What is the Difference Between PCOS and Endometriosis?

Both commonly misdiagnosed, this article explains difference between PCOS and endometriosis to inform you and help get the right diagnosis.

Polycystic Ovary Syndrome

PCOS is a chronic hormonal disorder. It occurs when the ovaries produce too many hormones called androgens. This affects ovulation and progesterone production. The resulting imbalance of hormones can cause a number of symptoms.

An overview of documented PCOS symptoms:

–    Irregular periods and fertility issues

When too much testosterone hormone is produced, it can interfere with your cycle and cause irregular periods. Often with PCOS periods become less frequent, once every three months or even longer, but they can last any length of time and tend to be heavy and more painful. This irregularity interferes with ovulation which can make it difficult to conceive.

–    Skin conditions

Hormonal conditions affect your skin, causing excess oiliness and outbreaks which can lead to acne.

–    Weight gain

Hormonal imbalance can mess with your body’s insulin production and may lead to weight gain

–    Excessive hair growth (Hirsutism)

Heightened levels of testosterone can trigger male-pattern hair growth on the chin, upper lip, chest and back. Like with men, this hair is often coarse and dark.

–    Mental health problems

As well the array of distressing physical symptoms, hormonal changes can have a profound effect on your emotional wellbeing. PCOS is often thought to trigger depression, anxiety and other mental health issues.


Endometriosis occurs when the lining of the uterus (endometrium) grows outside of the uterus or on other areas such as the ovaries, the outer surface of the uterus, the fallopian tubes, the cervix, the bladder or rectum. It can, in fact, be found anywhere in the body. During menstruation this tissue sheds, bleeds and exits the body through the uterus as your period. Endometrium tissue growing elsewhere behaved in the same way during your cycle, but is unable to leave the body, so it stays where it is causing pain, inflammation and scarring.

An overview of the symptoms:

–    Pelvic pain  

Shooting or stabbing pain in the pelvis can be unprompted and severe and can interfere with daily activities. Pain may also present in the lower back and down the legs. For this reason endometriosis is sometimes misdiagnosed as sciatica.  

–    Painful periods and fertility issues

Like with PCOS, endometriosis and cause periods to be heavy, irregular, painful and long lasting. Likewise, though it does not make it impossible to have children, it can certainly make it more challenging.

–    Pain during sex, urination and bowel movements

These activities can cause extreme pain in the pelvis, abdomen and affected areas.

–    Mental health issues

Endometriosis, much like PCOS can have a detrimental psychological impact, as its symptoms can negatively affect physical and emotional wellbeing often putting a strain on relationships, social activities and work commitments.

There is an inherent thread of misinformation and misdiagnosis with these conditions and patients routinely suffer for years unable to access the help and support they need. Although PCOS and endometriosis each affect an estimated one in ten people with uteruses, receiving a successful diagnosis can be a frustratingly lengthy procedure, mainly because there are a host of other conditions that have similar presenting symptoms. But endometriosis and PCOS are different and have varying effects on the reproductive system.

It is even possible to have both conditions at the same time

So what can you do about it…?

Regulation of your menstrual cycle and hormone testing can help differentiate between the two conditions. Contraceptive medication is typically used as the first line of defence, and IVF treatment can help with fertility problems. Pain medication is also a go-to treatment for both conditions, but it’s important to note that only endometriosis is characterised by severe pain which can be incapacitating for those who suffer from it.

Beyond this point, treatment options diverge:

PCOS is treated on a symptom-by-symptom basis, whereas endometriosis, can require surgical intervention for diagnosis and to remove endometrium tissue. Invasive treatment is not always necessary, or desirable for that matter, and a combination of diet, exercise, sleep, hormone-therapy, strong painkillers and current medical treatment can really help in managing your condition and taking care of your emotional wellbeing.

Anybody experiencing especially painful or irregular menstrual cycles, abnormal hair growth, or struggling with infertility should visit their doctor.

Remember that there are many treatment options available; you do not have to simply put up with your symptoms because you have a uterus!

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