Endometriosis and pregnancy: what to expect

Q: Will endometriosis symptoms definitely improve during pregnancy?

You may well find symptoms ease in pregnancy, as the change in your hormones pauses your cycle and settles the tissue that usually flares. It is not guaranteed though. You might find pain carries on, particularly in the early months. If your symptoms feel significant, speak to your midwife or GP.

Q: Does pregnancy cure endometriosis?

No. Any relief you get during pregnancy is usually temporary. Symptoms tend to return after you give birth and once breastfeeding has stopped, when your cycle starts again and the tissue becomes active. If you want to look at longer-term management after pregnancy, your GP or specialist can help.

Q: Should you tell your midwife you have endometriosis?

Yes. Telling your midwife and GP at the start of pregnancy means your care team has the full picture. Routine antenatal care will apply in most cases, and your history is still useful context. If something concerns you at any point, raise it at your next appointment, or sooner if symptoms are acute.

Q: What are the signs of an ectopic pregnancy to watch for?

Sharp one-sided pelvic pain, pain at the tip of your shoulder, vaginal bleeding, and feeling faint or unwell in early pregnancy can all be signs of an ectopic pregnancy. This is a medical emergency. If you notice any of these, call 999 or go to your nearest emergency department straight away.

Q: Can you use hormonal endometriosis treatments while trying to conceive?

Hormonal treatments for endometriosis are not suitable while you are actively trying to conceive. If you are using one and want to try for a pregnancy, speak to your GP or specialist before changing anything. They can advise on the right approach for your circumstances.

Pregnant woman resting in bed, with hands behind head.

The information in this article is for general informational purposes only and does not substitute for professional medical or dietary advice, particularly during pregnancy. If you are outside the UK, please consult your local doctor, midwife, or healthcare provider for guidance that reflects your country's recommendations.

If you live with endometriosis, you will know the kind of pain that can arrive alongside your cycle. Some days it sits low and dull, other days it is sharp enough to stop you in your tracks. One thing you may notice is that this pain often eases during pregnancy. Understanding why that happens, and what to keep an eye on in the months ahead, is a useful part of knowing what pregnancy can mean for you.

Why symptoms can improve during pregnancy

The relief many notice in pregnancy comes down to a shift in your hormones. With endometriosis, tissue similar to the lining of your womb grows outside it. Through your usual cycle, that tissue responds to the same hormonal signals as the womb lining, which brings inflammation and pain. Pregnancy can change that picture. Your monthly cycle pauses, and without that regular hormonal push, the tissue is no longer stirred up in the same way. For many, that means a noticeable drop in pain and other symptoms.²

Why symptoms don't always improve

Not everyone gets this relief, though. Some people find their endometriosis symptoms stay the same or even get worse during pregnancy, particularly in cases of deep infiltrating endometriosis. As the growing uterus stretches and shifts surrounding tissue, it can pull on or irritate areas affected by endometriosis, causing pain. Hormonal changes in pregnancy, particularly the rise in estrogen in early pregnancy before progesterone fully dominates, may also stimulate endometrial tissue in some people before the suppressive effects take hold. Research suggests this happens in a meaningful minority of cases, so if your pain doesn't ease up or starts getting worse, that doesn't mean anything is wrong with your pregnancy.¹

Pregnancy is not a cure for endometriosis, so it helps to hold the relief in context. Symptoms usually return after you give birth and once breastfeeding has stopped, when your cycle starts up again and the tissue becomes active once more. If you are hoping for relief that lasts, it is worth talking with your GP or specialist about how to manage things after pregnancy.³

Your experience may look different. In the early months especially, you might find the pain carries on, or feels stronger rather than easing. This is less common, though it does happen. If you are dealing with significant pain at any point in pregnancy, let your midwife or GP know.⁴

Pregnancy complications linked to endometriosis

Having endometriosis can raise the chance of certain pregnancy complications, including preterm birth, miscarriage, and ectopic pregnancy. These are not set outcomes, and many pregnancies with endometriosis go smoothly. Knowing where the risks sit means you can have clearer conversations with your care team.⁵

Pregnant woman in blue robe and white bra showing her belly.

