Endometriosis is a condition in which the tissue that normally lines the uterus begins to grow in other areas. The most common symptoms associated with it are pelvic pain, heavy menstruation, bleeding between periods, and pain during sex or when using the bathroom. Interestingly, the degree of discomfort a woman feels isn't an indicator of the stage of the endometriosis. Women with severe endometriosis can experience few or no symptoms, while women with mild endometriosis may experience debilitating pain.
Doctors track the progression of this condition in stages. Stage I is considered minimal, stage II is considered mild, stage III is moderate, and stage IV is considered severe. However, most of the women who have endometriosis don't progress past stage I or II.
Stage I and II
In stage I endometriosis, tiny bits of tissue begin to develop on the ovaries or the peritoneum, which is a membrane that lines the abdominal cavity and the pelvic organs. The bits of tissue are called implants. In some cases, implants may also be found on the surface of the woman's pelvis as well.
In stage II endometriosis, implants begin to penetrate further into the peritoneum and may also begin to appear superficially on both ovaries.
Stage III
In stage III, the condition will begin to permeate across the entirety of the peritoneum. Endometrial tissue may also be found in the "cul de sac," which is the area directly behind the uterus. Growths also start to penetrate the insides of one or both of the ovaries. Depending on the individual, the endometrial tissue in stage III can be filmy or dense.
Stage IV
Stage IV is considered severe endometriosis. In this stage, the cul de sac is completely obliterated or covered in endometrial tissue. Additionally, the ovaries become completely invaded by dense growths. At least one fallopian tube must also contain dense adhesions for a stage IV classification. By this point, a woman is most likely infertile because endometrial tissue can prevent the egg from entering the fallopian tube when it leaves the ovaries.
In Stage IV endometriosis, the ovaries are also invaded with chocolate cysts, which get their name because they are filled with blood that has turned a dark, red-brown over time. These cysts can be pea-sized or larger than a baseball. If left untreated, there is a risk that these cysts will rupture, which can lead to further complications.
