Diagnosis
How many stages of endometriosis are there?
The short answer
There are four stages of endometriosis in the most commonly used system (ASRM): stage I (minimal), II (mild), III (moderate), and IV (severe). Stage does not reliably predict how much pain you feel or how much the condition impacts daily life.
There are four stages of endometriosis in the most commonly used staging system, ASRM: stage I is minimal, stage II is mild, stage III is moderate, and stage IV is severe. Staging is based mainly on what’s seen at surgery, such as the location, depth, and extent of lesions, plus scar tissue (adhesions) and ovarian endometriomas.
Importantly, stage does not reliably predict how much pain you feel or how much the condition impacts daily life. Some people with low-stage disease have severe symptoms, and others with high-stage disease have surprisingly little pain. That’s why we also focus on disease subtypes (like superficial disease, deep infiltrating endometriosis, and endometriomas). Where endometriosis is and how it behaves often matters more than the stage label. If you’d like, you can reach out to our team to discuss how staging and subtypes apply to your symptoms and goals.
Where to go from here
Understand it, compare it with what you're feeling, then talk it through with us.
Step 2 · Compare
Symptoms it can relate to
Step 3 · Speak with Us
Understand Your Endometriosis Stage
Knowing your stage helps tailor your care plan. Our specialists guide you through diagnosis and treatment options with empathy and expertise.
Questions people ask next
All diagnosis questionsWhat do endometriosis stages I–IV actually measure?
Endometriosis stages I to IV mainly describe the visible amount and distribution of disease and scar tissue seen and scored at surgery. They do not directly measure pain or its effect on daily life, so someone with low-stage disease can still have severe symptoms.
Does endometriosis stage predict pain severity?
Endometriosis stage does not reliably predict pain severity. Stages mainly describe what’s seen at surgery, so someone with low-stage disease can have debilitating symptoms, while someone with more extensive disease reports surprisingly little pain.
Is laparoscopy the only way to confirm endometriosis?
Yes. At this time, the only definitive way to confirm endometriosis is laparoscopy, with direct visualization and biopsy of suspected lesions. Imaging and exams can strongly suggest it, but can’t reliably rule it in or out in every case.
Further reading
Your Symptoms May Point to a Specific Endometriosis “Type”
Discover how your symptoms may reveal a specific endometriosis type. Learn about phenotypes and adenomyosis in our latest research article.
Different Types of Endometriosis Pain Explained
Explore types of endometriosis pain, evaluation, and evidence-based treatments, including triggers, pelvic floor therapy, CNS sensitization, and adenomyosis.
Deep Infiltrating Endometriosis: Current and Future Treatments
Deep infiltrating endometriosis: symptoms, causes, diagnosis and treatment. Medical therapy, ICG-guided surgery, stenting, pathology, and future outlook.
