Endometriosis can look quite different depending on its stage and severity. Typically, it involves the growth of tissue similar to the lining of the uterus outside the uterus, mainly on pelvic organs like ovaries and fallopian tubes, but sometimes on other organs in the pelvic area. Visual signs include small, superficial nodules or implants in early stages, and larger, deeper implants, cysts (called endometriomas or "chocolate cysts"), scar tissue, and adhesions in more advanced stages. The tissue may appear as black, brown, red or white lesions and can cause swelling or bloating of the abdomen, sometimes visibly distending it. Here are the typical visual characteristics by stage:
- Stage 1 (minimal): Few small nodules or scars on pelvic lining, often 1 to 3 mm lesions that may be white or red vesicles or flame-like.
- Stage 2 (mild): Multiple small to medium superficial lesions and some deeper lesions more than 5 mm beneath the surface.
- Stage 3 (moderate): Many deep implants, possibly cysts on ovaries, and bands of adhesions often around ovaries and fallopian tubes.
- Stage 4 (severe): Extensive deep implants including large cysts, thick scar tissue, and dense adhesions fixing organs together.
Common images show implants that look like black or dark puckered lesions (sometimes called gunshot lesions), reddish or white spots, and cysts on ovaries filled with old blood (chocolate cysts). The disease may cause a visibly bloated or swollen abdomen due to inflammation ("endo belly") especially around menstrual periods. These visuals can be seen during laparoscopic surgery, which is the definitive way to diagnose and view endometriosis directly. Severity of visual signs does not always match the severity of symptoms, which vary widely among individuals.
