Table of ContentsView AllTable of ContentsEndometriosis vs. PCOSSymptomsCauses and Risk FactorsDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Endometriosis vs. PCOS
Symptoms
Causes and Risk Factors
Diagnosis
Treatment
Frequently Asked Questions
Endometriosisandpolycystic ovary syndrome(PCOS) are both linked to hormonal imbalances and can lead to infertility. However, these two conditions affect femalereproductive organsdifferently.
PCOS primarily affects the ovaries and is linked to excess androgens, commonly considered male hormones, though females do make them in small amounts.Endometriosis is associated with higher levels of the female hormone estrogen. It can affect the ovaries, the uterus, and other organs in the lower abdominal cavity, such as the bladder and intestines.
Approximately 6% to 10% of people with a uterus are diagnosed with endometriosis.Between 6% and 12% of people assigned female at birth are diagnosed with PCOS.Both occur during the childbearing years.
This article explains the differences between PCOS and endometriosis. It also discusses the symptoms of each and how they are diagnosed and treated.
How to Know if It’s Endometriosis or PCOS
Although endometriosis and PCOS share symptoms, they are different conditions. Endometriosis causes chronic pelvic pain, while PCOS is ametabolic disorder.
What Is Endometriosis?
The innermost lining of the uterus is called theendometrium. The endometrium helps keep the uterus functioning properly, especially during pregnancy.When the endometrial tissue begins to grow outside theuterus, it’s called endometriosis. Endometriosis is the most common cause of pelvic pain in women of childbearing age.
Endometriosis
What Is PCOS?
PCOS occurs when the ovaries andadrenal glandsproduce too much androgen hormone. This is called hyperandrogenism.
Theovarieshave several important functions, including the release of reproductive hormones. The growth and release of an egg from the ovary (ovulation) depend on those reproductive hormones.
In addition, cysts (fluid-filled sacs) form in the ovaries of most people with PCOS.
PCOS
Endometriosis and PCOS have a few common symptoms, including heavy menstrual periods and infertility. However, several differences set them apart.
EndometriosisAbdominal painChronic pelvic painConstipationFrequent urinationHeavy periodsInfertilityPainful bowel movementsPainful periodsPainful sexPainful urinationRectal bleedingUrinary urgencyPCOSDiabetes andinsulin resistanceFluid-filled sacs in the ovariesExcess body and facial hairInfertilityInfrequent menstrual cyclesMale-pattern baldnessMasculine featuresObesitySevere acne
EndometriosisAbdominal painChronic pelvic painConstipationFrequent urinationHeavy periodsInfertilityPainful bowel movementsPainful periodsPainful sexPainful urinationRectal bleedingUrinary urgency
Abdominal pain
Chronic pelvic pain
Constipation
Frequent urination
Heavy periods
Infertility
Painful bowel movements
Painful periods
Painful sex
Painful urination
Rectal bleeding
Urinary urgency
PCOSDiabetes andinsulin resistanceFluid-filled sacs in the ovariesExcess body and facial hairInfertilityInfrequent menstrual cyclesMale-pattern baldnessMasculine featuresObesitySevere acne
Diabetes andinsulin resistance
Fluid-filled sacs in the ovaries
Excess body and facial hair
Infrequent menstrual cycles
Male-pattern baldness
Masculine features
Obesity
Severe acne
Signs of PCOS are more systemic. In addition to infrequent periods, the hormonal imbalance in PCOS leads to excess hair growth on the face and body (hirsutism), severe acne, and male pattern baldness.
PCOS is a metabolic disorder. It commonly presents along with excess body weight, obesity, diabetes, insulin resistance, and acanthosis nigricans—patches of thick, velvety, darkened skin on the neck and skin folds associated with insulin resistance.
Although hormonal imbalances play a part in endometriosis and PCOS, other causes and risk factors are unique to each condition.
It’s unclear what causes endometriosis, but possibilities includeretrograde menstruation(menstrual blood flowing in the wrong direction), genetics, impaired immune system,increased estrogen levels, and abdominal surgery (endometrial tissue can be transferred to other organs during surgery).
