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Endometriosis: What are the Types and Stages?

With one in ten women experiencing endometriosis during the ages 16-49, it’s important that you are aware of the signs, symptoms and potential issues that can arise with this condition. Many women may not recognise that abnormal periods, menstrual cramps and pelvic pain can be signs of endometriosis and can often go untreated.

What is endometriosis?

Endometriosis occurs when the cells that are found in the uterine lining (endometrium) are found outside of the uterus on other tissues and organs, such as the ovaries, bladder and bowel. Because the cells can not shed and leave the body the same way the endometrium can, they can result in scarring and cysts that can be both painful and harmful to women.

The most common signs of endometriosis are:

  • Abnormal periods, including heavy bleeding, strong cramps before and during your period and spotting
  • Pain during intercourse and pain defecating
  • Pain and fullness in the lower abdomen
  • Pain in the pelvis, rectum or vagina

If you experience these symptoms, we advise you speak to your GP to check for the possibility of endometriosis.

What are the types and stages?

There are two commonly used categorisations of endometriosis, with the ARSM stages using a points system to determine the stage and the Endofound Endometriosis Classification that has more descriptive categories to help understand the severity.

There are four types of endometriosis, determined in stages of severity, number of lesions and depth of infiltration. Note that the stage does not dictate the amount of pain that the patient experiences.

ARSM stages

Stage I (minimal) will have a few superficial implants and minimal manifestation.

Stage II (mild) has more implants that are deeper than stage I.

Stage III (moderate) will have a number of deep implants, presence of filmy adhesions and will have small cysts on either one or both of the ovaries.

Stage IV (severe) is the most severe form with many deep implants, dense adhesions and large cysts on one or both of the ovaries.

Endofound Endometriosis Classification

Category I (peritoneal)

Minimal form of endometriosis where the membrane that lines the abdomen is infiltrated with endometriosis tissue.

Category II (ovarian)

Endometriosis is already established in the ovaries. Ovary cysts are at risk of breaking and spreading the tissue within the pelvic cavity.

Category III (Deep Infiltrating Endometriosis I)

The first form of endometriosis where various organs within the pelvic cavity are infiltrated. This includes the ovaries, rectum and uterus, and can severely impact the anatomy of pelvic organs.

Category IV (Deep Infiltrating Endometriosis II)

The most severe form of endometriosis involves organs both within the pelvic cavity and outside it, including the ovaries, uterus, rectum, diaphragm, appendix, heart and lungs.

Using tests, a doctor or specialist can determine the stage of endometriosis and propose appropriate surgery or treatment.

Speak to your doctor for more information

If you have any questions or concerns about pelvic pain or the possibility of endometriosis book an appointment with your GP. New can existing patients can contact Omni Gynaecare on 1300 851 968.

Book an appointment

Call Omni today on 1300 851 968

Three convenient locations

St Leonards Clinic

1300 851 968


1300 851 971


Ground Floor
Suite 2/8 Northcote St
St Leonards NSW 2065

Penrith Clinic

1300 851 968


1300 851 971


Level 2, Suite 2.01
Somerset Hospital, 38 Somerset Street
Kingswood NSW 2747


1300 851 968


1300 851 971


Suite 1005, Level 10
229 Macquarie St
Sydney NSW 2000