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Endometriosis Stages

There are four stages of endometriosis that are accepted by the medical fraternity around the world, including the American Society of Reproductive Medicine. While these stages represent a useful tool in the diagnosis of the disease, the endometriosis stages do have limitations in describing and categorizing the symptoms.

It is generally accepted that the severity and range of the endometriosis symptoms experienced by a patient has no bearing on the extent or seriousness of the endometriosis in her body. A woman with Stage I or mild endometriosis may experience debilitating pain every month, seriously impacting her daily life; another woman may have Stage III endometriosis but may not experience any major symptoms, and may be unaware she even has the condition.

The American Society of Reproductive Medicine has described the endometriosis stages, making use of a point system which assesses the adhesions and lesions found within the pelvic cavity. This complex system only takes the physical aspects of the disease into account and does not assess any of the endometriosis symptoms the patient is experiencing, like pain, heavy periods or infertility. The reason for this is possibly because there is no direct correlation between the symptoms and the stage the endometriosis has progressed to.

Stage I
This stage is described as minimal. There will be evidence of only a few small and superficial lesions scattered throughout the pelvic cavity, with the possibility of limited adhesions.

Stage II
This stage is described as mild. There will be evidence of superficial lesions with some lesions being visibly deeper and located in the cul-de-sac area of the pelvic cavity, which is between the uterus and the bowel.

Stage III
This stage is described as moderate. In addition to all the above lesions, there will be additional adhesions and scarring as well as endometriosis implants evident on the ovaries. The endometriosis is more widespread than in Stage I and II.

Stage IV
This stage is described as severe. All the symptoms listed for stages I to III will be present in addition to large endometriosis implants and extensive adhesions, which may have distorted or displaced some affected organs.

Some of the terminology used in the description of the endometriosis stages might be confusing, so here is an explanation to help your understanding:

Endometriosis – the condition where specialized endometrial tissue, normally only found in the lining of the uterus, is found outside the uterus in other parts of the pelvic cavity.

Endometriosis implants – the name given to mass of endometriosis cells where they attach to other parts of the pelvic cavity.

Lesions – another name for endometriosis implants. May also mean an open wound within tissue.

Adhesions – another name for scar tissue; the fibrous tissue form a web which binds pelvic organs together, when they usually are not bound. This often pulls them out of their correct positions, which can cause pain, fertility digestive problems.

Endometriosis symptoms are often confused with other conditions and women may be diagnosed with a different complaint that is associated with the area of endometriosis implants. For example, a woman may initially be diagnosed with irritable bowel syndrome because she has bowel symptoms, whereas she may actually have endometrial implants on the bowel.

Endometriosis stages are used to describe and categorize the disease but women who have been diagnosed with endometriosis are usually more concerned about the endometriosis symptoms they are experiencing than by the stage their condition is at.

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