Endometriosis is a chronic inflammatory disease in which the cells forming the inner lining of uterus are deposited in other areas, such as the fallopian tubes, the ovaries, the pelvis or the back of the uterus. This displacement can cause anatomical distortions and severe pain. According to the National Institutes for Health, more than 5.5 million women in the United States suffer from endometriosis. Endometriosis symptoms during pregnancy can range from mild to severe.
For most patients suffering from endometriosis, pregnancy is a time of relief from symptoms, especially after the first weeks of pregnancy are over. This is mainly caused by heightened levels of progesterone brought on by the pregnancy. A healthy woman produces 20 mg of progesterone per day during a regular menstrual cycle; however, the peak progesterone level during the pregnancy is 400 mg per day. This hormone is produced in several locations including the placenta.
Progesterone prevents shedding of the uterus lining and slows down the growth of the endometrial cells. It also prevents the ovaries from ovulating. Aside from progesterone, the lack of menstruation during pregnancy can also diminish the symptoms experienced due to endometriosis since the displaced endometrial cells are no longer bleeding in incorrect places.
Dr. SE. Bulun and colleagues from the Feinberg School of Medicine at Northwestern University showed in a study published in the March 2006 issue of “Molecular Cell Endocrinology” that some endometriosis patients do not respond to progesterone and have built resistance to progesterone, however. According to these doctors, the resistance to progesterone experienced by patients suffering from endometriosis may be related to an overall reduction in the levels of receptors that interact with the hormone. In these patients, the heightened levels of progesterone during the pregnancy may not bring relief from any symptoms caused by endometriosis.
For some women, symptoms of endometriosis are more severe during the pregnancy. There are several reasons why this might happen. The rapidly growing uterus might be stretching the endometriosis scars and cysts. This can be very painful.
According to the RNceus.com, toward the end of a pregnancy, a woman produces more estrogen in one day than a non-pregnant woman produces in three years. These heightened levels of estrogen may also make the endometrial cells grow faster and worsen the symptoms. Just like progesterone, estrogen is also produced by the placenta throughout the pregnancy.
There are many endometriosis symptoms that have little to do with hormonal changes, the growing fetus, or the lack of menstruation. These symptoms are not affected by the pregnancy in significant ways. For example, if a patient had scars or cysts before becoming pregnant, they are likely to continue experiencing pain even after the onset of pregnancy. Moreover, if a patient feels pain while experiencing a shaking movement such as when traveling by train, becoming pregnant is not likely to alleviate this discomfort.