Endometriosis risk factors include:
Although the exact reason why PCOS occurs is not fully understood, experts agree that it is a complexendocrinecondition with multiple causes, including diet and lifestyle factors.
Fat cells also release androgens, which is why it’s not uncommon for obese people to experience PCOS. Hyperandrogenism also leads to insulin resistance anddiabetes.
Additionally, the hormonal changes lead to anovulation, subsquently irregular menstrual cycles, and possible infertility. PCOS is one of the most common causes offemale infertility, affecting 70% to 80% of people wanting a pregnancy.
Risk factors for having PCOS include:
Is There a Link Between Endometriosis and PCOS?
A study found that although endometriosis and PCOS share abnormalities in hormonal balance, body weight, age of menarche (when periods start), and reproductive irregularities, the causes of those abnormalities differ. Therefore, a link between the two gynecologic disorders cannot be made.
Can You Have Both?Although rare, people can have both endometriosis and PCOS. Such reported cases show that endometriosis is often mild when found in combination with PCOS.
Can You Have Both?
Although rare, people can have both endometriosis and PCOS. Such reported cases show that endometriosis is often mild when found in combination with PCOS.
Endometriosis and PCOS require several tests to confirm their diagnosis. Endometriosis often takes longer to diagnose than PCOS.
Diagnosing Endometriosis
The following are ways to diagnose endometriosis:
Your healthcare provider may give you medications that help decrease estrogen levels. If medications relieve your symptoms, you likely have endometriosis.
Diagnosing PCOS
The following are ways to diagnose PCOS:
Your healthcare provider will also review a history of your menstrual cycles and fertility.
Medications, surgery, and lifestyle changes can improve the symptoms and quality of life for people with endometriosis or PCOS.
How Endometriosis Is Treated
Treatment for endometriosis is often geared toward pain management. However, considering the person’s desire for pregnancy is also important.
How PCOS Is Treated
When to See a Healthcare ProviderCall your healthcare provider for the following symptoms:Heavy, irregular, or absent periodsChronic pelvic painSigns of androgen excessInfertility
When to See a Healthcare Provider
Call your healthcare provider for the following symptoms:Heavy, irregular, or absent periodsChronic pelvic painSigns of androgen excessInfertility
Call your healthcare provider for the following symptoms:
Summary
Endometriosis and PCOS are different gynecologic disorders but are both chronic conditions that are difficult to manage.
Endometriosis occurs when endometrial tissue travels outside the uterus and damages other organs. PCOS, however, occurs when androgen levels are abnormally elevated, and multiple cysts are found in the ovaries. PCOS results in signs of androgen excess and infertility.
Endometriosis and PCOS are managed with medications, surgery, and lifestyle changes. Although treatable, neither condition is curable.
A Word From Verywell
Endometriosis and PCOS can be frustrating conditions to manage. Fortunately, they rarely occur together, but each disorder can negatively affect your quality of life.
Although living a healthy lifestyle can alleviate the symptoms of endometriosis and PCOS, having a sense of well-being also improves these conditions. It’s essential to have social support in addition to medical help when living with endometriosis or PCOS.
Frequently Asked QuestionsNo. Endometriosis does not usually cause weight gain; most people with this condition are average or underweight.PCOS and endometriosis are not linked and do not trigger one another.PCOS is not considered an autoimmune disease; it is the most common endocrine disorder in women.A diet of natural ingredients and rich in fresh fruits and vegetables improves symptoms of endometriosis and PCOS. Exercising also improves quality of life.PCOS has been shown to increase the risk of developing certain types of cancer, such as endometrial cancer.PCOS and endometriosis have high rates of infertility. About 30% to 50% of people with endometriosis are infertile, and 70% to 80% of people with PCOS experience infertility.
No. Endometriosis does not usually cause weight gain; most people with this condition are average or underweight.
PCOS and endometriosis are not linked and do not trigger one another.
PCOS is not considered an autoimmune disease; it is the most common endocrine disorder in women.
