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Stages of Endometriosis

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  • The American Society of Reproductive Medicine classified endometriosis into four stages: minimal, mild, moderate and severe
  • A doctor can determine the stage of a woman’s endometriosis by checking factors like affected body parts, depth and reach of endometrial tissue and presence and severity of pelvic adhesions
  • Women with stage 4 endometriosis can have blocked fallopian tubes and damaged ovaries, making it difficult for them to conceive

To accurately diagnose endometriosis, doctors use the four-stage system specified by the American Society of Reproductive Medicine.1 According to WebMD, factors that differentiate these stages from each other include the body parts affected, how far the endometrium tissue has abnormally grown and its depth.2

Minimal Endometriosis (Stage 1)

It’s characterized by the presence of small lesions and endometrial implants on your organs or on tissue found on the abdomen or pelvis. No scar tissue is detected at this stage yet.3 EMedicineHealth adds that the tissue implants are often isolated and do not show adhesions4 (abnormal tissues that are sticky and adhere organs to each other).5

Mild Endometriosis (Stage 2)

Women with stage 2 endometriosis have several mild lesions,6 and endometrial implants that are less than 5 centimeters overall and are deeper in the tissue. While adhesions don’t show up at this stage,7 scar tissue may already appear.8

Moderate Endometriosis (Stage 3)

WebMD notes that this stage is characterized by the development of deep implants, small cysts on an ovary or the appearance of both.9 At this point, lesions may be located deeper, and adhesions10 are seen around your fallopian tubes and ovaries.11

Severe Endometriosis (Stage 4)

Considered the most widespread stage, this signifies the presence of deep implants, thick adhesions12 and ovarian cysts.13

The American College of Obstetricians and Gynecologists highlights that women with stage 4 endometriosis can have blocked fallopian tubes and damaged ovaries.14 Women with this condition may find it difficult to get pregnant and often require additional procedures so they can conceive a child.15

Factors to Determine the Stage of Endometriosis

Johns Hopkins Medicine discusses that there are other specific factors that may help your doctor determine the stage of endometriosis you’re currently dealing with. They include:16

  • Abnormal tissue’s location, quantity and size
  • Possible presence of abnormal endometrial tissue in the pelvic cavity
  • Severity of pelvic adhesions
  • Presence of fallopian tube blockage

The organization also points out that factors like discomfort, infertility risk or current indicators won’t exactly show your doctor the particular stage of endometriosis you’re struggling with. This is because there are cases wherein women with Stage 1 endometriosis struggle with intense pain, but women with stage 4 endometriosis do not notice any endometriosis symptoms.17


Endometriosis: Introduction

What Is Endometriosis?

Endometriosis Symptoms

Endometriosis Causes

Is Endometriosis Hereditary?

Endometriosis Stages

Endometriosis Treatment

Endometriosis in Pregnancy

Endometriosis vs Adenomyosis

Endometriosis Prevention

Endometriosis Diet

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