Endometriosis Stages:
Understanding the Different Stages of Endometriosis

Have you received a formal diagnosis for your endometriosis? If so, did you receive a specific stage / classification for how deep and/or infiltrating your endo was? Many individuals may not receive a certain classification (due to their pain and symptoms not accurately representing stages).

For endometriosis, there are four distinct stages that categorize the level and extent of endometriosis lesions, adhesions, and nodules found throughout the body. Endo appears in many different forms and has severe allergies diverse clinical presentations depending on the extent and individual presentation of the disease.

Endometriosis can be classified into four stages. The American Society of Reproductive Medicine (ASRM) bases these stages on the lesions themselves, particularly the number of endometrial implants and their depth. However, the ASRM revised their classification to include a point system. This point system allows for a way to numerically scale the disease and help determine classification. A score of 15 or less indicates minimal or mild disease. A score of 16 or higher may indicate moderate or severe disease. It is important to note that the stage of the disease does not necessarily reflect the level of pain or presence of symptoms. Someone may have Stage 1 endo and have excruciating pain whereas someone with Stage 4 endo may have no symptoms (but have more extensive endo present).

While these are the official numbered stages of endometriosis as identified by the ASRM, the Endometriosis Foundation of America has proposed using more descriptive categories. This is because every numbered stage has so many variations and does not give any insight into the patient’s pain or where lesions can be localized. Therefore, EndoFound classifies endometriosis by its anatomical location within the pelvic and abdominal cavity

In this video, I dive into two classification systems that were developed (both by the American Society for Reproductive Medicine and the Endometriosis Foundation of America). I dive into the four stages of endo, as well as the pointscale system that has been coined (which includes Peritoneal Endometriosis, Ovarian Endometrioma, Deeply Infiltrating Endometriosis I, and Deeply Infiltrating Endometriosis II).


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