidence from two articles supporting that it’s just a myth and doesn't have any role in the present scenario, but still, some of the medical professionals advise getting pregnant can be a solution to endometriosis

Understanding endometriosis, raising awareness, and improving medical education are crucial. Current treatment options, including hormonal therapy, ovulation suppression, and stopping periods, provide symptom relief. While pregnancy can offer temporary relief, there is no clinical evidence to support the claim that pregnancy cures endometriosis. ⁽⁵⁾

It is a myth that pregnancy cures endometriosis. Overall, we need to understand and rule out the outdated old-century myth existing today from clinical evidence-based medical practices.

Note: The information on this website is for informational purposes only and is not intended to substitute medical advice, diagnosis or treatment. Always contact your healthcare practitioner regarding any questions you may have about medical conditions, procedures or treatment.

References:

1. Cano-Herrera, Gabriela, Sylvia Salmun Nehmad, Jimena Ruiz de Chávez Gascón, Amairani Méndez Vionet, Ximena A. van Tienhoven, María Fernanda Osorio Martínez, Mauricio Muleiro Alvarez, Mariana Ximena Vasco Rivero, María Fernanda López Torres, María Jimena Barroso Valverde, and others. 2024. “Endometriosis: A Comprehensive Analysis of the Pathophysiology, Treatment, and Nutritional Aspects, and Its Repercussions on the Quality of Life of Patients.” Biomedicines 12, no. 7: 1476. Accessed January 28, 2025. https://doi.org/10.3390/biomedicines12071476.

   https://www.mdpi.com/2227-9059/12/7/1476.

2. Smolarz, Beata, Krzysztof Szyłło, and Hanna Romanowicz. 2021. “Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature).” International Journal of Molecular Sciences 22, no. 19: 10554. Accessed January 28, 2025. https://doi.org/10.3390/ijms221910554.

   https://www.mdpi.com/1422-0067/22/19/10554.

3. Leeners, Beata, and Cindy M. Farquhar. 2019. “Benefits of Pregnancy on Endometriosis: Can We Dispel the Myths?” Fertility and Sterility 112: 226–227. Accessed January 28, 2025. https://pubmed.ncbi.nlm.nih.gov/31280954/.

4. Vital Health Endometriosis Center. n.d. “The ‘Pregnancy Cures Endometriosis’ Myth.” Vital Health Endometriosis Center Blog. Accessed January 28, 2025. https://www.vitalhealth.com/endo-blog/pregnancy-myth/.

By Dr. Lakshmi Sahithi Tanneru

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