Ectopic pregnancy: recognising the signs

An ectopic pregnancy happens when a fertilised egg implants outside the womb, most often in a fallopian tube. With endometriosis, the chance of this is higher than usual. An ectopic pregnancy is a medical emergency. If you have a positive pregnancy test and notice sharp one-sided pelvic pain, pain at the tip of your shoulder, vaginal bleeding, or you feel faint or unwell, get urgent help straight away. Call 999 or go to your nearest emergency department.⁶

What your antenatal care is likely to look like

Right now, there are no national guidelines that call for extra monitoring in pregnancy purely because you have endometriosis. Your care will usually follow the standard antenatal path, unless a specific complication comes up. Research into how endometriosis affects pregnancy is ongoing, so this guidance may change over time.⁷

Your history still matters here. Tell your midwife and GP that you have endometriosis at the start of your pregnancy, if they do not already know. That information helps your care team watch the right things and respond if anything changes. If something concerns you at any point, raise it, and ask for a referral to a specialist if you feel that would help.⁸

Planning a pregnancy with endometriosis

If you are trying to conceive, how you manage your endometriosis needs to factor in fertility. The hormonal treatments often used for endometriosis are not suitable while you are actively trying to get pregnant. Talk to your GP or specialist before you change anything, as stopping or adjusting medication is something to do with their guidance.⁹

When fertility is the priority, a care plan that draws on more than one team, sometimes including a fertility specialist, can help make sure this is built in. If you have endometriosis and are finding it hard to conceive, or you have questions about how it might affect your chances, your GP is the right place to start. They can refer you to a specialist who fits your situation.¹⁰

Frequently Asked Questions

Will endometriosis symptoms definitely improve during pregnancy?

Does pregnancy cure endometriosis?

Should you tell your midwife you have endometriosis?

What are the signs of an ectopic pregnancy to watch for?

Can you use hormonal endometriosis treatments while trying to conceive?

Sources

[1] What You Should Know About Endometriosis During Pregnancy

As the growing uterus stretches and shifts surrounding tissue, it can pull on or irritate areas affected by endometriosis
[2] Endometriosis and pregnancy

Pregnancy often leads to a temporary improvement in endometriosis symptoms because the hormonal environment of pregnancy suppresses the menstrual cycle, and endometrial-like tissue is no longer activated in the same way.
[3] Endometriosis and pregnancy

Symptoms typically return after giving birth and once breastfeeding has stopped, when the menstrual cycle resumes and the endometrial-like tissue is reactivated.
[4] Endometriosis, fertility and pregnancy

For some, particularly in the early months of pregnancy, pain may continue or feel more intense. This is not the most common picture, but it does happen.
[5] The impact of endometriosis on pregnancy

Research suggests that having endometriosis is associated with a higher risk of certain pregnancy complications, including preterm birth, miscarriage, and ectopic pregnancy.
[6] Endometriosis, fertility and pregnancy

An ectopic pregnancy occurs when a fertilised egg implants outside the womb, and evidence indicates that the risk is significantly higher in those with endometriosis.
[7] The impact of endometriosis on pregnancy

At the time of writing, there are no specific national guidelines recommending additional monitoring during pregnancy solely because of an endometriosis diagnosis. Care will typically follow standard antenatal pathways unless a specific complication arises. Research is ongoing.
[8] Endometriosis - NHS Essex ICB

It is important to speak to a GP or specialist if you have endometriosis and are concerned about its impact on your daily life or fertility.
[9] Endometriosis: diagnosis and management Visual summary

Hormonal treatments for endometriosis are not suitable for those who are actively trying to conceive.
[10] Endometriosis: diagnosis and management Visual summary

When fertility is a priority, a multidisciplinary approach including input from a fertility specialist can help ensure this is reflected in the management plan.