What is the difference between Endometriosis and Polycystic Ovarian Syndrome?

Endometriosis and polycystic ovary syndrome (PCOS) are medical conditions that affect those with vaginas who are between 12 and 50 years old. Both disorders affect menstrual periods, fertility, and hormonal functions. Though they have many similarities, the two conditions are strikingly different. 

Polycystic ovary syndrome is a hormonal condition affecting the ovaries of childbearing age. The most common symptoms are missed or irregular periods, cysts on ovaries, infertility, and excess body hair. On the other hand, endometriosis is a hormonal condition that results from the endometrium (the tissue lining the uterus) growing in other parts of the body due to high levels of estradiol (estrogen). These body parts include but are not limited to ovaries, fallopian tubes, peritoneum, uterus, bladder, rectum, lungs, and intestines. The endometrium can get thicker during menstruation, leading to painful, heavy bleeding.

Symptoms of Endometriosis & Polycystic Ovarian Syndrome

Endometriosis - occurs due to the overproduction of the female hormone estrogen and affects people and women of reproductive ages. This condition causes heavy bleeding during menstruation and makes it harder to get pregnant. Other symptoms include pain during periods; urination; intercourse; and/or bowel movements; bleeding between periods; heavy periods; rectal bleeding; bloating; fatigue; chronic pelvic pain; lower abdominal pain; constipation, frequent urination; and nausea.

Polycystic Ovary Syndrome (PCOS) - occurs due to the ovaries and adrenal glands’ overproduction of the male hormone, androgen, and affects those of reproductive ages (12 to 50 years old). It also affects menstruation leading to heavy bleeding and causes infertility. Other symptoms include periods (missed, irregular, or light), excess body or facial hair, large ovaries or cysts on ovaries, oily skin, obesity, severe acne, diabetes, male-pattern baldness, and chronic lower abdominal or pelvic pain.

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Risks Factors of Endometriosis & Polycystic Ovarian Syndrome

  • Endometriosis risk factors include: hereditary; heavy bleeding for over a week; early menses before age 11; short menstrual cycle; and infertility.
  • PCOS risk factors include sudden weight gain; hereditary; being overweight or obese; poor eating habits; insulin resistance; sedentary lifestyles; and diabetes.

Diagnosis of Endometriosis & Polycystic Ovarian Syndrome

Early diagnosis is critical for maintaining and controlling the symptoms of endometriosis and PCOS. It is possible, though rare, to have both conditions. It is crucial to schedule annual gynecology checkups to know what is happening down there.


  • Pelvic exams can be done to identify cysts, scarring, masses, or areas of pain. Pelvic ultrasounds can find ovarian cysts, and magnetic resonance imaging (MRI) is used to capture detailed images of the organs and tissues affected by endometriosis. 
  • Laparoscopy is a surgical procedure to check for abnormal tissue growth in the abdominal cavity. This procedure may call for a biopsy to be performed for diagnosis confirmation.

Polycystic Ovarian Syndrome

  • Pelvic ultrasound is used to find cysts and growths on the ovaries.
  • Physical exams can help identify BMI and other physical attributes of PCOS symptoms.
  • Blood work is done to check for changes in cholesterol levels, diabetes, and androgen levels.

Treatment of Endometriosis & Polycystic Ovarian Syndrome

There are no cures for either condition, but several treatments are available to treat their symptoms.


For endometriosis, medical treatment focuses on limiting estrogen production and pain, such as 

  • Surgery to remove endometrial tissue growth.
  • Estrogen medication: Medication, like birth control, can help reduce estrogen and regulate the growth of endometrial tissue.
  • Hysterectomy - removal of the uterus for those who do not want to conceive. 
  • Pain medication - prescribed or over-the-counter pain medication for pain relief.
  • Lifestyle changes: Eating a balanced diet to manage symptoms and control weight gain.

Polycystic Ovarian Syndrome

Medical treatment for PCOS focuses on increasing ovulation and decreasing androgen production, such as:

  • Medications for ovulation medication include those to regulate hormones and induce periods or birth control to limit androgen production.
  • Laparoscopy - to remove androgen-releasing tissues.
  • Medications to reduce excess hair growth and manage acne.
  • Lifestyle changes: eat a healthy diet and regular exercise to manage symptoms.

For endometriosis and PCOS, see a trained gynecologist or healthcare professional if you have:

  • Infrequent or no periods
  • Pelvic or lower abdominal pain
  • Heavy bleeding during periods
  • Bleeding in between periods
  • Pain during intercourse
  • Difficulties with fertility

Although there are no cures for PCOS and endometriosis, early diagnosis is critical for maintaining and controlling the symptoms of both conditions. If you are experiencing symptoms that are similar to those of PCOS and/or endometriosis, we advise you to go see a gynecologist for medical care. Remember, the best care is preventative care, so get your annual gynecology checkups and take care of your health!

November 22, 2023

This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.