Endometriosis vs. PCOS—What's The Difference?

Endometriosis and PCOS are two different conditions with overlapping symptoms that can leave women feeling lost on their search for a diagnosis and relief.

Endometriosis affects an estimated 190 million reproductive-age women, and approximately 116 million women are affected by PCOS globally (why isn’t this talked about more?!)

It can be challenging to figure out if you have endometriosis vs PCOS, and some women suffer from both conditions. These chronic conditions affect women of childbearing age, don’t have a definite cure, and require ongoing medical management for their symptoms.

Understanding the difference between PCOS vs endometriosis is important if you want to identify and apply the right treatment strategy for maximum symptom improvement.

Let’s take a closer look at the similarities and differences of endometriosis vs PCOS.

What is Endometriosis?

Endometriosis occurs when tissue similar (but not the same) as the endometrium (the uterine lining), grows in other parts of the body. Other areas for these lesions tend to be on the ovaries, fallopian tubes, and pelvic organs, however endo has now been found on every organ of the body. These lesions behave similarly to the endometrium in that they thicken, break down, bleed in response to hormonal changes. Unfortunately, because the lesions aren’t located on the inside of the uterus, they have no way to exit the body, bleeding into the pelvis or elsewhere, creating scar tissue.

These endometriosis lesions lead to inflammation in the body, endometriosis flare ups, pain, infertility and more. This causes a range of symptoms, both mentally and physically, for endowarriors.

Some common symptoms of endo include:

• Painful, heavy, or irregular periods

• Ovulation pain

• Pain during or after sex

• Pain with bowel movements and urination

• Infertility

• Digestive issues

• Constipation or diarrhea

• Bloating

• Back, nerve, or pelvic pain

• Fatigue

• Depression or anxiety

This list is a general consensus of what many endowarriors deal with regularly. You may also have other symptoms from endometriosis not included on this list (see my blog for uncommon symptoms of endometriosis to learn more!)

So, how do you know if you have endometriosis?

How to Get an Endometriosis Diagnosis

Endo is diagnosed primarily through a laparoscopy or advanced ultrasound. Only skilled surgeons trained in endometriosis laparoscopic surgery are able to perform this procedure. If you have mild to severe endo, this could be an option for you with the right surgeon.

The laparoscopy procedure involves making an incision in your abdomen where a small tube with a camera is inserted. Some cases might require more than one incision to find and remove endometriosis. Many endowarriors might be a bit hesitant to have surgery, but it’s certainly one management option for relieving pain. However, there’s still a chance that pain could return even if you do pursue surgery.

As far as the advanced ultrasound route goes, this one can be a bit tricky. Only certain specialists trained in advanced ultrasounds may be able to diagnose your endometriosis. However, it’s important to know that using ultrasound to successfully detect endometriosis is challenging and not always viable.

What is PCOS?

PCOS stands for polycystic ovarian syndrome, which is a metabolic condition. While incredibly complex, most often, PCOS involves an overproduction of androgens and insulin. PCOS can cause serious health conditions such as diabetes and some types of cancer.

In some women with PCOS, the outer edge of your ovaries develops tiny sacs of fluid called cysts. These cysts contain immature eggs called follicles, which fail to release the eggs regularly. With the exact cause of PCOS being unknown, there are still many questions surrounding the condition.

Women who receive a diagnosis, coupled with a better understanding of their hormone levels and insulin levels have a very good chance of conceiving, reducing the risk of chronic conditions that stem from PCOS and living a good quality of life.

Some common symptoms of PCOS include:

• Long or irregular period cycles

• Limited cervical mucus

• Infertility

• Excessive body or facial hair

• Acne

• Hair loss

• High androgens, and symptoms that come with this including hair growth, aggression and acne

• Insulin resistance

• Weight gain or obesity

• Depression or anxiety

And how do you know if you have PCOS?

How to Get a PCOS Diagnosis

PCOS is diagnosed when you meet two of the three following criteria:

• Irregular menstrual cycles, varying from cycle to cycle in length

• Elevated androgen hormone levels (testosterone, DHEA)

• Polycystic ovaries with multiple small cysts

You may also be wondering, is PCOS an autoimmune disease? Since low levels of progesterone often accompany PCOS, this could be one possible method of action that overstimulates the immune system leading to the production of autoantibodies. Because of this, PCOS could be considered an autoimmune disease, although it has not been formally recognized as one.

Shining a Light on PCOS and Endometriosis Awareness

Looking at shared PCOS vs endometriosis symptoms, both conditions can cause fatigue, heavy bleeding, irregular periods, and infertility. They can also both greatly impact mental health and quality of life. Since these symptoms overlap, it can be confusing trying to determine which condition you might have.

That’s why I believe it’s so important to advocate for endometriosis awareness and PCOS awareness. With so many women experiencing these conditions, we need to normalize conversations around them and find better options for treatment.

Being an endometriosis dietitian (and an endowarrior!) has inspired me to help as many women as possible improve their endo symptoms through nutrition and lifestyle changes.

To reach more endowarriors, I created the Endo Thrive Society as a safe place for anyone with endometriosis who wants extra support and a shared community along the way! This program was designed using a functional-medicine, step-by-step process that can greatly improve symptoms of endo and fertility.

Are you ready to take back control of your body, health plan, and lifestyle? Join the Endo Thrive Society along with hundreds of others who have been through the program and seen improvement in their endo symptoms.

Feel free to leave any questions below or contact me directly!