What are the Stages of Endometriosis?

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  • Written By: Anna T.
  • Edited By: Kathryn Hulick
  • Last Modified Date: 07 January 2020
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There are four stages of endometriosis: minimal, mild, moderate, and severe. Doctors often have difficulty knowing what stage of endometriosis a woman is in based on symptoms because these vary from person to person. It is not uncommon for someone with mild endometriosis to experience painful symptoms or for someone with severe endometriosis to have none. Surgery is the most effective way for a doctor to determine what stage of endometriosis a woman is in, but this isn't typically performed unless she is experiencing severe symptoms.

Endometriosis is a condition that causes the endometrium, which is the lining of tissue that thickens and sheds during the menstrual period, to grow outside the uterus. Most of the time this only affects the ovaries and fallopian tubes, but the endometrium may also form in other parts of the body. The majority of women affected by this problem are in their child-bearing years. Symptoms almost always disappear at the onset of menopause.


Minimal endometriosis is diagnosed when there are only small, isolated areas of the endometrial lining growing outside the uterus. Mild endometriosis is diagnosed when there are several spots of endometrium growing along with a very small amount of scar tissue. When the stages of endometriosis progress from mild to moderate, there may be many deep areas of the lining and scar tissue found outside the uterus. Women in the severe stage have much greater degrees of excess lining and scar tissue, which might also extend outside the pelvic region and into the rectum.

Symptoms of this condition usually include heavy periods, spotting between periods, irregular periods, pelvic pain, and difficulty getting pregnant. The fertility problems are often only present during the moderate and severe stages of endometriosis. Many women do not even know they have the disorder until they see their doctor about problems with conceiving.

Women who do not want to get pregnant can occasionally control their endometriosis symptoms with birth control pills or other types of hormone therapy. Very severe cases may require surgery to remove the excess endometrial tissue growing outside the uterus. If pregnancy is desired, surgery might be necessary before conception can occur.

Women with mild to moderate endometriosis may not require surgery in order to become pregnant. Even if a woman has no desire for pregnancy, surgery may be recommended if she is in the moderate or severe stages of endometriosis in order to eliminate other painful symptoms.


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Post 3

@alisha-- I have stage four but with very mild endometriosis signs. In fact, my doctor thought that I must be at stage one but discovered that the endometrium tissue has spread to many organs during my laparoscopy.

Post 2

@burcinc-- I don't know about others but my symptoms (irregular periods, fatigue and nausea) started when I was eighteen years old. I was probably at stage one then. I'm now twenty six and have been diagnosed with endometriosis. My symptoms have worsened over the years and now I am at stage three.

So in a way, it does correlate. I don't know how someone could be at stage four without pain. I'm sure that someone at stage four has some signs and symptoms of endometriosis, even if it's just difficulty getting pregnant.

Is anyone here at stage four? What symptoms do you have?

Post 1

I thought that the symptoms of endometriosis would correlate to the stage one's in but that's clearly not the case.

My sister recently had a hysterectomy because of endometriosis. She only had mild endometriosis but the pain and bleeding was so bad that she couldn't take it anymore. She and her husband were not planning to have any more kids anyway so she went ahead and had the hysterectomy. Since she's in menopause now, the endometriosis disappeared. Her bleeding, cramps and pain has stopped.

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