A diet of natural ingredients and rich in fresh fruits and vegetables improves symptoms of endometriosis and PCOS. Exercising also improves quality of life.
PCOS has been shown to increase the risk of developing certain types of cancer, such as endometrial cancer.
PCOS and endometriosis have high rates of infertility. About 30% to 50% of people with endometriosis are infertile, and 70% to 80% of people with PCOS experience infertility.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control.Diabetes and polycystic ovary syndrome (PCOS).Office on Women’s Health.Endometriosis.Deswal R, Narwal V, Dang A, Pundir C.The prevalence of polycystic ovary syndrome: a brief systematic review.J Hum Reprod Sci. 2020;13(4):261. doi: 10.4103/jhrs.JHRS_95_18The American College of Obstetricians and Gynecologists.FAQs: Endometriosis.The American College of Obstetricians and Gynecologists.FAQs: Polycystic ovary syndrome.Abraham Gnanadass S, Divakar Prabhu Y, Valsala Gopalakrishnan A.Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update.Arch Gynecol Obstet. 2021;303(3):631–43. doi:10.1007/s00404-020-05951-2National Institutes of Health.What are the risk factors for endometriosis?Peterson CM, Johnstone EB, Hammoud AO, et al.Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study.American Journal of Obstetrics and Gynecology. 2013;208(6):451.e1-451.e11. doi: 10.1016/j.ajog.2013.02.040Khan MJ, Ullah A, Basit S.Genetic basis of polycystic ovary syndrome (pcos): current perspectives.Appl Clin Genet. 2019;12:249-260. doi:10.2147/TACG.S200341Melo A, Ferriani R, Navarro P.Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice.Clinics. 2015;70(11):765-769. doi:10.6061/clinics/2015(11)09Sirmans S, Pate K.Epidemiology, diagnosis, and management of polycystic ovary syndrome.CLEP. doi:10.2147/CLEP.S37559Dinsdale NL, Crespi BJ.Endometriosis and polycystic ovary syndrome are diametric disorders.Evol Appl. 2021;14(7):1693-1715. doi:10.1111/eva.13244Office of Women’s Health.Polycystic ovary disease.Rafique S, Decherney AH.Medical management of endometriosis.Clinical Obstetrics & Gynecology. 2017;60(3):485-496. doi:10.1097/GRF.0000000000000292Singh SS, Suen MWH.Surgery for endometriosis: beyond medical therapies.Fertility and Sterility. 2017;107(3):549-554. doi:10.1016/j.fertnstert.2017.01.001ennberg Karlsson J, Patel H, Premberg A.Experiences of health after dietary changes in endometriosis: a qualitative interview study.BMJ Open. 2020;10(2):e032321. doi:10.1136/bmjopen-2019-032321Rocha AL, Oliveira FR, Azevedo RC, et al.Recent advances in the understanding and management of polycystic ovary syndrome.F1000Res. 2019;8:565. doi:10.12688/f1000research.15318.1Memorial Sloan Kettering Cancer Center.Polycystic ovary syndrome associated with higher risk of pancreatic cancer, new study shows.Bulletti C, Coccia ME, Battistoni S, Borini A.Endometriosis and infertility.J Assist Reprod Genet. 2010;27(8):441-447. doi:10.1007/s10815-010-9436-1
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control.Diabetes and polycystic ovary syndrome (PCOS).Office on Women’s Health.Endometriosis.Deswal R, Narwal V, Dang A, Pundir C.The prevalence of polycystic ovary syndrome: a brief systematic review.J Hum Reprod Sci. 2020;13(4):261. doi: 10.4103/jhrs.JHRS_95_18The American College of Obstetricians and Gynecologists.FAQs: Endometriosis.The American College of Obstetricians and Gynecologists.FAQs: Polycystic ovary syndrome.Abraham Gnanadass S, Divakar Prabhu Y, Valsala Gopalakrishnan A.Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update.Arch Gynecol Obstet. 2021;303(3):631–43. doi:10.1007/s00404-020-05951-2National Institutes of Health.What are the risk factors for endometriosis?Peterson CM, Johnstone EB, Hammoud AO, et al.Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study.American Journal of Obstetrics and Gynecology. 2013;208(6):451.e1-451.e11. doi: 10.1016/j.ajog.2013.02.040Khan MJ, Ullah A, Basit S.Genetic basis of polycystic ovary syndrome (pcos): current perspectives.Appl Clin Genet. 