Types and Stages Of Endometriosis

Woman researching on a laptop about the types and stages of endometriosis As with many health conditions, endometriosis has various stages of severity. Here at Maiden Lane Medical, with locations throughout New York City, our expert gynecologists offer expert diagnosis, evaluation, and treatment of endometriosis.

Understanding your condition is critical to delivering the best treatment to relieve your symptoms and restore your reproductive health. 

What Are The Different Endometriosis Stages?

There are four stages of endometriosis identified by the location, amount, depth, and size of the endometrial tissue. The stages include:

Stage 1

Minimal with few superficial growths

Stage 2

Mild with slightly deeper growths and filmy adhesions

Stage 3

Moderate with many deep growths, some small ovarian cysts, and dense adhesions

Stage 4

Severe with many deep infiltrating growths, large ovarian cysts, very dense adhesions, and multiple organs glued to each other

Other factors that help identify the stage of your condition include how the disease affects your pelvic structures, the extent of the adhesions, and whether or not your fallopian tubes are blocked with endometrial adhesions or scar tissue. 

Importantly, the symptoms of endometriosis don’t necessarily intensify with the stage. It’s possible for a woman with stage 1 or 2 endometriosis to have severe pain and other symptoms, while a stage 4 endometriosis patient may be asymptomatic. 

The Endometriosis Foundation of America recommends the use of categories instead of stages to describe the type of endometriosis present in the body. 

These categories offer more descriptive classifications of endometriosis over the stages as there are too many variations to provide adequate insight into each patient’s condition or needs. 

What Are The Categories Of Endometriosis?

The Endometriosis Foundation of America suggests four descriptive categories. The categories incorporate the necessity and complexity of treatment. For example, the more diffuse the endometrial adhesions, the more likely you are to need treatment, including surgery.

Category I: Peritoneal Endometriosis

This is the mildest form of visible disease. You have endometrium on your peritoneum — the membrane that lines your abdomen. 

Category II: Ovarian Endometriomas (Chocolate Cysts)

In this form of the condition, the disease has spread to your ovaries and is causing certain types of cysts to form. The cysts are problematic as they can cause pain and affect fertility.

Category III: Deep Infiltrating Endometriosis I (DIE I)

The first “deep” category occurs when endometriosis affects other organs and tissue in your pelvic area, such as the ovaries, fallopian tubes, uterus, bladder, and bowel. It can cause severe pain and organ dysfunction, such as a frozen pelvis where multiple organs are stuck or glued to each other. 

Category IV: Deep Infiltrating Endometriosis II (DIE II)

This severe form of the disease has adhesions that are so dense, patients are at high risk of needing surgery or experiencing infertility.

Often there is the presence of endometriosis inside and outside your pelvic area. For example, you may have endometrial adhesions or scar tissue on your bowel, appendix, diaphragm, lungs, and heart. In some cases, it can even grow on the brain.

Some groups may refer to category or stage 5 endometriosis when a patient has many dense endometrial adhesions on several organs and is at high risk of needing surgery or experiencing infertility. 

These categories can help your physician explain your condition and identify the best treatment.

How Do I Know What Stage Or Type Of Endometriosis I Have?

The Maiden Lane Medical gynecologists provide comprehensive testing to diagnose and assess your condition. They may suggest a diagnostic imaging study such as an ultrasound, MRI, or CT scan to examine your pelvic organs in detail. 

In some cases, your doctor may recommend laparoscopy, a minimally invasive surgery, to locate and remove endometrial adhesions and scar tissue. 

While you’re under anesthesia, your surgeon inserts a camera into your abdomen which sends images from inside your body to a monitor in the operating room that the surgeon can view

What Happens If Endometriosis Is Left Untreated? 

Woman suffering from Endometriosis pain in bed If you have suspected mild or asymptomatic endometriosis, your doctor may suggest waiting and watching. However, you may need treatment if your adhesions are causing pain, bowel blockages, or fertility problems.

Untreated, symptomatic endometriosis can lead to worsening generalized pain, pain with sex, organ dysfunction, or fertility problems — all of which can severely impact your quality of life. 

Are The Treatments For The Various Stages And Types Of Endometriosis Different? 

Yes, the health professionals at Maiden Lane Medical provide customized treatment plans for endometriosis. Depending on the results of your exams and tests, your gynecologist may recommend:

  • Watchful waiting
  • Fertility testing
  • Over-the-counter anti-inflammatories
  • Hormonal medications
  • Surgery such as endometriosis resection or hysterectomy

If you have any symptoms, call Maiden Lane Medical or make an appointment online today. Getting an accurate diagnosis early can help you get the treatment you need to manage your symptoms and restore your reproductive health.

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