Endometriosis is a disorder which occurs when the tissue that lines the uterus tends to grow outside the uterine cavity. This uterine lining is known as the endometrium. The growth may further spread to other pelvic areas or organs like the ovaries and the tissues lining the pelvis. Although, it usually affects the ovaries, fallopian tubes, the uterine lining and the tissue ovaries, and remains within the pelvic area, in rare cases, it may spread to the other parts or organs of the body. Hormonal changes during menstrual cycle sometimes affect the endometrial tissue when then tend to thicken and break down. These broken or spilled tissues cannot escape from the pelvis and gradually pile up inside it, resulting in irritation, inflammation, scarring and adhesion.
Endometriosis occurs over a period of time. It may be diagnosed at its preliminary stage or much later. A thorough examination of the female reproductive organs is carried out in order to determine the stage of endometriosis. This is usually done through laparoscopy. Sometimes an women suffering from endometriosis may not have prior knowledge about the condition and it may be detected during an unrelated surgery or pelvic examination. The stages of endometriosis are based on factors like its location and depth to which it has penetrated to normal tissues. It can also be based on the severity of the scar tissues in the pelvic area, especially outside the uterus, ovaries, fallopian tubes, bowels or tissues lining any other organ.
Endometriosis Is Classified In Four Stages:
Stage I: minimal
Stage II: mild
Stage III: moderate
Stage IV: severe
Stage 1 Endometriosis (Minimal)
Small lesions, superficial implants, or wounds are present on the ovary. These cysts are often mistaken for cysts, benign or non-benign. They cause irritation or inflammation in the adjacent areas which becomes internal scars. These scars restricts the free movement of tissues and organs, and makes the affected areas painful. The adhesion may sometimes distort the normal functioning of the organs.
Stage 2 Endometriosis (Mild)
Minimal or mild endometriosis are the most common forms of endometriosis. Apart from the symptoms found in the mild stage which become more aggressive, black spots appear over the fibrous adhesion or internal scars at this stage. This may cause pain in the pelvis or irritation during the ovulation period. Superficial implants not more than 5 cm can develop at this stage. Moreover, lesions also develop in places between the rectum and the uterus.
Stage 3 Endometriosis (Moderate)
At the moderate stage, deep implants occur on the linings around the ovaries and the pelvic lining. More lesions are also likely to show up. Endometriomas, a form of cyst begins to appear. These cysts are also known as “chocolate cysts” as the blood blocked inside them are ususally old blood which have become dark red or brown. The signs and symptoms are more apparent now. The patient may experience extreme abdominal pain and pelvic inflammation and even infection and increase in adhesions. These adhesions increase in size and numbers in response to the increase of the endometriomas. The areas around the fallopian tubes and ovaries are also prone to multiple implants and adhesion.
Stage 4 Endometriosis (Severe)
This is the final and the most severe stage of endometriosis. Unnumerable cysts and thick adhesions may develop around the endometrium. Further deep implants on both the ovaries and the pelvic lining are most likely to be seen. At this stage, endometrium can grow quite large and will need to be removed surgically, if the size exceeds 2 cm. Deep implants can also be seen on the pelvic lining, fallopian tubes, the bladder and bowels. The patient may also experience difficulty in digestion, severe abdominal pain and infertility. The condition of endometriosis becomes so severe at this stage that it can badly distort the normal anatomy of the pelvis.