2019;12:249-260. doi:10.2147/TACG.S200341Melo A, Ferriani R, Navarro P.Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice.Clinics. 2015;70(11):765-769. doi:10.6061/clinics/2015(11)09Sirmans S, Pate K.Epidemiology, diagnosis, and management of polycystic ovary syndrome.CLEP. doi:10.2147/CLEP.S37559Dinsdale NL, Crespi BJ.Endometriosis and polycystic ovary syndrome are diametric disorders.Evol Appl. 2021;14(7):1693-1715. doi:10.1111/eva.13244Office of Women’s Health.Polycystic ovary disease.Rafique S, Decherney AH.Medical management of endometriosis.Clinical Obstetrics & Gynecology. 2017;60(3):485-496. doi:10.1097/GRF.0000000000000292Singh SS, Suen MWH.Surgery for endometriosis: beyond medical therapies.Fertility and Sterility. 2017;107(3):549-554. doi:10.1016/j.fertnstert.2017.01.001ennberg Karlsson J, Patel H, Premberg A.Experiences of health after dietary changes in endometriosis: a qualitative interview study.BMJ Open. 2020;10(2):e032321. doi:10.1136/bmjopen-2019-032321Rocha AL, Oliveira FR, Azevedo RC, et al.Recent advances in the understanding and management of polycystic ovary syndrome.F1000Res. 2019;8:565. doi:10.12688/f1000research.15318.1Memorial Sloan Kettering Cancer Center.Polycystic ovary syndrome associated with higher risk of pancreatic cancer, new study shows.Bulletti C, Coccia ME, Battistoni S, Borini A.Endometriosis and infertility.J Assist Reprod Genet. 2010;27(8):441-447. doi:10.1007/s10815-010-9436-1
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control.Diabetes and polycystic ovary syndrome (PCOS).Office on Women’s Health.Endometriosis.Deswal R, Narwal V, Dang A, Pundir C.The prevalence of polycystic ovary syndrome: a brief systematic review.J Hum Reprod Sci. 2020;13(4):261. doi: 10.4103/jhrs.JHRS_95_18The American College of Obstetricians and Gynecologists.FAQs: Endometriosis.The American College of Obstetricians and Gynecologists.FAQs: Polycystic ovary syndrome.Abraham Gnanadass S, Divakar Prabhu Y, Valsala Gopalakrishnan A.Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update.Arch Gynecol Obstet. 2021;303(3):631–43. doi:10.1007/s00404-020-05951-2National Institutes of Health.What are the risk factors for endometriosis?Peterson CM, Johnstone EB, Hammoud AO, et al.Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study.American Journal of Obstetrics and Gynecology. 2013;208(6):451.e1-451.e11. doi: 10.1016/j.ajog.2013.02.040Khan MJ, Ullah A, Basit S.Genetic basis of polycystic ovary syndrome (pcos): current perspectives.Appl Clin Genet. 2019;12:249-260. doi:10.2147/TACG.S200341Melo A, Ferriani R, Navarro P.Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice.Clinics. 2015;70(11):765-769. doi:10.6061/clinics/2015(11)09Sirmans S, Pate K.Epidemiology, diagnosis, and management of polycystic ovary syndrome.CLEP. doi:10.2147/CLEP.S37559Dinsdale NL, Crespi BJ.Endometriosis and polycystic ovary syndrome are diametric disorders.Evol Appl. 2021;14(7):1693-1715. doi:10.1111/eva.13244Office of Women’s Health.Polycystic ovary disease.Rafique S, Decherney AH.Medical management of endometriosis.Clinical Obstetrics & Gynecology. 2017;60(3):485-496. doi:10.1097/GRF.0000000000000292Singh SS, Suen MWH.Surgery for endometriosis: beyond medical therapies.Fertility and Sterility. 2017;107(3):549-554. doi:10.1016/j.fertnstert.2017.01.001ennberg Karlsson J, Patel H, Premberg A.Experiences of health after dietary changes in endometriosis: a qualitative interview study.BMJ Open. 2020;10(2):e032321. doi:10.1136/bmjopen-2019-032321Rocha AL, Oliveira FR, Azevedo RC, et al.Recent advances in the understanding and management of polycystic ovary syndrome.F1000Res. 2019;8:565. doi:10.12688/f1000research.15318.1Memorial Sloan Kettering Cancer Center.Polycystic ovary syndrome associated with higher risk of pancreatic cancer, new study shows.Bulletti C, Coccia ME, Battistoni S, Borini A.Endometriosis and infertility.J Assist Reprod Genet. 2010;27(8):441-447. doi:10.1007/s10815-010-9436-1
Centers for Disease Control.Diabetes and polycystic ovary syndrome (PCOS).
