Getting pregnant with endometriosis

Endometriosis is characterised by the presence of tissue similar to the endometrium outside the uterus.

The endometrium is the lining that covers the inner wall of the uterus. Its role is to thicken during the menstrual cycle, under the influence of oestrogens, in order to receive a potential embryo.
 

This endometrium, in the absence of fertilisation, breaks down and is shed, causing what we know as "periods".
 

Tissue similar to the endometrium can then be found on the fallopian tubes, ovaries, bladder, intestines, and in the most severe cases, even the kidneys, brain and lungs.
 

Endometriosis is sometimes accompanied by adenomyosis, which is characterised by the presence of endometrium within the uterus.
 

The non-physiological presence of these tissues outside the uterine cavity leads to various complications. Indeed, due to their similarity to endometrial tissue, they respond in the same way under the influence of hormones during the menstrual cycle.
 

These tissues, located outside the uterus, bleed during the menstrual phase but do not allow the blood to drain away properly. This can give rise to adhesions, pain and inflammation.

Research on the subject has not yet made it possible to identify the causes of this condition.

Several avenues are nonetheless put forward

Endometriosis is complex and does not manifest in the same way in all women.

Its symptoms vary in terms of location, effects and even intensity. They also evolve over time.
 

The complexity of this condition also stems from the fact that the intensity of symptoms is not proportional to the stage of the disease, and is therefore not representative of its extent.

The most common symptoms are:
- Intense pelvic pain
- Heavy periods
- Digestive issues
- Exhaustion
- Infertility
- Pain during sexual intercourse
- Pain during urination
- Pain during bowel movements
Endometriosis can also be asymptomatic, which does not mean it has less of an impact on the chances of conception. In such cases, it is often discovered during a fertility assessment. It is particularly common to observe a low ovarian reserve.

Among women with endometriosis, around 40% experience fertility problems and will find it difficult to conceive. Knowing that you have the condition makes it possible to adapt your care and avoid recourse to a IVF journey, to IVF...
 

Indeed, endometriosis is at the root of several issues that affect the chances of achieving a positive pregnancy test.
 

For a pregnancy to proceed well, several stages are required: ovulation, the unobstructed movement of the egg along the fallopian tube to the uterus, fertilisation, implantation of the fertilised egg, and good-quality sperm.
 

Endometriosis can complicate several of these stages.

Endometriosis is an "oestrogen-dependent" condition — endometrial cells are particularly sensitive to oestrogen, which promotes the growth of the disease. Furthermore, this excess of oestrogen contributes to a progesterone deficiency, which is the hormone responsible for implantation.
 

Endometriosis causes inflammation and irritation of the tissues, releasing biochemical factors that disrupt egg maturation. If the ovaries are the site of endometriosis deposits, cysts can form and directly interfere with egg maturation. Their contents consist of blood that cannot drain away. Because of their colour, they are known as "chocolate cysts".

It is also responsible for adhesions and anatomical lesions on the reproductive organs. These adhesions can cause mechanical blockages (such as obstruction of the fallopian tubes), which may hinder or even prevent the transport of the egg to the uterus.
 

The immune system's defensive response against endometriosis lesions can also prevent the fertilised egg from implanting in the uterus. Finally, a particular form of endometriosis affecting the uterine muscle, known as adenomyosis, can also disrupt the implantation of the fertilised egg in the uterus.
 

Following various surgical procedures, the reproductive organs can sometimes be affected. Medical treatments, particularly those aimed at putting the body into an artificial menopause, inherently increase the risk of achieving a negative pregnancy test.
 

Regardless of the severity of the condition, sexual intercourse can be very painful, further reducing the chances of conceiving.

To find out more, read our article endometriosis and pregnancy.

No medical treatment can cure endometriosis; it can only help relieve symptoms and slow the progression of the condition.

The most commonly proposed medical solutions are:

A cure is not possible; however, it is possible to considerably improve quality of life, relieve pain, and optimise the chances of pregnancy through natural and accessible techniques.

Step 1: Reducing inflammation to conceive with endometriosis

Inflammation is a normal and temporary reaction of the body in response to an external threat. It is, however, not normal for it to become "chronic".
 

In the case of endometriosis, bleeding outside the uterine cavity is a source of inflammation. The more endometrial cells spread, the more the inflammation propagates.
 

Reducing inflammation therefore helps both to relieve symptoms and pain, as well as to restore conditions favourable to conception.
 

Many factors contribute to this inflammation.
 

Factors to reduce
- the consumption of inflammatory foods (processed or industrial foods, dairy products, red meat, gluten, sugar, coffee, tea, chocolate, alcohol)
- stress
- Toxins (tobacco, endocrine disruptors, additives, preservatives, pesticides)
Furthermore, it is strongly advisable to adopt a diet that nourishes your body with goodness to help it combat this inflammation and function optimally.

