Stages of Endometriosis

The tissue that is shed during one’s period is called the endometrium. When this tissue grows in places outside of the uterus, it leads to a condition called endometriosis. Endometriosis can be quite painful and can cause the formation of scar tissue and lesions. It can also cause difficulty in urination and sexual intercourse due to pain.

Endometriosis affects nearly 200 million girls and women all over the world, according to the World Health Organization. Although it currently has no cure, there are ways to manage its symptoms, including any infertility that it may cause. In this article, we shall be discussing the stages, symptoms, treatment, and the impact of endometriosis on a person’s health and fertility.

What Is Endometriosis

A person who has endometriosis would experience a fairly normal menstrual cycle, however, the condition causes the endometrium to begin growing in other parts of the body as well. This tissue is then found covering ovaries, fallopian tubes, parts of the pelvis, and although rare, other organs.

What makes this condition problematic is the fact that outside of the uterus, the endometrial tissue cannot break down, and neither does it have an exit. This results in a range of painful complications which can be managed with some types of treatments. 

Types of Endometriosis

There are three main groupings into which endometriosis is categorized. This is largely based on where the endometriosis is located in the body, and how severe it is.

Superficial Peritoneal Endometriosis 

Also known as superficial endometriosis, it is the most common type, seen in more than half of all endometriosis cases globally. It presents as shallow lesions along the thin internal abdominal lining, or the peritoneum. Its symptoms include painful menstruation and urination, discomfort during intercourse, and infertility.

Ovarian Endometriosis 

This type presents as cystic lesions inside the ovaries which contain dark brown endometrial fluid. These are commonly known as endometriomas, or “chocolate cysts”, due to their dark brown coloring. Symptoms of endometriomas are more severe than those of superficial endometriosis and also include nausea, bloating, vomiting as well as back pain. 

Deeply Infiltrative Endometriosis 

This type is the most severe and occurs when endometrial tissue grows on other organs such as the bowels and bladder. It usually does not respond to medication, and often surgery is the only way to treat it. Its symptoms include pelvic pain as well as lower back pain, blood in the urine, an increase in the frequency of urination and sometimes, the loss of kidney function.

Symptoms of Endometriosis

Depending on the location, type, and severity of the condition, the symptoms of endometriosis vary greatly. However, there are some symptoms that are common to a large percentage of the population affected by this condition. They include:

• Excessive, heavy bleeding during a period 
• Bleeding in between periods
• Severe cramping before and during a period
• Pelvic and stomach pain 
• Lower abdominal pain during or after sexual intercourse
• Diarrhea, bloating, or constipation 
• Bloating particularly around the time of a monthly period
• Pain in the pelvic area when urinating
• Pain in the pelvic area when having bowel movements

As it progresses without treatment, endometriosis can cause severe long-term complications, such as infertility, and certain types of cancer have been associated with endometriosis.

Stages of Endometriosis

Endometriosis has four main stages. These are not classified according to the symptoms experienced by a patient. Sometimes, very advanced endometriosis can cause mild symptoms, while mild endometriosis can cause very severe symptoms. That being said, here are the main stages of endometriosis:

1. Stage 1 Endometriosis presents as small implants or lesions on the peritoneum, with little or no scar tissue at all.
2. Stage 2 Endometriosis is a bit more severe, with deeper lesions and more scar tissue than in stage 1.
3. Stage 3 Endometriosis presents multiple deep lesions, ovarian cysts, and adhesions, or bands of scar tissue, in the pelvic area.
4. Stage 4 Endometriosis is the most severe and presents with large ovarian cysts, dense adhesions, and multiple organs being attached to each other by scar tissue.

Endometriosis and Fertility

When endometrial tissue grows on reproductive organs and tissues, it interferes with their normal function leading to infertility which is found in 30 to 50 percent of patients. The good news is that infertility that results from endometriosis does not eliminate the chance to have a child. Depending on the severity, there are treatments available to enable one to build a family. 

Intrauterine Insemination (IUI)

If one has stage 1 or stage 2 endometriosis, and it has not affected their fallopian tubes and eggs, intrauterine insemination (IUI), is one viable option. It is affordable and less invasive when compared to in vitro fertilization.

In-vitro Fertilization (IVF)

If IUI has been unsuccessful after several rounds, n vitro fertilization (IVF) may be a better option. Although comparatively IVF costs more and can be invasive, it has a higher success rate than IUI.

Surgery

Surgery may be required if the endometriosis is very advanced. This is helpful particularly before beginning any IUI or IVF treatments as it removes both the scar tissue and cysts, increasing the chances of success. Surgery also serves to reduce the complications associated with advanced endometriosis.

When to Consult a Doctor

If you are experiencing severe menstrual pain, or symptoms that are similar to those of endometriosis, consult a doctor for proper diagnosis. Typically, a laparoscopic procedure is the only definitive way to diagnose endometriosis. When you are proactive, an early diagnosis allows for steps to be taken to mitigate symptoms and reduce discomfort. 

Patients sometimes use non-prescription pain medication, birth control pills and progesterone medications to manage the symptoms of endometriosis.Birth control pills and progesterone medication have been particularly effective as they keep the body from ovulating, preventing endometrial tissue from developing altogether. 

Contact Us

If you want to have a family but have been diagnosed with endometriosis, seek out an accredited fertility center such as Ivy Fertility to help you figure out the most appropriate steps you can take to build your family. For more information regarding reproductive health, contact us at any of our locations across the country.