Office on Women’s Health.Endometriosis.
Deswal R, Narwal V, Dang A, Pundir C.The prevalence of polycystic ovary syndrome: a brief systematic review.J Hum Reprod Sci. 2020;13(4):261. doi: 10.4103/jhrs.JHRS_95_18
The American College of Obstetricians and Gynecologists.FAQs: Endometriosis.
The American College of Obstetricians and Gynecologists.FAQs: Polycystic ovary syndrome.
Abraham Gnanadass S, Divakar Prabhu Y, Valsala Gopalakrishnan A.Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update.Arch Gynecol Obstet. 2021;303(3):631–43. doi:10.1007/s00404-020-05951-2
National Institutes of Health.What are the risk factors for endometriosis?
Peterson CM, Johnstone EB, Hammoud AO, et al.Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study.American Journal of Obstetrics and Gynecology. 2013;208(6):451.e1-451.e11. doi: 10.1016/j.ajog.2013.02.040
Khan MJ, Ullah A, Basit S.Genetic basis of polycystic ovary syndrome (pcos): current perspectives.Appl Clin Genet. 2019;12:249-260. doi:10.2147/TACG.S200341
Melo A, Ferriani R, Navarro P.Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice.Clinics. 2015;70(11):765-769. doi:10.6061/clinics/2015(11)09
Sirmans S, Pate K.Epidemiology, diagnosis, and management of polycystic ovary syndrome.CLEP. doi:10.2147/CLEP.S37559
Dinsdale NL, Crespi BJ.Endometriosis and polycystic ovary syndrome are diametric disorders.Evol Appl. 2021;14(7):1693-1715. doi:10.1111/eva.13244
Office of Women’s Health.Polycystic ovary disease.
Rafique S, Decherney AH.Medical management of endometriosis.Clinical Obstetrics & Gynecology. 2017;60(3):485-496. doi:10.1097/GRF.0000000000000292
Singh SS, Suen MWH.Surgery for endometriosis: beyond medical therapies.Fertility and Sterility. 2017;107(3):549-554. doi:10.1016/j.fertnstert.2017.01.001
ennberg Karlsson J, Patel H, Premberg A.Experiences of health after dietary changes in endometriosis: a qualitative interview study.BMJ Open. 2020;10(2):e032321. doi:10.1136/bmjopen-2019-032321
Rocha AL, Oliveira FR, Azevedo RC, et al.Recent advances in the understanding and management of polycystic ovary syndrome.F1000Res. 2019;8:565. doi:10.12688/f1000research.15318.1
Memorial Sloan Kettering Cancer Center.Polycystic ovary syndrome associated with higher risk of pancreatic cancer, new study shows.
Bulletti C, Coccia ME, Battistoni S, Borini A.Endometriosis and infertility.J Assist Reprod Genet. 2010;27(8):441-447. doi:10.1007/s10815-010-9436-1
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