Endometriosis: Stages, Symptoms and Risk Factors

Endometriosis is the development of uterine-lining tissue outside the uterus. The tissue that normally lines the inside of your uterus, grows outside your uterus.

Updated: June 16, 2022

Endometriosis is the development of uterine-lining tissue outside the uterus. The tissue that normally lines the inside of your uterus, grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.
The clumps of tissue called implants go through the same growing, breaking down, and bleeding that the uterine lining or endometrium goes through during each menstrual cycle. Because these clumps of tissue has no way to exit your body, it becomes trapped. This is why endometriosis pain may start as mild discomfort a few days before the menstrual period and then usually is gone by the time the period ends. But if an implant grows in a sensitive area, it can cause constant pain or pain during certain activities, such as sex, exercise, or bowel movements.

Stages of endometriosis:

Based upon the exact location, extent, and depth of the endometriosis implants, endometriosis is classified into four stages. The presence and severity of scar tissue and the presence and size of endometrial implants in the ovaries also be taken in to consideration.
These stages are minimal, mild, moderate, and severe. If there are superficial implants and mild scarring the stage is minimal or mild where as moderate and severe endometriosis typically result in cysts and more severe scarring.

Symptoms of Endometriosis:

The primary symptom of endometriosis is pelvic pain, often associated with your menstrual period. Women with endometriosis will have menstrual pain which is worse than usual cramping.
Common signs and symptoms of endometriosis may include:

Painful periods:

Pelvic pain and cramping may begin before your period and extend several days into your period. You may also have lower back and abdominal pain.

Excessive bleeding:

You may experience occasional heavy periods or bleeding between periods.

Pain with bowel movements or urination:

You are most likely to experience these symptoms during your period.

Painful intercourse:

Pain during or after sex is common with endometriosis.

Infertility:

Endometriosis is first diagnosed in some women who are seeking treatment for infertility. Implants are often found in individuals during evaluations for infertility which are totally asymptomatic. Endometriosis may result scar tissue formation within the pelvis. The mechanical processes involved in the transfer of fertilized eggs into the tubes may be affected if  the ovaries and fallopian tubes are involved. This diminishes fertility in many patients with endometriosis. The endometriotic lesions may produce inflammatory substances which adversely affect ovulation, fertilization, and implantation.

Other symptoms:

Fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods are some of the other symptoms of endometriosis.
Some women with mild endometriosis have intense pain, while others with advanced endometriosis may have little pain or even no pain at all. Therefore the severity of your pain is not an indicator of the extent of the condition.
Sometimes other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts can be mistaken as endometriosis.  It may be confused with irritable bowel syndrome (IBS) which is a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.
Rare symptoms of endometriosis include:

  • chest pain or coughing blood due to endometriosis in the lungs
  • headache and/or seizures due to endometriosis in the brain

Risk Factors of Endometriosis:

The risk of developing endometriosis include:

  • Infertility
  • Starting your period at an early age
  • Going through menopause at an older age
  • Short menstrual cycles,such as less than 27 days
  • Low body mass index
  • Alcohol consumption
  • Family history
  • Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
  • Any medical condition that prevents the normal passage of menstrual flow out of the body
  • Uterine abnormalities

Endometriosis affects women during their reproductive years. It usually develops several years after the onset of menstruation. Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause.


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