Endometriosis and polycystic ovary syndrome (PCOS) are disorders that affect women during their reproductive years. While it’s possible for them to coexist, they are separate conditions. Each has its own symptoms, treatments, and methods of being diagnosed.
Understanding Endometriosis
Although it’s a common condition, endometriosis is painful and can make it difficult to navigate daily life. The endometrium is the inner lining of the uterus that sheds during a menstrual cycle. Normally, this tissue grows only inside the uterus and thickens in the early stages of pregnancy to help support a growing fetus.
For those with endometriosis, endometrial-like tissue grows in areas outside of the uterus. This excess tissue doesn’t shed during menstrual cycles and builds up over time. This can lead to cysts, inflammation, and, in some cases, excess tissue that connects multiple reproductive organs.
Areas of the body that could potentially be affected include the:
- Abdomen
- Bladder
- Diaphragm
- Fallopian tubes
- Lungs
- Ligaments around the uterus
- Outside surface of the uterus
- Ovaries
- Rectum
What Causes Endometriosis?
Experts are unclear what causes endometriosis; however, they have noticed some factors that may indicate the likelihood of developing it later in life. These include:
- Family history
- Heavy menstrual bleeding
- Increased estrogen levels
- Period beginning before age 11
- Shorter time between periods
Those concerned about their chances of developing endometriosis should speak with their healthcare provider.
What Is Polycystic Ovary Syndrome (PCOS)?
PCOS happens when the ovaries produce too many male hormones called androgens. This causes an imbalance between estrogen and androgens, which can lead to excess hair growth and ovulation disruption.
In a typical ovulation cycle, a mature egg is released from the ovaries to be fertilized by male sperm. When the egg isn’t fertilized, it leaves the body during a menstrual cycle. With PCOS, a woman may have trouble creating enough hormones to ovulate, which causes the eggs to become trapped within the ovaries.
Small fluid-filled sacs, or cysts, may form within the ovaries, though this isn’t always the case. Each cyst contains immature eggs that are unable to be released. As a result, the ovaries become enlarged.
What Causes PCOS?
Much like with endometriosis, the exact cause of PCOS is unclear. However, some risk factors can include:
- Genetics. Having a family history of PCOS could increase someone’s chances of developing the condition later in life.
- Insulin resistance. Insulin is a hormone created in the pancreas that regulates blood sugar levels. Excess insulin may cause the body to make too much androgen, which could make ovulation difficult.
- Obesity. This can increase insulin levels, which may increase androgen production.
- Low-grade inflammation. White blood cells are the first line of defense when the body is injured or infected. They create inflammatory factors to limit the progression of these abnormalities and remove them entirely. With low-grade inflammation, the body continuously produces inflammatory factors even when there isn’t an immediate threat.
Endometriosis vs. PCOS Symptoms
Although both conditions can result in painful cramps and cause infertility, there are other symptoms to keep in mind.
Severe pain during periods, or dysmenorrhea, is a common sign of endometriosis. While cramping is a normal part of a menstrual cycle, it typically subsides within two to three days. With dysmenorrhea, cramps last longer than three days and can be accompanied by nausea, fatigue, and diarrhea.
Those with PCOS may miss their period due to an inability to create enough hormones to ovulate. Having increased amounts of androgen could lead to other health problems such as type 2 diabetes, high blood pressure, or uterine cancer.
Here’s a comparison of some of the symptoms:
Endometriosis | PCOS |
Painful cramps that worsen over time | Diabetes and insulin resistance |
Pain during or after sex | Ovarian cysts |
Abdominal or back pain during or in between periods | Abnormal hair growth |
Heavy bleeding during periods | Irregular periods |
Light bleeding between periods | Weight gain |
Difficulty becoming pregnant | Enlarged ovaries |
Painful bowel movements or urination during periods | Dark or thick skin patches under the breasts, in the armpits, on the back of the neck, and between the legs |
How Is Endometriosis Diagnosed and Treated?
If any of the above symptoms occur, it’s advisable to reach out to a healthcare provider or gynecologist. They may ask about a family history of this condition and if there are any other symptoms prior to running tests. They may perform a pelvic exam or ultrasound, order an MRI, or perform a laparoscopy.
During a laparoscopy, the doctor may collect a small sample of tissue and send it to the lab for a definitive diagnosis.
Although there currently isn’t a cure for endometriosis, the symptoms can be managed. Common treatment options for those currently not trying to get pregnant include:
- Birth control pills to manage periods
- Ibuprofen
- Progestins to manage periods
Surgical treatment options include a laparoscopy, which involves a small cut in the abdomen through which a doctor can examine the area by camera and remove excess tissue. In severe cases, a surgeon may suggest a hysterectomy, the removal of the uterus and ovaries.
A hysterectomy is typically a last resort for treating endometriosis.
How Is PCOS Diagnosed and Treated?
Start by speaking with your primary care physician to discuss your symptoms. Once they have this information, they may refer you to a specialist such as a gynecologist and/or endocrinologist to help provide an accurate diagnosis and treatment plan. Testing for PCOS may include a pelvic exam, an ultrasound, and blood work (to check hormone and glucose levels).
Like endometriosis, PCOS can’t be cured; however, the symptoms can be managed.
If those with PCOS are actively trying to conceive, they may manage their condition through dietary changes and exercise. Losing weight can help the body better regulate insulin levels and reduce excess androgen. This helps balance hormone levels and begin ovulation.
Taking medication to cause ovulation can also help, though it comes with some risks, including:
- Pelvic pain
- Bloating
- Increased chance of conceiving multiple children at once
Those with PCOS who aren’t trying to conceive can also manage their condition through diet and exercise. In addition, they may:
- Take birth control pills to regulate menstrual cycles.
- Use diabetes medication to lower insulin resistance.
- Take other medications to treat specific symptoms.
Related: What You Should Know About an Endocrinologist
Early Diagnosis Can Help Better Manage These Conditions
Although neither endometriosis nor PCOS have cures, they can be managed. Annual medical visits can help a doctor identify, diagnose, and treat conditions before they worsen — which can greatly improve someone’s quality of life.
Everyone’s situation is different. As such, it is necessary to consult a healthcare professional for specific treatment plans. For more information on gynecologists and how they differ from obstetricians, check out our previous post.
Interested in making a difference in women’s health? Apply to American University of the Caribbean School of Medicine (AUC) today!