Stage 4 is considered the most severe stage of endometriosis. At this stage, tissue grows in multiple places in a person’s body. The most common symptom of this stage of endometriosis is general pain: pain during sexual activity, bowel movements, and/or while urinating.
Severe menstrual cramping, spotting or bleeding between periods, and difficulty getting pregnant are some of the other common symptoms of Stage 4 endometriosis. Back pain and pelvic pain are also expected.