Endometriosis is a disease that attacks women’s reproductive system and is characterized by tissue that usually lines in the uterus growing outside the uterus. The uterus is the organ where mothers carry their babies before being born, and the tissue inside it is known as the endometrium. When it grows outside the uterus, the tissue is known as endometriosis patches, implants, nodules or lesions, and the most common areas for it to grow is on or under the ovaries, on the fallopian tubes, which carry egg cells from the ovaries to the uterus, behind the uterus, on the tissues that hold the uterus in place, on the bowels or bladder, and occasionally on the lungs or other parts of the body.
The two main symptoms of endometriosis are pain and infertility, but there are also other signs of the disease. These include painful, even debilitating, menstrual cramps, which may get worse over time, pain during or after sex, pain in the intestine or lower abdomen, painful bowel movements or painful urination during menstrual periods, heavy menstrual periods, premenstrual spotting or bleeding between periods, painful bladder syndrome, digestive or gastrointestinal symptoms similar to a bowel disorder, as well as fatigue, tiredness, or lack of energy.
Definition of Endometriosis Stages
According to the American Society for Reproductive Medicine (ASRM), up to 10% of all women suffer from endometriosis. But the disease does not always manifest itself in the same way. “In others, infertility may be the only symptom of endometriosis. Often, endometriosis is diagnosed when a woman has pelvic surgery because of a persistent ovarian cyst or other reasons. Endometriosis can affect women who have had children and can occur in teenagers and young women. Some specialists feel that endometriosis is more likely to be found in women who have never been pregnant. Endometriosis may be found in 24% to 50% of women who experience infertility and in more than 20% who have chronic pelvic pain,” explain the society in their online endometriosis resources.
While some women experience all or some of the symptoms, others may experience only few or no symptoms at all. The same is true for infertility, which affects some but not all patients. The manifestation or severity of the symptoms is not linearly correlated to the extent of the disease. However, in addition to the symptoms, physicians also evaluate the severity or extent of endometriosis. To do so, a system of stages in used, depending on location, extent, and depth of endometriosis implants, presence and severity of adhesions, as well as presence and size of ovarian endometriomas, which helps physicians define a treatment plan and fertility hypothesis.
Endometriosis Stages Classification
A classification system has been created to classify the stages of endometriosis, but the most common is a numeral classification system divided into four stages. The four stages of endometriosis are equivalent to minimal, mild, moderate, or severe endometriosis, and the majority of patients are included in the two first categories. The classification is made during the same surgical procedure used to confirm the diagnosis, which is called a laparoscopy. During the surgery, a surgeon makes small incisions in the abdomen to observe the reproductive organs, intestines, and other surfaces.
Stage I — minimal endometriosis is characterized by isolated implants and no significant adhesions
Stage II — mild endometriosis by superficial implants less than 5 cm in aggregate without significant adhesions.
Stage III — moderate endometriosis and IV — severe endometriosis consists of multiple implants and scarring around the tubes and ovaries or on multiple implants, including large ovarian endometriomas with thick adhesions, respectively.
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