Endometriosis vs PCOS: What Is The Difference Between The Two?

Endometriosis and PCOS are both prevalent conditions in women. These conditions affect their reproductive organs, hormone levels, cause infertility, and more. While these two conditions have similar symptoms, they are actually quite different. What are the differences between PCOS and endometriosis, and how can they be treated? In this blog, we are going to answer these questions and more.

When trying to get to the bottom of their pain or infertility, many women begin to explore endometriosis vs PCOS. What is the difference between PCOS and endometriosis, and is there even a difference? Let's dive into each condition and its unique characteristics.

Endometriosis is a disorder that causes the tissues that line a woman's uterus (the endometrium) to begin growing outside of the uterus. This endometrial tissue can affect a woman's ovaries, fallopian tubes, and pelvic cavity lining. This condition is excruciatingly painful and can be debilitating for some women.

The endometrial lining will act as it does in the uterus. It will thicken and then begin to break down and bleed, just as it would in the uterus. Since there is nowhere for the blood to escape, it becomes trapped. The surrounding tissues can become irritated by this, and scar tissue can begin to form. Fibrous tissues can start causing pelvic tissues and organs to stick together. This is just as painful as it sounds and effects over 10% of women who suffer from it.

Polycystic ovary syndrome occurs in women when their ovaries produce too many androgens, male sex hormones. These women also begin to develop small fluid-filled follicles in their ovaries that surround the eggs. This results in irregular periods, ovulation, and many other symptoms. PCOS can affect women of all ages but most commonly, women from 15-45 years of age and around 4-20% of women worldwide.

Many women with PCOS will suffer from insulin resistance. Science is still debating whether PCOS causes insulin resistance or vice versa. Nonetheless, 70-95% of obese PCOS patients and 30-75% of lean PCOS patients will deal with it. Insulin resistance is when the body is not using insulin properly, causing the pancreas to make too much. This excess insulin causes inflammation, weight gain, impairs ovulation and makes excess testosterone.

Women with PCOS are also at a higher risk for developing cardiovascular problems and diabetes.

The difference between PCOS and endometriosis is that PCOS is caused by an overproduction of androgens causing a hormonal imbalance. This imbalance leads to irregular periods, lack of ovulation, ovarian cysts, amongst other symptoms. In comparison, endometriosis is a uterine issue that causes tissue to grow outside of the uterus and is linked to excess estrogen. 

Can you have PCOS and endometriosis together? Yes, since PCOS and endometriosis are two different disorders, you can have them simultaneously. A 2015 study concluded that women with PCOS are more likely to be diagnosed with endometriosis.

Doctors believe that when women have endometriosis and PCOS at the same time it is due to the excess androgens and insulin, causing excess estradiol. Estradiol is a type of estrogen that puts women at a higher risk of developing endometriosis when increased. 

Since women can have PCOS and endometriosis at the same time, it can be hard to narrow down which one you have and if you have both. However, if you experience any of the following symptoms, you should visit your physician or gynecologist for some testing:

• Pelvic pain
• Bleeding between periods
• Irregular periods
• Experiencing infertility
• Painful sex

Often when caught early enough, PCOS and endometriosis can be successfully managed and treated.

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Resources: 

1 - Endometriosis. By Mayo Clinic Staff. Published July 2018.

2 - Endometriosis. By World Health Organization. Published March 2021.

3 - The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. By Deswal R, Narwal V, Dang A, Pundir CS. Published December 2020.

4 - The link between PCOS and insulin resistance. By Dr. L Briden. Published September 2018.

5 - Cardiovascular Risk in Women With PCOS. By Scicchitano P, Dentamaro I, Carbonara R. Published September 2012.

6 - The Potential Implications of a PCOS Diagnosis on a Woman’s Long-Term Health Using Data Linkage. By R Hart, D A Doherty. Published March 2015.