Lexi Young is officially out of contention for Joey Graziadei's heart. In Monday night's episode of The Bachelor, the digital strategist—who first went on a romantic one-on-one with Joey during a trip to Malta—discovered that their timelines for settling down didn't line up, and decided to leave the dating reality show.
During a group date in Montreal, Canada, Joey explained that he's looking for a two to three year-long engagement. Then, he'd like to share a couple of years with his wife before starting a family, since he wanted to "enjoy the marriage" ahead of having children.
But unfortunately, this didn't work for Lexi, 30, who had previously revealed her stage 5 endometriosis diagnosis to Joey, alongside her increased risk for infertility.
"Because I have endometriosis, having children is going to be a lot more difficult," she said in a confessional. "I do feel Joey came into my life for a reason. He could be my future husband. It's just like: Is it the wrong timing?"
Lexi ultimately told Joey she didn't have the "privilege" of waiting to have children, but didn't want to stop him from moving at his own pace. The split devastated Joey, with the tennis pro telling cameras, "It doesn't feel right to let someone that special just walk out."
During week four, Lexi first revealed her stage 5 endometriosis diagnosis to Joey while on their one-on-one. After about a year and a half of not feeling well, Lexi recalled, she went to a doctor who told her she might not be able to have her own kids because of her endometriosis.
Joey had never heard of endometriosis, so Lexi explained it this way: “It’s a reproductive condition where tissue that’s supposed to grow inside of your uterus grows on other organs.”
Lexi also revealed that she and an ex broke up after she shared that she might not be able to have kids. Joey’s response was sweet. “That’s a lot to hold, but I don’t want you to think in any way that’s something that I hear and it makes me want to run way,” he said. “That’s all I can say. It doesn’t scare me in any sense. There are a lot of other ways to create a family.”
Lexi’s revelation has raised a lot of questions about endometriosis, including what "stage 5 endometriosis" means. Here’s what you need to know:
What is endometriosis?
Endometriosis is a condition where the tissue that lines the uterus starts growing outside of the uterus where it does not belong, according to the U.S. Office on Women’s Health (OASH). The name stems for the specific kind of tissue, endometrium, that lines the uterus. It can appear on the ovaries, fallopian tubes, outer surface of the uterus, and in some cases, the vagina, cervix, vulva, bowel, bladder, or rectum.
How many stages are there?
Technically, here are four stages of endometriosis, Johns Hopkins Medicine says. The stages are based on where the endometrial tissue is in the body, how far it’s spread, and how much tissue is in those areas. The four stages break down as follows, according to the Endometriosis Treatment Center of America:
Stage 1 (minimal): tissue growths are small, shallow, and smaller in number
Stage 2 (mild): tissue growths may be deeper and scarring may begin to occur
Stage 3 (moderate): many deep endometrial tissue growths and cysts may develop on at least one ovary
Stage 4 (severe): many deep endometrial tissue growths, large cysts on at least one ovary, thick adhesions in the pelvic region, and lots of scar tissue
What is stage 5 endometriosis?
Endometriosis really only has four stages, so it’s not entirely clear what Lexi meant. Fertility doctor Lucky Sekhon, MD, posted about Lexi’s revelation on Instagram and shared that "stage five" is actually an “unofficial stage that was proposed back in the ‘90s” that suggested that having a particularly intense case of endometriosis would put a patient into a fifth stage.
Does it actually make you unable to have children?
While endometriosis is linked to infertility, having the condition doesn’t automatically mean that you can’t have your own biological children. “I say that no two patients with endometriosis are going to be exactly the same,” Sekhon explains in her video. “Not everyone who has endometriosis will have infertility.”
And, as Joey pointed out, there’s more than one way to have kids. Lexi commented on Sekhon’s post and shared that she froze her eggs before going on the show.
What are the symptoms?
It’s possible to have endometriosis and have no symptoms, the American College of Obstetricians and Gynecologists (ACOG) says. However, the most common symptom is chronic pelvic pain, especially before and during your period.
People with endometriosis can also have pain during sex, as well as pain while pooping and peeing, and heavy bleeding during periods, ACOG says.
Is there treatment for endometriosis?
Endometriosis is treated with medications, surgery, or both.
Medications include nonsteroidal anti-inflammatory drugs (NSAIDs), and hormonal medications like birth control pills, progestin-only medications, and gonadotropin-releasing hormone (GnRH) agonists, ACOG says. Surgery can be used to remove the excess endometrial tissue.
How common is it?
Endometriosis may impact more than 11 percent of American women between the ages of 15 and 44, OASH says.
Is it curable?
Endometriosis is not curable. Even after surgery for endometriosis, ACOG notes that up to 80 percent of women will have pain again within two years. But treatments can help manage the disease and pain associated with it.
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