PCOS & Endometriosis: What is the difference?

PCOS & Endometriosis: What is the difference?

Both PCOS and endometriosis are common disorders in females. Endometriosis and polycystic ovary syndrome (PCOS) are mainly conditions that affect the female reproductive organs. Endometriosis can affect the ovaries, the uterus, and other organs, such as the bladder and intestines, whereas PCOS only affects the ovaries.

According to a 2018 study, Endometriosis affects between 70 percent of women who experience persistent pelvic discomfort. It is estimated that 10 to 15% of women have it. According to a 2017 study, 5 to 20 percent of women of reproductive age have PCOS.

Endometriosis Vs. PCOS

Even though endometriosis and PCOS have similar symptoms, they are two distinct diseases. While PCOS is a metabolic condition, endometriosis causes persistent pelvic pain. 


What is Endometriosis?

The condition known as Endometriosis results in the endometrium, the tissues that line a woman’s uterus, starting to grow outside of the uterus. The lining of a woman’s pelvic cavity, fallopian tubes, and ovaries can all be impacted by this endometrial tissue. For some women, this illness can be crippling and causes severe pain.

What is PCOS?

Women who have excessive androgen, or male sex hormone, production in their ovaries are said to have polycystic ovarian syndrome. These women also start to form tiny, fluid-filled follicles around the eggs in their ovaries. Women of all ages can develop PCOS, although those between the ages of 15 and 45 are most likely to have it.

What are the symptoms of Endometriosis & PCOS?


PCOS and Endometriosis both have some similar symptoms, such as excessive bleeding and trouble becoming pregnant. However, the majority of the symptoms vary.


  • Heavy bleeding
  • Bleeding between periods
  • Difficulty getting pregnant
  • Painful periods
  • Pelvic pain before periods
  • Pain during or after sex
  • Painful urination or bowel movements
  • Digestive issues
  • Fatigue
  • Low energy


  • Heavy bleeding
  • Irregular periods
  • Missed periods
  • Pelvic pain
  • Excess body hair
  • Hair loss on head
  • Difficulty getting pregnant
  • Acne
  • Oily skin
  • Dark, thickened skin
  • Weight gain
  • Bleeding without ovulation

Sometimes, these disorders might also exist without any symptoms. The symptoms can occasionally be vague or misdiagnosed.

What are the causes of Endometriosis & PCOS?

The exact causes of endometriosis and PCOS are not entirely understood by medical professionals. However, researchers have discovered a few potential causes.


  • Retrograde menstruation: In retrograde menstruation, shed tissue reaches the pelvic cavity through the fallopian tubes, clings to tissue there, and forms ectopic endometriosis lesions.
  • Weak immune system: Endometriosis might manifest in people with immune system issues or people having weak immune systems.
  • Lymphatic or vascular system spread: Endometrial transit via the lymphatic system may be possible if shed endometrium is implanted in ectopic areas.
  • Coelomic metaplasia: The mesothelial lining of the visceral and abdominal peritoneum contains specialized cells that undergo metaplasia and give rise to endometriosis.
  • Surgery: Endometrial tissue may inadvertently move during some surgical procedures, such as a cesarean (C-section) or hysterectomy.


  • Insulin resistance: Both obese and lean PCOS share the common trait of insulin resistance. It happens in 70-95% of obese PCOS patients and 30-75% of lean PCOS patients.
  • Hormonal imbalance: PCOS may be exacerbated by high amounts of several hormones, including testosterone.

What are the risk factors for Endometriosis & PCOS?



  • History of endometriosis in the family
  • Starting menstruation before age 11
  • Infertility
  • Menstrual cycles lasting less than 27 days
  • Severe menstrual bleeding that lasts longer than 7 days


  • History of PCOS in the family
  • Diabetes
  • Sudden weight gain
  • Being obese or overweight

How to diagnose Endometriosis & PCOS?

A number of tests are necessary to confirm the diagnosis of PCOS and endometriosis.


  • Pelvic exam: Using this exam, a doctor can check for cysts or scarring behind the uterus.
  • Imaging test: As MRI can help detect tiny locations of endometriosis, particularly around the intestine and pelvic ligaments, it is frequently used in combination with pelvic ultrasound.
  • Blood test: A blood test known as the CA125 test measures the blood’s levels of the CA125 blood protein, which is also used to identify a specific protein present in the blood of endometriosis-affected women.
  • Laparoscopy: A surgical technique known as laparoscopy enables a physician to access the belly and pelvis from the inside without having to make significant skin incisions.
  • Medical history: If you have any family members who have endometriosis, your doctor will inquire about those issues as well.


  • Pelvic exam: Using this exam, a doctor can check for cysts or scarring behind the uterus.
  • Medical history: If you have any family members who have PCOS, your doctor will inquire about those issues as well.
  • Ultrasound: Your uterus and ovaries can be visualized with ultrasound technology to check cysts.
  • Blood test: Blood tests that show inflammatory marker readings that are abnormally high could be a sign of PCOS.

Can you have PCOS & Endometriosis at the same time?


Yes, it is possible to have both PCOS and endometriosis simultaneously. According to a 2015 study, endometriosis diagnoses are more common in women with PCOS.

Doctors think that the extra androgens and insulin, which result in excess estradiol, are to blame when a woman has endometriosis and PCOS at the same time. When levels of the hormone estradiol rise, women are more likely to develop endometriosis.

How to treat Endometriosis & PCOS?

For those who have endometriosis or PCOS, medications, surgery, and lifestyle modifications can reduce their symptoms and enhance their quality of life.


  • Hormonal birth control
  • Medication for pain
  • Surgical removal of tissue
  • Lifestyle changes


  • Medication
  • Lifestyle changes
  • Hormonal birth control
  • Weight management


Despite being distinct gynecologic disorders, endometriosis and PCOS are both chronic, challenging to treat conditions. 

When endometrial tissue leaves the uterus and harms other organs, endometriosis develops. However, PCOS manifests as numerous ovarian cysts and unusually increased androgen levels.

Infertility and masculine characteristics are side effects of PCOS. PCOS and endometriosis are treated with drugs, surgery, and lifestyle modifications. Both conditions are curable, but only through treatment.