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BackgroundTransitioning to parenthood is stressful for relationships. Women with endometriosis face several health challenges, which may further strain their relationships when they become parents. However, it remains uncertain whether this transition compromises their relationships beyond what is observed in the general population.ObjectivesTo compare the risk of relationship dissolution, relationship satisfaction, anxiety, and depression between women with and without endometriosis.DesignLongitudinal population-based cohort study including 99,531 singleton pregnancies to 84,642 women.Methods1,476 pregnancies to women with self-reported endometriosis were compared to 98,064 pregnancies in women without endometriosis, using data from the Norwegian Mother, Father and Child Cohort Study (1999-2017). Women were followed up to 8 years postpartum. Adjusted risk ratios (aRR) with 95 % confidence intervals (CI) were calculated by multivariable log-binomial regression, adjusting for age, education and income.ResultsWe observed increasing trends of mothers not living with the biological father (12% at 8 years postpartum) and of relationship dissatisfaction (4.7% at 5 years postpartum), without significant differences in the risk of relationship dissolution (10% vs. 12%) or dissatisfaction (4.8% vs. 4.7%) between women with and without endometriosis. However, women with endometriosis had significantly higher risks of anxiety (aRR: 1.30, 95% CI: 1.06-1.58) and depression (aRR: 1.32, 95% CI: 1.16-1.50) at 8 years postpartum.ConclusionMothers with endometriosis did not exhibit increased relationship dissolution or dissatisfaction compared to those without, despite experiencing a greater mental health burden. While these findings are encouraging, they should not trivialize the potential impact of endometriosis on quality of life.