Endometriosis vs PCOS: Know the Difference



Endometriosis and Polycystic Ovary Syndrome (PCOS) are two of the most common gynecological conditions. They affect approximately 5 to 10% of women menstruating women. Given the similarities between them, oftentimes, women have a hard time distinguishing whether they have one or the other.

If you’re struggling to figure this out, knowing the differences can help you and your gynecologist diagnose the condition as soon as possible.


Endometriosis is a condition where tissue that is similar to the lining of the uterus (endometrium), grows on the outside instead of inside. When this happens, the tissue has no way of leaving the body and gets trapped in the pelvis and abdomen. Which essentially causes the symptoms that are listed below.

Polycystic ovary syndrome is a consequence of hormonal imbalance. Due to this, a number of small and large cysts grow along the outer edge of each ovary. In turn, many women miss period periods and experience several other symptoms.


First, we’ll start with the commonalities. Symptoms that both PCOS and endometriosis share are heavy bleeding, pelvic pain, difficulty getting pregnant, and irregular periods.

If you have PCOS, in addition to those symptoms you can experience:

  • Missed periods
  • Excess body hair
  • Hair loss
  • Acne & oily skin
  • Weight gain
  • Dark, thickened skin
  • Bleeding without ovulation

On the other hand, symptoms of endometriosis are:

  • Pain during or after sex
  • Painful urination & bowel movements
  • Digestive issues
  • Fatigue
  • Low energy

Causes of PCOS and endometriosis

Even though the exact causes of both conditions are still unknown, researchers have managed to find several possible reasons why they occur.

For endometriosis, several studies have shown that it can be linked to other conditions. Some of the health issues are:

  • Retrograde menstruation
  • Coelomic metaplasia
  • Post-surgery implantation
  • Endometrial cell transport
  • Immune system problems

Whereas PCOS is associated with high levels of certain hormones, such as testosterone, insulin resistance, and inflammation due to high levels of male hormones.


If you have any of the risk factors listed below, these two conditions are more likely to develop.


  • Family history
  • Early menstruation (before 11 years old)
  • Menstrual cycles that are less than 27 days
  • Long (7+ days) and heavy periods
  • Infertility issues
  • Have never given birth


  • Family history
  • Rapid weight gain
  • Overweight or obesity
  • Diabetes


In order to find the exact diagnosis, you’ll need to visit your doctor so they can take a look into your medical history and proceed accordingly.

If they assume that you have either of the two they’ll move forward with a pelvic exam, blood tests, and imaging tests (ultrasound or MRI). If your doctor believes endometriosis is in question, they’ll conduct a laparoscopy as well.

Apart from your gynecologist, an endocrinologist can also help diagnose and treat PCOS.


Both conditions are treatable and based on different goals. Treatment of endometriosis concentrates on reducing estrogen and pain. While the center of attention for PCOS is to stimulate ovulation and decrease androgens.

In both cases, you’ll receive medication that can help manage the symptoms such as pain, acne, hair loss, and estrogen production. If you’re dealing with PCOS, weight management will most likely be a form of treatment. Endometriosis might require an endometriosis diet.

If medication and lifestyle changes don’t help improve the condition, surgical measures will have to be taken. For endometriosis, removal of the tissue or a hysterectomy will be carried out. For PCOS laparoscopic ovarian drilling will be administered.

When to see a doctor?

The best time to see a doctor is as soon as you notice any recurring symptoms. Early diagnosis can help keep the symptoms at bay.


Endometriosis and polycystic ovary syndrome are conditions that can affect women of reproductive age. Although they are similar in terms of the symptoms that they share, they are vastly different. Differences between the two can be seen by the possible causes, the impact it has on your reproductive system, risks, diagnosis, and treatment. As soon as any concerning symptoms arise, contact your doctor.