Endometriosis, also known as endo, is when tissue that’s supposed to be chilling inside of your uterus decides to set up camp outside. And take our word for it, endo is not a minor inconvenience – it has the ability to cause serious disruptions to your day-to-day life. 

The misplaced tissue can attach itself to various organs and tissue, leading to debilitating pain, inflammation, and scar tissue formation. While the severity of endometriosis ranges from person to person, stage 4 endometriosis is considered to be the most advanced and severe form of the condition. 

In stage 4 endometriosis, the endometrial-like tissue has spread extensively and can be found in the fallopian tubes, ovaries, and in some cases, the bladder and intestines. Large cysts (also called endometriomas) can also form and be found on the ovaries, and adhesions may develop, causing organs to stick together. 

While a stage 4 endo diagnosis can feel daunting, remember, it’s a setback – not the end of the journey. With specialist care and the right approach from specialists in women’s health, you can still lead an active, happy, and fulfilling life. 

How common is stage 4 endometriosis? 

Affecting 14% of the Australian population — or around 1 in 7 females and folks assigned female at birth— almost 2% of people diagnosed with endometriosis are living with stage 4 endometriosis. 

Symptoms of stage 4 endometriosis  

While some people living with endometriosis experience little to no symptoms, stage 4 endo can often come with several key symptoms that often go beyond just painful periods. 

Some of the most common stage 4 endometriosis symptoms include:

• Chronic pelvic pain
• Fatigue
• Discomfort during bowel or bladder movements 
• Dysmenorrhea (aka painful periods)
• Irregular periods 
• Dyspareunia (aka painful sex) 
• Digestive issues 
• Bloating (aka endo belly) 
• Frozen pelvis

The physical pain and discomfort associated with endometriosis aside, if your symptoms leave you feeling drained, frustrated, or mentally exhausted, know that you’re not alone. 

Endometriosis symptoms are infamously overwhelming and can interfere with your everyday life, however, there are treatments and support available to you to help you not only manage your symptoms but also find relief from the physical (and mental) aspects of this condition. 

At Hazel, our women’s health experts take the time to understand your health history and your specific endo symptoms to help you receive answers, fast. Using your individual experience and goals, our team of doctors, psychologists, sexologists, and naturopaths can work with you to establish a treatment plan that places you back in control of your life. 

Endometriosis diagnosis

The path to receiving an endo diagnosis is not always straightforward. Many patients experience diagnosis delays or are misdiagnosed with conditions with similar symptoms – all contributing to the average 6.5 year diagnosis delay.

Painful periods, chronic pelvic pain, digestive issues, and bloating/endo belly mimic the symptoms of other conditions, such as IBS or pelvic inflammatory disease. The good news? There are ways to identify the root cause of your symptoms and we’re here to help. 

How is endometriosis diagnosed? 

To gain a better understanding of your symptoms, your doctor may suggest taking a closer look inside your pelvis. Yes, literally. 

There are some non-invasive screening tools that can be used to detect the presence of endometriosis. In some cases, a pelvic exam or ultrasound are accessible, non-surgical screening tools that can be used to detect the presence of endometriosis. However, while high-res ultrasounds and pelvic exams can give a closer look, they have their limits.

If, for example, endometriosis exists outside of the pelvis or has deeply infiltrated organs, an ultrasound or pelvic exam might miss these details, leaving you without a definitive diagnosis. 

In most cases where endometriosis is suspected, your doctor may recommend laparoscopic surgery. A laparoscopy is a form of surgery that allows doctors to get a closer look at your reproductive organs, pelvis, and surrounding organs to determine if endometrial tissue is present. If endometriosis is found during laparoscopic surgery, your doctor may choose to remove the excessive tissue growth.  

The TLDR? Laparoscopic surgery enables patients to receive a diagnosis and treatment for endometriosis at the same time. 

While surgery is currently the only way to definitively diagnose endometriosis, there are a few things to remember: 

1. Laparoscopic surgery is still considered to be a major surgery
2. Removing the endometrial tissue during laparoscopic surgery doesn’t entirely prevent it from growing back in the future 
3. You may still experience pelvic pain and painful periods even after laparoscopic surgery 

While the road to receiving an endo diagnosis can feel never-ending, it’s important to trust your instincts and keep advocating for yourself in the doctor's office if something doesn’t feel right. 

Our team of specialist women’s health doctors work with you to identify the root cause of your symptoms and establish a treatment plan that aligns with your goals and wishes. No forced surgeries, medications, or procedures here. And that’s the way it should be. 

Stage 4 endometriosis treatment

Waiting to find the right treatment plan that works to successfully manage the symptoms of your stage 4 endometriosis can at times feel both physically and mentally exhausting. 

There’s no such thing as a one-size-fits-all approach to women’s health. There are many options to help you manage your pain, improve how you feel, boost your energy levels, and regulate your periods. 

The key is to find a treatment plan that works best for you, which can often involve incorporating a mix of different conventional and natural medications, treatments, and lifestyle changes tailored to your specific symptoms. 

Some of the most common treatments for stage 4 endometriosis include: 

Nonsteroidal anti-inflammatory drugs (NSAIDs) 

If popping a panadol or two is doing little to provide you relief from your pain, your doctor might recommend nonsteroidal anti-inflammatory drugs (aka NSAIDs). For people living with endo, NSAIDs may help to reduce inflammation, which can help provide temporary pain relief. 

