Endometriosis is a condition that affects up to 10% of women of reproductive age. The majority of women who have this condition are not infertile, but up to 40% of infertile women have some form of endometriosis. In addition, endometriosis may lead to higher rates of miscarriage. Here's what you should know.
What is endometriosis?
If you suffer from abnormally and severely painful and heavy periods, you may be suffering from endometriosis.
The endometrium is a tissue that lines the insides of your uterus. Sometimes, this tissue can grow outside of the uterus—spreading to your ovaries, bowels, or other areas in your abdomen and pelvis. This is known as endometriosis.
This growth can lead to the formation of cysts. Scarring from these cysts can end up blocking ovaries or fallopian tubes. It may also lead to severe pain during menstruation or sex. Other endometriosis symptoms usually occur during or after your menstrual cycle and can include:
- Lower back and abdominal pain
- Pain with bowel movements or urination
- Occasional bleeding or heavy periods between your menstrual cycles
Finally, one of the most significant effects of endometriosis is on your fertility. You can read more about that in our earlier post on the topic. Related to that are endometriosis and miscarriage risks.
Can endometriosis cause miscarriage?
A spontaneous pregnancy loss that occurs before 20 weeks of gestation is considered a miscarriage. While research is ongoing, newer studies from 2016 and 2017 do point to an increased risk of miscarriage for patients who have endometriosis.
"Four hundred and seventy-eight pregnancies in endometriosis-affected women and 964 pregnancies in controls were analyzed. The previous miscarriage rate was significantly higher in women with endometriosis compared with the controls (139/478 [29%] versus 187/964 [19%], respectively; P < 0.001)."
We do need more research into this topic, but based on this research, endometriosis may lead to miscarriage.
What can I do?
Many women who have endometriosis do go on to have healthy, happy pregnancies. If you suffer from endometriosis, there are ways to manage your risks.
Before all else, talk to your doctor to get a diagnosis. With a pelvic exam or ultrasound, your doctor can usually identify the extent of your cysts.
1. Consider treatments before conceiving
After a diagnosis, your doctor will consider the severity and risks to your fertility. Depending on your case, they may suggest endometriosis treatments before trying to conceive. These may include:
- Hormonal therapies to manage symptoms
- Surgery to excise endometriotic tissue from around the uterus and ovaries (done laparoscopically, this a fairly minimally-invasive procedure)
- Using in vitro fertilization (IVF) to improve your chances of a successful pregnancy, depending on your age and other factors
2. Reduce other risk factors
If you are diagnosed with endometriosis, one of the most important things you can do is to make lifestyle changes to reduce any other risk factors. You can do this by:
- Getting to, or maintaining, a healthy weight
- Eating a well-balanced diet that's rich in nutrients, focusing on vegetables and fruits
- Managing any other health conditions, such as diabetes
- Avoiding smoking, alcohol, and illicit drug use
3. Know common endometriosis and miscarriage symptoms
If you are pregnant and have endometriosis, it's important to work closely with a healthcare provider. They'll monitor the course of your pregnancy to ensure it's progressing normally.
If you have any of the following miscarriage symptoms, seek medical help immediately:
- Vaginal bleeding (some spotting can be normal, but it's okay to talk to your doctor to double-check)
- Pain and cramping
- Fluid or tissue release from your vagina
Finally, know that if you do have a miscarriage, it is not your fault. A miscarriage is the body's natural way of ending a non-viable pregnancy. No matter how much you try to reduce your risks, it may still occur. It's also common to grieve over this loss. You can learn more about this process in "Common Miscarriage Questions You're Afraid To Ask" and our post on the emotional effects of miscarriages.
If you're in the Gulf South, we encourage you to reach out to us at The Fertility Institute of New Orleans for more information about how we can help you manage endometriosis. With active management and monitoring, you can have a healthy pregnancy.