What is Endometriosis and its Types

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What is Endometriosis and its Types

The innermost lining layer of the uterus is known as the endometrium. The growth of endometrial-like tissue inside the ovaries, intestines, and pelvis is called Endometriosis

Endometrial tissue is unlikely to spread beyond the pelvic region, but it is not entirely impossible. The growth of endometrial tissue outside the uterus is known as an endometrial implant.

Hormonal changes in the menstrual cycle affect the endometrial tissue in the wrong place, resulting in swelling and pain in the area.

Tissue grows, thickens, and breaks down. As the ruptured tissue goes nowhere and gets stuck in the pelvis.


The ruptured tissue can become the cause of the following: 

  • Reproductive problems
  • Adhesives that connect the pelvic organs together
  • Irritation, discomfort and pain
  • Fatigue, Diarrhea, Constipation, Bloating, and Nausea.
  • Scar formation
  • Severe pain during menstruation, bowel movements and intercourse

Sometimes there are no symptoms at all. It is therefore important to have regular gynecological check-ups so that the gynecologist can monitor any changes.

This is especially important when you have two or more symptoms.

Types and Stages 

Endometriosis is grouped into its stage and type on the basis of different factors, such as tissue position, depth, size, and quantity.  The type of endometriosis plays a role in symptoms and treatment.

Also Read: Secondary Infertility: Meaning, Causes, and its Treatment

Types of Endometriosis

There are four main types of endometriosis, regardless of the area of ​​the pelvis or abdomen which gets affected:

Superficial Peritoneal Endometriosis

A thin membrane that lines the abdomen and pelvis and that also covers most of the organs in these cavities is known as the peritoneum.

It is the least severe form and In this type endometrial tissue attaches to the peritoneum.


Dark, fluid-filled cysts which are also called chocolate cysts, which vary in size and can appear in different parts of the pelvis or abdomen, are called endometriomas. They are most common in the ovaries.

Deeply Infiltrating Endometriosis (DIE)

A condition in which endometrial tissue invades organs including the ovaries, anus, bladder, and intestines, sometimes inside or outside the pelvic cavity, is called deep infiltrative endometriosis.

Sometimes (though very rarely) many scar tissues can attach the limbs to a position they are called a frozen pelvis.

Abdominal Wall Endometriosis

When endometrial tissue progresses to the abdominal wall or to a surgical incision, such as a C-section, it is called abdominal wall endometriosis.

Stages of Endometriosis

There are various methods for determining the stage of endometriosis, including the position, number, size and depth of the endometrial implant.

The points are determined by the depth and spread of endometrial tissues as well as the areas of the body that are involved.

Endometriosis has Four Stages on the Basis of Results: 

Stage 1 or Minor: There are some small sores or lesions on the ovaries and hollow endometrial implants. There is almost no scar tissue. Swelling may be present in or around the pelvic cavity.

Stage 2 or Mild: The number of implants is higher than in stage 1. The ovaries and pelvic lining have mild lesions and hollow implants, deep in the tissue, and may have some scar tissue.

Stage 3 or Medium: There are multiple deep implants on the ovary and pelvic lining. There can be small lumps either on one or both ovaries, and thick bands of scar tissue which is known as adhesions.

Stage 4 or Severe: This is the most widespread and severe stage of endometriosis, involving deep implants and thick adhesions on the lining of the pelvis and ovaries. Large cysts are also present on one or both ovaries. Lesions on the fallopian tubes and intestines can also be present.

There is no explanation as to why some patients have more severe cases than others. If left untreated, it can remain the same over time, becoming worse or better.


Endometriosis can actually be diagnosed by laparoscopy. The surgeon makes a small incision and inserts a small, thin-looking instrument into the abdomen to detect the symptoms of endometriosis.

To help rule out other causes, a small tissue sample or biopsy may be taken for examination.

Only superficial peritoneal endometriosis can be seen by laparoscopy but further tests are required before surgery, such as a pelvic examination to detect cyst, an ultrasound or MRI to look for an endometrioma.


Treatment is usually decided on the basis of symptoms and whether one wants to conceive.

The doctor will initially prescribe painkillers and hormone therapy. But if these treatments do not help, surgery may be needed to remove the implant.

This can be done by laparoscopy or abdominal surgery. For women who do not want to become pregnant, their uterus may be surgically removed.


Endometriosis can affect anyone, leading to pain and infertility.

There are both medical and surgical options available to help ease symptoms and manage any potential complications.

Doctors usually try conservative treatment first and then may recommend surgery if your condition does not improve.

Everyone can react differently to these treatment options.  An experienced doctor can help you find the doctor who works best for you.

IVF specialist in Ludhiana Dr. Shivani Bhutani has achieved a high success rate in the treatment of endometriosis through her experience and practical approach, especially for women who want to have children.

She has done a lot of treatment for this disease through her approach to this disease. Contact for appointment.

About The Author

Dr Shivani Bhutani
A doctor with a rich background and high success rate, Dr. Shivani Bhutani offers the boon of parenthood to couples dealing with infertility. She has opulent knowledge and expertise in offering successful treatment for infertility in females, gynecological disorders, and family planning consultation services. Highly dedicated, concerned, and attentive, Dr. Shivani understands the bliss of parenthood and offers appropriate medical help.