It’s important to note that while they may provide relief from the symptoms of stage 4 endometriosis, NSAIDs don’t treat the underlying cause of endometriosis, or stop the growth of endometrial tissue. 

Hormonal therapy 

Is endo affected by hormones? Yes. 

Is endo caused by hormones? No. 

Because of the complex interplay between hormones and endometriosis, hormonal therapy is one of the main treatments used to help manage the condition. Controlling hormone levels, particularly oestrogen, can help to reduce symptoms and may also slow the progression of the condition. 

For many people living with endo, their symptoms typically worsen in the lead-up to menstruation. Hormonal therapy, including the oral contraceptive pill, progestins, and GnRH agonists, can be used to stabilise oestrogen levels, regulate menstruation, or stop it all together. 

While hormonal therapy can help to manage symptoms, reduce the frequency of flare-ups, and improve your quality of life, it’s worth noting that it doesn’t cure the condition. Symptoms may return (and in some cases, even worsen) when you stop treatment. 

Lifestyle changes 

Looking for an alternative approach to endo treatment that involves fewer surgical and medical options? There are a range of natural options and lifestyle changes that you can implement to help manage the symptoms of endo, including: 

• Following an anti-inflammatory diet to reduce inflammation, digestive issues, and bloating/endo belly 
• Limiting your alcohol intake to avoid spikes in insulin levels, disruptions to gut health, and decrease the risk of inflammation 
• Incorporating supplements such as magnesium, fish oil, and vitamin B (with the help of a clinical naturopath) to reduce pain, decrease inflammation and promote wellness 
• Practicing mindfulness and implementing stress management strategies can improve your emotional wellbeing, which is beneficial for managing chronic health conditions like endometriosis

Working with a naturopath or doctor who specialises in women’s health and conditions like endo can help determine what lifestyle changes you can implement to manage your stage 4 endometriosis symptoms. 

Prescription natural medicine 

Studies have shown that prescription natural medicines, like medicinal cannabis, can assist with easing chronic pain and gastrointestinal issues associated with stage 4 endometriosis in some patients. 

Surgery 

If you and your doctor have decided to venture down the surgery path, know that just like any other treatment, laparoscopic surgery also comes with its own list of benefits and risks.

While laparoscopic surgery can be an effective approach to diagnosing endo and removing endometrial growths, there is always the risk of further scar tissue development and damage to healthy tissue. 

Additionally, laparoscopic surgery won’t grant you immunity against endometrial tissue growing back – meaning it may not solve your pesky pain problem. 

Not sold on surgery? Remember, just because it’s a common treatment option for endo, doesn’t mean it’s your only treatment option. We recommend speaking to a supportive doctor who specialises in women’s health to help determine the best treatment option for you. 

Finding the right treatment option for you

Successfully managing stage 4 endometriosis is all about finding your rhythm, Whether it’s a mix of conventional medicine, lifestyle changes, surgery, or integrating natural medicine options. Our collaborative team of women’s health experts will work with you to create a comprehensive care plan that’s completely tailored to you and your needs. 

Stage 4 endometriosis infertility  

Stage 4 endometriosis can sometimes make the journey to parenthood more complicated. But you’re not walking this road alone – as your partners in healthcare, we’re here to support you. 

While stage 4 endo can often be associated with reduced fertility and difficulties conceiving, the encouraging news is that many people living with stage 4 endometriosis can still successfully fall pregnant.

Establishing a care plan with your doctor is key, and can open up countless options for you to consider on your path to parenthood. If laparoscopic surgeries and natural alternatives (including medicinal cannabis and supplements) aren’t your jam or don’t bring the results you’re hoping for, assisted reproductive technologies like IVF are another option your specialist can help you explore. 

While these potential hurdles may feel overwhelming, with the support of a specialist who understands the complexities of endometriosis and a tailored treatment plan, there is hope and options in your path to becoming a parent. 

Can stage 4 endometriosis be cured? 

Ah, the big question: can stage 4 endometriosis be cured? While there is no known cure for endometriosis, with the help of a caring women's health doctor who specialises in endometriosis, you can leverage conventional medicine and natural medicine options, lifestyle changes, hormonal therapy, or surgery to manage your symptoms in a way that works best for you. 

We know that navigating life with a chronic condition like endometriosis can be challenging, but remember that you never have to go through it alone. With the right resources, treatment plan, and support from a care team and loved ones, you can manage your symptoms and focus on what really matters to you. 

The Wrap-Up 

The truth is, we know that stage 4 endo might feel impossible to navigate, with its relentless symptoms like chronic pain, fatigue, and fertility challenges. But with Hazel? You can put it back in its place. 

Endo involves endometrial-like tissue spreading to various organs, where it can form cysts and adhesions that can cause a whole lot of discomfort. While there’s no one-size-fits-all solution to managing this condition, treatments including hormonal therapy, supplements natural medicine, lifestyle adjustments and even surgery (if that’s your preference) can help. 

With Hazel’s team of experts who specialise in all areas of Women’s Health, you can access expert care that’s completely tailored to your needs and takes into account what your desired treatment plan might look like, so you can take control and live a fulfilling life. 

Because endo doesn’t get to define you.