Endometriosis is a chronic condition that affects approximately one in ten women of reproductive age. It occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterus — commonly on the ovaries, fallopian tubes, or within the pelvic cavity. While it’s often associated with painful periods and fertility challenges, endometriosis can also affect women during pregnancy — though in very different ways.
Australian conservationist and television personality Bindi Irwin brought global attention to the condition when she publicly shared her endometriosis journey in 2023. After years of fatigue, pain, and misdiagnoses, she underwent surgery and discovered more than 37 lesions, including one embedded in her appendix. The experience was life changing. “Validation for years of pain is indescribable,” she shared in a heartfelt post, highlighting the emotional toll of being dismissed by healthcare providers. Fortunately, after treatment, Bindi was able to conceive her daughter, Grace, and has spoken candidly about the hope and healing that came with motherhood.
Her story is not only one of resilience but also a reminder that many women silently battle endometriosis while trying to create life. If you're planning for pregnancy or already expecting with endometriosis, this guide offers evidence-based support, practical advice, and encouragement for the path ahead.
"...many women silently battle endometriosis while trying to create life."
Understanding Endometriosis
Endometriosis presents differently in every woman. Common symptoms include:
- Painful periods
- Abdominal, lower back, and pelvic pain
- Pain during intercourse
- Fatigue
- Fertility issues
- Bladder and bowel problems
- Bloating
- Anxiety and depression
Diagnosis is often delayed, as symptoms can mimic other conditions. Laparoscopy (keyhole surgery) is the gold standard for diagnosis, though ultrasound and symptom-based assessments can also provide valuable insights.
Endometriosis is typically classified into four stages—minimal (stage one), mild (stage two), moderate (stage three), and severe (stage four)—based on the location, extent, and depth of endometrial tissue seen during surgery.
If you’ve been diagnosed with endometriosis, understanding how your body may respond during conception and pregnancy can help you prepare.
"The most profound impact of endometriosis is often felt when trying to conceive. Reassuringly, the majority of women with endometriosis will be able to conceive naturally."
Endometriosis, Fertility and Conception
The most profound impact of endometriosis is often felt when trying to conceive. Reassuringly, the majority of women with endometriosis will be able to conceive naturally. However, around one in three experience fertility issues. Endometriosis can affect fertility through:
- Inflammation – Chronic pelvic inflammation can impair ovulation, egg quality, and embryo implantation.
- Structural issues – Adhesions and scar tissue may cause organs to stick together or block fallopian tubes, making conception more difficult.
- Distorted anatomy – In severe cases, normal pelvic anatomy may be altered, complicating the conception process.
Given these challenges, it’s understandable that many women with endometriosis feel anxious about their fertility. The good news is that there are lots of options:
- Women with mild endometriosis often conceive naturally, sometimes with time and monitoring.
- Women with moderate to severe endometriosis may require additional support through fertility treatments such as ovulation induction, intrauterine insemination (IUI), or in vitro fertilisation (IVF).
- Laparoscopic surgery can sometimes improve fertility by removing lesions and restoring pelvic anatomy.
If you're trying to conceive and suspect endometriosis, early intervention can make a real difference. A fertility specialist familiar with endometriosis is key to personalised and effective care.
"...with the right care and support, many women go on to experience healthy and fulfilling pregnancies."
Endometriosis and Pregnancy
The outdated belief that pregnancy is a “treatment” or “cure” for endometriosis has been firmly debunked. While pregnancy does not cure the condition, it can influence how endometriosis presents. For many women, pregnancy brings temporary relief from endometriosis symptoms. Hormonal shifts—especially increased progesterone—can suppress inflammation and reduce lesion activity.
This often results in fewer flare-ups and less pain. However, some women may still experience discomfort, especially in the first trimester, as the growing uterus places pressure on existing adhesions and scar tissue.
Research into endometriosis and pregnancy shows mixed results. While many endometriosis pregnancies progress normally, some studies suggest slightly increased risks, including:
- Miscarriage (first trimester)
- Placenta previa (when the placenta covers the cervix)
- Preterm birth
- Caesarean delivery
While these risks may sound alarming, all pregnancies carry some level of risk. What matters most is staying informed, attending regular prenatal appointments, and maintaining open communication with your healthcare team.
After birth, endometriosis may remain dormant for a time. Some women find their symptoms improve or even disappear. However, for many, symptoms return once breastfeeding stops and menstruation resumes. Ongoing medical care remains important after childbirth.
"While pregnancy does not cure the condition, it can influence how endometriosis presents. For many women, pregnancy brings temporary relief from endometriosis symptoms."
Coping Strategies for Each Stage
Whether you're trying to conceive or are currently pregnant, managing endometriosis involves both physical and emotional care.
1. Emotional Care
Conception and pregnancy can be emotionally taxing, especially when paired with a chronic condition. Here are a few ways to support your mental health:
- Relaxation techniques – Deep breathing, guided meditation, and progressive muscle relaxation help reduce stress.
- Therapeutic support – Anxiety and fear are common; consider seeing a psychologist or clinician specialising in perinatal mental health.
- Connecting with others – Online or in-person support groups can offer encouragement and shared experiences.
- Journalling – Tracking your journey can help with processing and self-reflection.
2. Physical Care
While Trying to Conceive:
- Track your cycle – Use apps or fertility monitors to identify ovulation patterns.
- Manage pain holistically – Heat packs, yoga, pelvic physiotherapy, and anti-inflammatory diets can provide relief.
- See a fertility-aware gynaecologist – Working with someone who understands the endometriosis-conception link is invaluable.
During Pregnancy:
- Listen to your body – Rest as needed and avoid overexertion.
- Gentle movement – Prenatal yoga, light walking, and stretching can aid circulation and ease discomfort.
- Heat therapy – A warm (not hot) compress can soothe cramps.
- Hydration and diet – Drinking water and eating anti-inflammatory foods (like leafy greens, berries, and omega-3-rich fish) supports overall health.
- Pelvic floor physiotherapy – Can assist with pain and body alignment.
- Sleep hygiene and positioning – A pregnancy pillow may help alleviate discomfort.
- Prenatal massage – May ease muscle tension and improve circulation.
- Regular check-ups – Particularly with obstetricians experienced in endometriosis.
3. Building a Support System
Because endometriosis is often invisible, it’s vital to communicate your needs clearly.
Communicate with Healthcare Providers:
- Share your endometriosis history, even if symptoms are currently mild.
- Bring a list of questions or concerns to each appointment.
- Request referrals to relevant specialists when needed.
Build a Personal Support Network:
- Explain your condition to family and friends in simple terms — many won’t have heard of it.
- If you have a partner, encourage them to attend appointments and learn alongside you.
- Don’t be afraid to ask for help — whether it’s practical, emotional, or logistical.
- Organisations like Gidget Foundation Australia and Endometriosis Australia offer resources and support.
Endometriosis can affect women during both the conception phase and pregnancy—but in different ways. Fertility is often the most impacted, due to inflammation, structural issues, and pelvic changes. Yet with the right care and support, many women go on to experience healthy and fulfilling pregnancies.
Whether you’re trying to conceive or already pregnant, honour your body’s resilience. Prioritise your physical and emotional wellbeing, advocate for your needs, surround yourself with a strong, informed support system, and extend to yourself the same care and grace you would offer to a friend on this journey.
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