Did you know that over 10% of women will experience endometriosis at some point in their life? A chronic inflammatory condition, endometriosis affects women throughout their reproductive years with often painful symptoms and fertility challenges.

If you are suffering from endometriosis or think you might be, you may find yourself wondering what your treatment options are and how endometriosis nutrition can come into play. Read on to discover what endometriosis is, its signs and symptoms, and how your nutrition and fertility go hand in hand when considering treatment options.

What is Endometriosis Stages?

Endometriosis is a common inflammatory condition that affects women during their reproductive years, resulting in tissues that are much like the lining of the uterus growing in other areas of the body, most often in the pelvis.[2] This condition is often painful, with moderate to severe pelvic pain, severe menstrual pain, and excessive menstrual bleeding. There is currently no known cause of endometriosis and no known cure.

These tissues that appear are characterized as ‘implants.’ These implants often resemble small flecks or patches across the surface of the affected area. If they grow atop an ovary, they tend to form into a blood-filled cyst known as an ‘endometrioma’ or ‘chocolate cyst.’ These cysts can be so small to be barely visible or as large as a piece of fruit, ranging in size from a cherry to a grapefruit. Endometriosis can also irritate pelvic tissue, creating internal scar tissues known as ‘adhesions’ that can cover or wrap around affected tissue and organs.

There are four stages of endometriosis that are classified using a points system that depends on three factors:

1) Location, size, and depth of implants

2) Existence and size of cysts

3) Existence and severity of adhesions

Stage 1:

    1. Peritoneal Endometriosis (1-5 Points)
    2. Severity: Minimal
    3. Implants: A few to the peritoneum
    4. Cysts: Few to none
    5. Adhesions: Few to none

Stage 2: 

    1. Ovarian Endometriosis (6-15 Points)
    2. Severity: Mild
    3. Implants: A few deep implants
    4. Cysts: Some cysts within the pelvis or on one or both ovaries
    5. Adhesions: Few to none

Stage 3: 

    1. Deep Infiltrating Endometriosis I (16-40 Points)
    2. Severity: Moderate
    3. Implants: A large amount of deep implants
    4. Cysts: Small on one or both ovaries
    5. Adhesions: A few filmy adhesions

Stage 4: 

    1. Deep Infiltrating Endometriosis II (>40 Points)
    2. Severity: Severe
    3. Implants: A large amount of deep implants
    4. Cysts: Large on one or both ovaries
    5. Adhesions: Many dense adhesions
Endometriosis stages Signs, Diagnosis & Treatments.

What are the Signs and Symptoms of Endometriosis?

While some women with endometriosis will experience little to no symptoms of their condition, there are several key signs to look out for when considering if you may have it:

1. Severe Menstrual Pain & Excessive Menstrual Bleeding

2. Mild to Severe or Chronic Pelvic Pain

3. Painful Intercourse

4. Fertility Issues

How is Endometriosis Diagnosed?

Endometriosis cannot be diagnosed based on symptoms alone. To determine if you have endometriosis and its level of severity, you will likely need to have a full pelvic exam and a laparoscopy. This procedure involves inserting a small camera into the abdomen that allows your physician to see the surface of your pelvis and reproductive organs, giving them the ability to visually determine what stage of endometriosis you may be in.

What are Treatment Options for Endometriosis?

While there is no established cure for endometriosis, there are many great treatment options available, ranging from innovative surgical techniques to working with a women’s health dietitian.

1. Pain Management:

The first step in treating endometriosis is managing your pain levels. This can be accomplished through a variety of techniques, including lifestyle changes such as diet or exercise, hormonal treatments, and surgeries, depending on physician recommendation.

2. Oral Hormonal Contraceptives:

Another treatment option for endometriosis is the use of oral contraceptives, such as birth control pills. This treatment often helps to reduce the cramping and excessive bleeding in the menstrual cycle and can also help reduce pelvic pain.

3. Surgical Techniques:

One of the more involved treatment methods, surgical procedures are an option for treating particularly difficult cases of endometriosis. Surgery for endometriosis is often suggested when the goal is preservation of fertility. These procedures, such as laparoscopy, involve removal of implants, cysts, and adhesions to provide pain relief. In fact, studies show that 60-80% of women who undergo fertility-preserving surgery experience improved relief from endometrial pain.

4. Fertility Support:

One of the most unfortunate side effects of endometriosis is its effect on fertility. In fact, 30-35% of women with endometriosis experience infertility or difficulties getting pregnant. This can be due to a variety of factors, including the presence of adhesions, chronic inflammation, and continued growth of endometriotic tissue.

Because endometriosis can have such a detrimental effect on reproductive health, it’s important to secure the right fertility support if you are considering getting pregnant. This can include fertility enhancing treatments such as ‘Controlled Ovarian Stimulation,’ the use of ‘Assisted Reproductive Technology (ART)’ options such as IVF and working with a fertility specialist with expertise in the areas of nutrition and fertility.

5. Nutrition Therapy:

Arguably one of the most important and overlooked treatment options, endometriosis nutrition therapy is key to managing pain, symptoms, and damage that can come from this condition. Through dietary changes, you can work to reduce inflammation and estrogen levels in the body to combat endometriosis.

healthy food checklist

How an Endometriosis Nutrition Plan Can Help

While managing endometriosis may feel like a huge undertaking, having the right plan of attack when it comes to your nutrition and fertility can make a world of difference. By bringing a women’s health dietitian into your treatment plan, you can effectively set yourself up for success and work to improve fertility outcomes.

A certified women’s health dietitian with experience in working with patients with endometriosis can help you craft a unique approach that targets inflammation and estrogen levels. By focusing on eating foods that combat chronic inflammation, this approach can help reduce endometriosis symptoms and improve fertility outcomes.

Additionally, through the power of food, a registered dietitian can also offer suggestions on foods and dietary practices to reduce the risk of developing endometriosis. This can include the consumption of more vegetables, increased omega-3 fatty acids, and added antioxidant vitamins.

If you are ready to take a new approach to treating your endometriosis with a custom nutrition plan, Holness Nutrition is here to help. Book a free Endometriosis Strategy Call with Nicole Holness, CEO and founder of Holness Nutrition, to get started. A Registered Dietitian Nutritionist with a wealth of experience in the field of nutrition and a strong culinary background, Nicole will help you craft a unique plan to improve your diet and lifestyle in order to maximize your recovery from endometriosis and its symptoms.


Endometriosis and Adenomyosis, Early Life Nutrition.

Patient Information Series: Endometriosis, American Society for Reproductive Medicine.

Zugna D, Richiardi L, Akre O, Stephansson O, Ludvigsson JF. A nationwide population-based study to determine whether coeliac disease is associated with infertility. Gut. 2010;59(11):1471-5. 2.

Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. J Assist Reprod Genet. 2010;27(8):441-7.

Halpern G, Schor E, Kopelman A. Nutritional aspects related to endometriosis. Rev Assoc Med Bras (1992). 2015;61(6):519-23.

Tanbo T, Fedorcsak P. Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obstet Gynecol Scand. 2017;96(6):659-67

Lee HJ, Lee JE, Ku SY, Kim SH, Kim JG, Moon SY, et al. Natural conception rate following laparoscopic surgery in infertile women with endometriosis. Clin Exp Reprod Med. 2013;40(1):29-32

Jurkiewicz-Przondziono J, Lemm M, Kwiatkowska-Pamuła A, Ziółko E, Wójtowicz MK. Influence of diet on the risk of developing endometriosis. Ginekol Pol. 2017;88(2):96-102.