January 20, 2023

Symptoms and stages of endometriosis

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One of the most common causes of pelvic pain and infertility in women is endometriosis. Read on for information from the women’s health experts at UW Health on the symptoms and stages of endometriosis. You’ll learn when to see a gynecologist who specializes in pelvic pain and minimally invasive surgery for complex pelvic disease.

What’s endometriosis?

Endometriosis is a long-term (chronic) inflammatory condition where tissue that usually grows inside the uterus grows outside the uterus. The most common places where endometriosis occurs are the ovaries, the fallopian tubes, the bowels and the areas surrounding the uterus. Rarely, endometriosis can also occur on the bladder and outside of the pelvis, like the lungs, skin, brain, or diaphragm.

Common signs of endometriosis

Symptoms of endometriosis can begin before the first menstrual period and remain throughout a lifetime, even into menopause. Ask your primary care physician for a referral to a pelvic health specialist if you have common signs and symptoms of endometriosis, including:

  • Pelvic pain

  • Pain with bowel movements or urination

  • Pain with intercourse

  • Infertility

Symptoms during menstruation

If you have endometriosis, the most common symptom you may experience during your period is pain (dysmenorrhea). Other symptoms include:

  • Bloating

  • Constipation

  • Diarrhea

  • Fatigue

  • Nausea

What are the four stages of endometriosis?

The location, amount, depth, and size of the endometrial tissue determine the stage of endometriosis. Pain level does not reflect the stage of endometriosis. Depending on the extent of the spread of tissue, and pelvic adhesions (scar tissue), the stage of endometriosis could be:

  • Stage 1: Minimal

  • Stage 2: Mild

  • Stage 3: Moderate

  • Stage 4: Severe

Treatment for endometriosis

Your doctor will ask you about your symptoms and where they take place to help diagnose endometriosis. Depending on the stage of your endometriosis, your gynecologist may recommend:

  • Hormone therapy – May reduce pain and growth from endometriosis

  • Pain medication – May reduce pain

  • Health psychology – This may include behavioral strategies to help manage the stress of a chronic condition

  • Surgery – This could include removing endometriosis implants and preserving your uterus and ovaries or a hysterectomy (removes uterus) and oophorectomy (removes ovaries)

  • Fertility treatment – Stimulates ovaries to make more eggs to help you conceive

Life with endometriosis: Easing the pain

If you have endometriosis, there are many strategies to help you cope with pain. Find comfort with:

  • Preventing constipation by eating a high-fiber diet and drinking plenty of water

  • Sleep hygiene to improve sleep quality

  • Regular exercise

  • Rest, relaxation, and meditation

  • Using a heating pad on your abdomen

  • Warm baths