Endometriosis is a chronic inflammatory condition where tissue similar to the uterine lining grows outside the uterus. This misplaced tissue responds to hormonal changes, leading to pain, inflammation, adhesions, and sometimes organ damage.

But here’s something important: endometriosis doesn’t always follow a worsening trajectory. While some cases progress, others stabilize or even regress, meaning it’s not an inevitable downward spiral.

Endometriosis Isn’t Always Progressive

Research suggests that endometriosis can remain stable or even regress over time. One study published in Human Reproduction found that 45.3% of asymptomatic women undergoing laparoscopy had endometriosis, with the majority being mild cases (stage I). Many of these women had no symptoms despite the presence of lesions. 

Another study in the Journal of Gynecology Obstetrics and Human Reproduction Journal of Gynecology Obstetrics and Human Reproduction analyzed 465 women undergoing tubal sterilization and found that 11.82% had endometriosis—again, mostly mild cases. Notably, even among women with children, the prevalence was 10%, showing that endometriosis doesn’t always prevent fertility and can exist without significant symptoms. 

These studies tell us something important: endometriosis isn’t always aggressive. In some cases, it remains inactive or regresses. Recognizing this gives us more control over our health and treatment choices.

The Four Stages of Endometriosis

Endometriosis is classified into four stages based on the number, location, depth, and severity of lesions, adhesions, and scar tissue. The classification is set by the American Society for Reproductive Medicine (ASRM), but it doesn’t always correlate with symptom severity – meaning someone with Stage I could have severe pain, while someone with Stage IV might have minimal discomfort.

Stage I (Minimal)

• Small, superficial lesions found on the peritoneum (the thin layer covering abdominal organs).
• Minimal scar tissue or adhesions.
• May go unnoticed or cause mild pain, bloating, or irregular cycles.

Stage II (Mild)

• More lesions, but still shallow and limited in spread.
• Small adhesions (scar-like tissue that can bind organs together) may start forming.
• Symptoms may include more noticeable cramping, bloating, and digestive discomfort.

Stage III (Moderate)

• Deeper infiltrating lesions affecting the ovaries and pelvic lining.
• Endometriomas (” cysts”) may be present on the ovaries.
• Adhesions start affecting the movement of reproductive organs.
• Pain becomes more pronounced, especially during periods, sex, or bowel movements.

Stage IV (Severe)

• Extensive, deep lesions with large adhesions binding organs together (e.g., uterus stuck to the bowel or bladder).
• Endometriomas (large ovarian cysts) are common.
• Symptoms can include chronic pelvic pain, severe bloating, painful bowel movements, infertility, and organ dysfunction.

Even though these stages classify the structural changes caused by endometriosis, they don’t always reflect pain levels, fertility impact, or overall health. This is why focusing on reducing inflammation, modulating immune function, and supporting hormonal balance is crucial – no matter the stage.

Can Acupuncture support in Endo pain? 

Acupuncture is an ancient practice rooted in Traditional Chinese Medicine (TCM) that involves inserting thin needles at specific points in the body to promote healing and restore balance. But does it actually work for endometriosis? 

Reduces Endometriosis-Related Pain

One of the most well-documented benefits of acupuncture is pain relief. A meta-analysis of 10 randomized controlled trials (RCTs) in 2021 found that acupuncture significantly reduces endometriosis-related pain, particularly dysmenorrhea (painful periods) and chronic pelvic pain. 

How it works:

• Acupuncture stimulates endorphin release, which are the body’s natural painkillers.
• It blocks pain signals from reaching the brain by stimulating sensory nerve fibers.
• It reduces muscle tension and inflammation in the pelvic region.

Lowers Inflammation & Supports Immune Function

Endometriosis is driven by chronic inflammation and an overactive immune system that fails to clear misplaced endometrial-like cells. Acupuncture has been shown to modulate immune function, reducing inflammatory cytokines like TNF-alpha and IL-6, which are elevated in endometriosis patients

Improves Blood Circulation to the Pelvic Region

Poor blood flow to the uterus and ovaries can contribute to pain, clotting, and hormonal imbalances. Acupuncture dilates blood vessels and enhances microcirculation, ensuring that oxygen and nutrients reach the pelvic organs.

Supports Gut Health & Reduces Digestive Issues

Many people with endometriosis experience IBS-like symptoms, bloating, constipation, or diarrhea—often due to gut inflammation, food sensitivities, and pelvic floor dysfunction

By understanding that endometriosis is an active process, we can adopt strategies aimed at interrupting this cycle. This involves addressing factors such as inflammation, hormonal imbalances, and immune system dysfunction.

Our body operates as an interconnected system, where each part influences the others. This holistic view helps explain why factors like stress reduction, dietary changes, and physical therapies can positively impact endometriosis symptoms. By supporting overall health, we can create an internal environment less conducive to the progression of endometriosis.

Visit Freyja Health Clinic  to talk about your fertility goals and explore personalized solutions. Our team is committed to providing comprehensive care, ensuring you are equipped with the tools to optimize your health and achieve your fertility aspirations. Your well-being is our priority, and we look forward to assisting you on your path to a healthier and more fulfilling life.