‘Pregnancy cures endometriosis’ myth persists

‘Feeling invisible. Feeling irrelevant. Angry. Disappointed. Deflated. Seen as a baby-making oven instead of being seen as a person.’
 
That is the haunting experience of one woman who was told by her doctor that having a baby would cure her endometriosis.
 
‘It was a nightmare,’ she concluded.
 
But she is far from alone, with a new Australian study revealing more than half of all patients surveyed were told to fall pregnant or have a baby to manage or treat endometriosis.
 
Around 90% of the patients given this recommendation were told to do so by their healthcare professional, including gynaecologists and GPs, with 36% told it would cure their condition.
 
Participants said this had a range of serious and lifechanging impacts, including rushing major decisions, an erosion of trust with healthcare professionals, worsening mental health, and strained relationships.
 
Professor Louise Hull, a fertility expert from the University of Adelaide and the paper’s co-author, said although this advice is well-meaning, there are better ways of discussing fertility.
 
‘Pregnancy or having a baby isn’t a treatment for endometriosis and this advice from health professionals can have negative impacts on those who receive it,’ she said.
 
‘Many other women in this survey reported feeling too young to have a baby and felt stressed and pressured after being given this inappropriate, albeit well-intentioned advice.’
 
The Endometriosis Patient Experience Survey questioned 3347 women medically diagnosed with endometriosis, with more than two-thirds of those women living in Australia.
 
The report details the experiences of several women who felt pressured to have a baby, including one who was 13 years old, and others who were in high school or university.
 
‘I was 21, single and at uni so it simply wasn’t an option,’ said one respondent.
 
‘[I] brought forward plans to have a baby by several years, despite reservations of my fiancé. I felt quite stressed and that it was a race against time to conceive,’ said another.
 
In other cases, it led to patients bypassing their GP completely and missing out on vital healthcare.
 
‘I ignored it [the advice to get pregnant] and continued with my high school studies. But it likely led to me actively avoiding having to visit that GP,’ one woman said.
 
Women’s health GP Dr Rebecca South told newsGP that historically, endometriosis has not been understood, taught, or managed well, and that as a nation, ‘we need to do a lot better’.
 
‘Things that stop ovulation and stop periods do provide relief from the symptoms of endometriosis, and pregnancy does do that, but long term there’s no evidence that it cures endometriosis,’ she said.
 
‘Women are under lots of pressure trying to juggle career decisions, financial goals, and pregnancy, without taking into account even finding your partner or deciding to do it on your own.
 
‘But I do think we can initiate that conversation about, “What are your future plans? Do you think that a pregnancy is something you’d like in the future?”.’
 
Endometriosis diagnoses continue to skyrocket across Australia, with more than 40,000 endometriosis-related hospital admissions recorded between 2021 and 2022.
 
It is now among the top 20 most common reasons for hospitalisation for women and girls aged 15–44.
 
Dr South said an increasing number of patients are seeking out help for endometriosis, and advised fellow GPs that it is important to establish their treatment priorities, ranging from pregnancy or exercise.
 
‘Periods that significantly interfere with daily activities are not normal and need attention,’ she said.
 
‘We have been overly reliant on the idea that there must be a laparoscopy procedure to make a diagnosis and that’s one of the reasons why there’s been this significant delay in women feeling they’re actually given a diagnosis of endometriosis.
 
‘You do not need a laparoscopy to make a working diagnosis of endometriosis, to start medical management, involve other health practitioners such as pelvic physiotherapy or a dietitian.’
 
The study ultimately recommended healthcare professionals strive for ‘patient-centric conversations’ when devising endometriosis care plans, where patients take an active role in their care.
 
‘This empowers patients in their medical decision making and results in tailored age-and-situation-appropriate advice,’ researchers said.
 
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