EndoInvasion : Stages

Our Uterus : center stage!

So there are four “Stages” of Endometriosis.  It’s the doctors way of categorizing the depth of the EndoInvasion in our bodies.  It was developed by the American Society of Reproductive Medicine.   Diagrams of the various stages can be found here and here.

I didn’t know my Stage level and had to ask my doctor yesterday.  My Endometriosis was Stage 4, the most severe it can get. Probably because it was brewing inside me undetected for nearly 2 decades. Ugly disease.

The interesting things about Stages: the Stage Level doesn’t necessarily dictate our symptom or pain levels.  Someone with Stage 1 can have severe pain, while someone with Stage 4 may not even realize it.  Just one more mystery o’Endo.

So what are these Stages?  Here ya go:


Stage 1 Endo (Minimal) : subtle growths and implants that may be mistaken for small cysts.  These are considered superficial implants.  No adhesions (spiderweb-like scarring) are present yet.


Stage 2 Endo (Mild) : black spots (implants) are beginning to take shape and form over your bodies’ organs and tissue.  There are more than Stage 1, and are deeper in the body. Adhesions may have begun to form.


Stage 3 Endo (Moderate) : Same as above, but implants and cysts are present, usually on the ovaries, growing as large as 4cm.  Adhesions may be in greater number.


Stage 4 Endo (Severe) : Same as above, but many more solid masses of Endometriosis implants 5-6cm are present, as well as deep implants.  One or both ovaries have entrometriomas (a blood-filled choclate cyst), and extensive adhesions are binding organs or tissue together.  Sometimes the rectum is attached by an adhesion to the uterus.

Regardless of what Stage of Endo we are (or were at the times of our excision surgeries), all EndoSisters share this invisible illness.  And we all share the desire for better treatments and a cure to be found.  We are all in this together.  We all suffer together.  And we’ll get through this…together.

Resources and More Info:

American Society for Reproductive Medicine

DaVinci Surgery

Johns Hopkins Medicine


Merck Manual 


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