The severity of your endometriosis is determined by a doctor using a 4-stage system (Minimal, Mild, Moderate, Severe) based on the location, depth, and spread of endometrial tissue, often with a point system (ASRM), but the stage doesn't always match your pain level, as some with Stage 1 can have severe symptoms, while others with Stage 4 have minimal pain, so only your healthcare provider can tell you your specific stage and how it impacts you.
The classification also uses a point system to try to quantify endometriotic lesions . This point system allows for a way to numerically scale the disease. A score of 15 or less indicates minimal or mild disease. A score of 16 or higher may indicate moderate or severe disease.
Inflammatory proteins from endometriosis can travel to the bladder and bowels, causing nausea during your period as well as diarrhea, constipation, or pain with urination throughout the month. “There's also overlap between endometriosis and conditions such as irritable bowel syndrome,” Dr. Kossl says.
Deep infiltrating endometriosis is also sometimes called 'severe', 'stage 4', or 'advanced disease'. It refers to endometriosis that is deeper embedded in the abdomen and into structures in your pelvis and abdomen such as the bowel, bladder, nerves and blood vessels.
And people diagnosed with stage 4 endometriosis are most likely to face severe, painful menses, painful intercourse, and painful defecation. The majority of them also encounter chronic pelvic pain due to the severity of the disease.
For many patients living with endometriosis, the ER is one of the first—and most painful—stops in their care journey. Severe pelvic pain, ruptured cysts, and flares can bring you to an emergency department or urgent care quickly.
Endometriosis can also grow directly onto nerves, which can cause excruciating pain, similar to the way that the nerve-invading disorder shingles does.
Stage 4 Endometriosis: Severe
Stage 4 of endometriosis is considered severe. This stage is characterized by many deep endometrial implants and large cysts on at least one ovary. Thick adhesions appear throughout the pelvic region, causing widespread scar tissue and an increased risk of infertility.
Under the Americans with Disabilities Act (ADA), endometriosis isn't automatically classified as a disability. However, if it causes chronic pain, fatigue, or reproductive complications that limit daily activities, a patient may be eligible for reasonable workplace accommodations.
Flare-ups don't look the same for everyone, but common symptoms include: Severe pelvic or abdominal pain. Intense cramping, especially during menstruation. Lower back and leg pain.
pain when you poo or pee. pain during or after sex. extreme tiredness (fatigue) pain or bleeding in other areas, such as in the chest, which may cause shortness of breath and coughing up blood.
With bowel endometriosis the usual symptoms are pain on opening the bowels (dyschezia) and deep pelvic pain with sex (dyspareunia). Although bowel endometriosis can be associated with bleeding from the rectum during a period this is perhaps more commonly caused by haemorrhoids (piles) and other bowel conditions.
Pain Relief for endometriosis
An endometriosis flare-up refers to a sudden worsening of symptoms, often including intense pelvic pain, heavy bleeding, and fatigue. These flare-ups can occur due to hormonal changes, particularly during menstruation.
The most common endometriosis adhesions form and cause scarring within the ovaries, fallopian tubes, uterus, small intestines, and pelvic sidewall, between the bowel, rectum, and recto-vaginal septum. These “sticky” adhesions can cause the space between two organs to fill with scar tissue and inflammatory enzymes.
Blood that occurs due to spotting may be red, pink, or brown. People with more advanced stages of endometriosis may have ovarian cysts. These cysts, also known as endometriomas or chocolate cysts, contain old blood. If the endometriomas rupture, they can leak dark brown, bloody fluid into the pelvis.
Symptoms may not last for longer than three days and you may have multiple periods of absence within an 8-week period. If this is a regular occurrence for you, it may be appropriate for you to discuss this with your employer and consider whether a change in your working practices can be made.
In summary, alcohol may not only contribute to the initial development of endometriosis but also can exacerbate its symptoms. This is through its impact on oestrogen and its ability to create inflammation in the body.
Safe Work Australia's endometriosis fact sheet for employers states, 'severe endometriosis can amount to a physical disability'. It's illegal to discriminate and not make reasonable adjustments for people with disabilities. The fact sheet guides employers on how to support workers with endometriosis.
Additional symptoms that may suggest endometriosis can include dyspareunia — pain with intercourse — and/or dyschezia (pain with bowel movements). ”Pelvic pain can also be caused by scar tissue, previous infections, pelvic floor myalgias or other, nongynecologic syndromes such as painful bladder syndrome and irritable ...
DOs and DON'Ts in Managing Endometriosis:
DO take pills as instructed by your health care provider. DO see your health care provider regularly. DO exercise and take ibuprofen or similar drugs to help relieve painful periods and cramps. DO call your health care provider if treatment isn't helping symptoms.
If you have endometriosis and you're trying to become pregnant, this type of surgery may boost your chances of success. It also may help if the condition causes you terrible pain — but endometriosis and pain may come back over time after surgery.
6 Endometriosis Imposters That Could Delay a Correct Diagnosis and Wreck Your Future
Continuous Progestin Hormonal Therapy
When taken in a long-term continuous fashion, progestins tend to thin the lining of the uterus which stops regular periods and lessens the chance for break-through bleeding or spotting and has similar activity against endometriosis lesions themselves.