Allies for conceiving
- Foods rich in antioxidants and nutrients (vegetables, fruits, nuts and seeds)
- Organic foods (containing fewer toxins and more nutrients)
- Foods rich in omega 3 (linseed or camelina oil, sardines, avocados). If needed, you can take a food supplement for pregnant women rich in omega 3, like Baby Bump
- "anti-inflammatory" spices (turmeric or cinnamon)
- plants thanks to their "anti-inflammatory" properties and their action on healthy endometrial development (nettle or yarrow).

These habits thus contribute to relieving symptoms and fostering conditions favourable to conception. They can also help to reduce excessive reliance on NSAIDs, which relieve pain but can, over time, put strain on your liver.

Step 2: Reducing stress to support pregnancy
 

Stress, due to its inflammatory nature, is one of the aggravating factors of endometriosis. Furthermore, it plays a significant role in the chances of conception.
 

Learning to manage your emotions more effectively therefore helps both to relieve pain and symptoms, as well as to optimise your chances of conceiving.
 

Several techniques can help you manage them better so that you can live more serenely:
- Identify and reduce your sources of stress
- Cultivate positive thoughts (all your positive thoughts create a virtuous cycle and generate further positive thoughts and feelings).
- Practise sophrology exercises (breathing exercises, muscle relaxation and visualisation are particularly effective at reducing your stress and negative emotions, thanks to their physiological effects on your parasympathetic nervous system and on the interdependence between your physical and psychological tensions)
- Try Bach Flower Remedies (the "rescue" blend contributes to a sense of calm)
- Practise gentle physical activity (movement helps to optimise psychological and emotional wellbeing)

Step 3: Restoring hormonal balance before trying for a baby
 

Endometriosis is an "oestrogen-dependent" condition: endometrial cells are particularly sensitive to oestrogens, which encourages the growth of the disease.
 

Excess oestrogen gives rise to several issues:
- Deficiencies in certain nutrients that may increase symptoms and harm fertility. It is possible for this purpose to take a food supplement to conceive suited. We are thinking in particular of vitamin during pregnancy which is B9, also to be taken when trying for a baby.
- Progesterone deficiency (closely linked to oestrogen levels and whose deficiency is encouraged by inflammation)
It is for this reason that prescribed treatments often aim to reduce or even suppress oestrogen production, thereby triggering an artificial menopause.
 

Naturally, the aim is not to prevent oestrogen production, but to avoid excess.
 

In order to relieve symptoms and support the chances of conception, it is important to restore hormonal balance.
 

To do this, the first steps to take will be:
- Reduce factors of hormonal imbalance, in particular by managing stress and reducing sugar intake.
- Optimise progesterone levels to support endometrial development favourable to implantation (certain plants such as chaste tree, lady's mantle or evening primrose may be of interest, with the advice of a professional*).
- Reduce excess oestrogen by limiting your exposure to endocrine disruptors that mimic oestrogens, avoiding foods rich in phyto-oestrogens, plastic packaging, processed foods…
- Support the liver. The liver plays a central role in hormonal balance as it synthesises hormones and eliminates their excess (by adopting the most natural diet possible, known as "hypo-toxic", by staying well hydrated, and by regularly applying a heat pad to the liver to help it regenerate). 

Step 4: Relieving pain to conceive with endometriosis
 

Endometriosis is a condition that causes intense pain due to adhesions and inflammation.
 

This pain affects both your energy and your sleep, as well as your psychological and emotional state. All of these factors also have an impact on your chances of conception.
 

In order to restore wellbeing and optimise your chances of pregnancy, several habits are worth adopting:
- Reduce inflammation
- Encourage relaxation in order to reduce stress, which is a source of inflammation as well as tension that can prove painful.
- Massage the abdomen during a flare-up ofendobelly with vegetable oil and essential oil of exotic basil or tarragon (with the advice of a professional*). Apply a warm heat pad to the painful areas. 
- Practise gentle physical activity regularly. Movement encourages the release of feel-good hormones as well as better circulation of blood, nutrients and oxygen, allowing tissues to be less congested.

Step 5: Reducing fatigue and lack of energy to conceive with endometriosis

Endometriosis, due to heavy periods, pain, and the possible deficiency in certain nutrients caused by excess oestrogen, can have a particularly significant impact on vitality.

This is clearly a barrier to wellbeing but also a factor in infertility.
 

To address this, there are several natural solutions:
- A remineralising diet rich in vitamins and minerals (vegetables, fruits, wholegrains, legumes…).
- Optimal iron levels (white meat, fish, legumes, wholegrains, spirulina).
- Quality rest (rest whenever possible and whenever the need arises).
- Adequate hydration.
- A course of Quinton water (rich in minerals, particularly restorative).
 

To find out more, read our article endometriosis and fatigue.

And on top of that, all this advice is also good for your overall health!

It is possible to become pregnant with endometriosis by following a few tips, which will also help you maximise your health and wellbeing! To find out more about endometriosis, see our other article: Living with endometriosis.

*Please do not self-supplement or use essential oils without advice from a doctor, pharmacist or naturopath trained in aromatherapy. It is also preferable to work with a naturopath for personalised support. This advice does not replace the opinion of a doctor or any ongoing medical treatment. Do not hesitate to speak to your gynaecologist.