Many Australian women say they have ever been told that endometriosis can be treated and even cured simply by "having a baby," a message that matches that of women from other countries and comes from several sources: from self-help books to online forums, including medical professionals.
It seems that the idea of pregnancy as a natural cure for endometriosis dates back to the early twentieth century. However, in the 50s and 60s pregnancy was still used as a treatment for endometriosis and the evidence came from case reports of women whose endometriosis improved during pregnancy, but these types of reports are usually isolated cases that they do not necessarily represent what happens to most women.
Treating endometriosis with a pregnancy does not appear in current international recommendations for the treatment of endometriosis. Nor is it mentioned as a possible treatment according to Australian specialists in pelvic pain and is classified as "myth" by recognized pages on endometriosis.
Endometriosis and the lack of a cure
Endometriosis occurs when endometrial tissue forms outside the uterus and it is difficult to know exactly how many women are affected by this disease, although only in Australia it is estimated that one in ten women are affected during their reproductive life.
Although severe menstrual pain is a common symptom of endometriosis, it is much more than "a very painful rule." Virtually all areas in a woman's life are negatively affected by this disease.
Current medical treatments are usually based on hormonal therapies and are not always effective. In addition, the side effects of many of the hormonal treatments are usually very annoying for women, causing them to abandon the treatment.
Undergoing an operation to eliminate the injuries caused by endometriosis is the most effective treatment today, but surgery is not an option for many women if we consider the cost and risks of any surgical procedure. Unfortunately, even the surgery is not always successful and About 50% of women return to symptoms five years later.
If we consider the situation of women worldwide, it seems that having children does reduce menstrual painBut the problem is that we do not know if these women suffer from endometriosis and this type of study cannot tell us for sure if pregnancy has been what has helped reduce menstrual cramps.
Pregnancy, pains and the brain
Women who suffer from endometriosis, as with other chronic diseases, have changes in the way their brains process pain. Nerves, especially those of the pelvis, are also more sensitive than those of women who do not have chronic pain. and the concept of "calming down" these incessant pain pathways is an important strategy for the treatment of chronic pains related to endometriosis. With the arrival of menstruation, these nerves become irritable and the pains increase.
One way to prevent pains from increasing is by interrupting menstruation and that is why many women who suffer from endometriosis receive hormonal contraceptives on an ongoing basis.
During pregnancy there is also an interruption of menstruation, hence the pain associated with endometriosis is reduced. It is also possible for a pregnancy to increase these pains because the pressure on the irritable nerves of the pelvis is increased. The problem is that there is not enough research to answer these questions.
After giving birth it is very likely that the pains return (in the case that they have decreased during pregnancy), something that occurs especially when women return to have the period in a normal way because there is no evidence that pregnancy reduces endometrial lesions or that it changes the way pain is processed over time. Both endometrial lesions and changes in pain processing are the main causes of endometriosis pain.
Should pregnancy be recommended as a treatment?
A pregnancy could help reduce the symptoms of endometriosis, but only temporarily. In addition, women suffering from endometriosis may feel upset and offended (something very justifiable) if they are recommended to have a baby as an option to treat endometriosis.
There are also additional risks because women suffering from endometriosis are more likely to suffer premature births, higher rates of C-sections and higher risks of abortion.
Having a child should not be a solution to treat the pain of endometriosis and that is why we have to give priority to understanding its causes, as well as finding effective treatments and even a possible cure.
Author: Mike Armor, postdoctoral researcher in women's health, NICM, Western Sydney University.
This article has originally been published in The Conversation. You can read the original article here.
Translated by Silvestre Urbón.
