The 4 Stages of Endometriosis

What is Endometriosis?

In women who suffer from endometriosis, tissues similar to endometrial linings are found outside the uterus and in other parts of the body. The endometrial tissue normally lines the uterus and is what peels off and causes bleeding during menstruation.

Because of this, endometriosis is characterized by abnormally heavy and painful periods, severe abdominal cramps, pain during sex or dyspareunia, and pelvic or uterus pain. It is a reproductive disorder affecting 176 million women worldwide and is the leading cause of infertility and chronic pelvic pain.

Endometriosis is also linked to other health conditions such as fibroids, certain autoimmune diseases, interstitial cystitis, adenomyosis, and even some forms of cancer.

4 Stages of Endometriosis

There are four different stages of endometriosis according to severity. These are described in the following list.

  • STAGE 1 (Minimal)

The first and least severe stage is called minimal endometriosis. This is characterized by shallow, superficial endometrial implants or small lesions or wounds. It can be mistaken for ovarian cancer or cysts.

These implants appear like small, flat flecks or patches on the pelvic floor or surface. They can cause inflammation and irritation in the pelvic cavity as well as the surrounding tissues, leading to the development of adhesions.

Adhesions are bands of internal scar tissues. These adhesions bind to organs or tissues are normally mobile and lead to organ dysfunction and pain.

  • STAGE 2 (Mild)

The next stage of endometriosis involves all the characteristics of the first stage, but this time, the symptoms are more aggressive. Most women diagnosed with endometriosis have the first or second stages.

In mild endometriosis, the fibrous adhesions grow in size and intensity. Black spots also appear on them. The increased severity amplifies pelvic pain and likely causes irritation during ovulation.

During this stage, the area between the rectum and uterus, called the recto-uterine pouch, also becomes affected and covered by lesions. Shallow implants and light lesions may also develop on the pelvic lining and one of the ovaries.

  • STAGE 3 (Moderate)

As endometriosis progresses into the moderate stage, endometriomas or also known as chocolate cysts begin to develop. These cysts acquire their name due to the darkening and browning of the blood contained inside them after some time.

Once a cyst ruptures, its content may cause inflammation in
the pelvic region and extreme abdominal pain will be experienced.

Infection and inflammation then lead to the formation of more lesions or adhesions. These adhesions also grow in size and increase in number as more and larger endometriomas develop.

  • STAGE 4 (Severe)

The final and most severe stage of endometriosis is associated with a very large number and size of cysts and adhesions. Endometriomas may grow to a size as big as a grapefruit during this stage.

Surgery may be required to remove and extract endometriomas that have grown more than 2 cm in diameter.

Most of the cysts in this stage are located in the rectum and the back wall of the uterus. Because of this, women suffering from stage 4 or severe endometriosis may experience digestive difficulties which may include constipation, nausea, vomiting, painful bowel movements, and abdominal pain. There is also a higher risk of infertility or likelihood to experience a difficult pregnancy.

This stage involves deep implants on the ovaries and the pelvic lining. Lesions may have also spread on the bowels and fallopian tubes.

Endometriosis is a painful disease that affects many women around the world. It has four stages that correspond to the severity of the symptoms. Because of the effects of endometriosis, a woman may experience debilitating pain and is more likely to be infertile.



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