EndoInvasion : Stages

A stage with the Bloomin' Uterus logo centered on it in a spotlight
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 in an article published in Fertility & Sterility back in 1997.

I didn’t know my Stage level and had to ask my doctor.  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. (Update: As of June 6, 2019, I’ve now had a total of four excision surgeries; each one classified my illness as Stage 4).

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 present.  These are considered superficial implants.  No adhesions (spiderweb-like scarring) are present yet. Evidence of inflammation may be found.


Stage 2 Endo (Mild) : Spots (implants/leions) are beginning to take shape and form over your body’s organs and tissue.  There are more than Stage 1, and are deeper in the body. Adhesions may have begun to form. The lesion colors can range from clear to black.


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


Stage 4 Endo (Severe) : Same as above, but many more solid masses of Endometriosis, as well as deep implants.  One or both ovaries have entrometriomas (a blood-filled chocolate cyst), and extensive adhesions are binding organs or tissue together.  The bowels, bladder, and other organs may also be involved.

Regardless of what Stage of Endo we are (or were at the times of our excision surgeries), all EndoWarriors 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.

(Updated December 28, 2020)

Resources and More Info:

Endometriosis Foundation of America

Fertility & Sterility – (Article; 1997) – Revised American Society for Reproductive Medicine classification of endometriosis: 1996

Johns Hopkins Medicine


Merck Manual 


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