Polycystic Ovary Syndrome (PCOS) and Endometriosis are two gynaecological conditions that affect millions of women worldwide. Both conditions cause menstrual discomfort, such as heavy bleeding and painful cramps, and they can impact a woman’s ability to fall pregnant.
That said, they are two distinct conditions which cause very different symptoms and require different treatments. It’s also possible to have endometriosis and PCOS at the same time. In this blog, we’ll explain the definition of PCOS and Endometriosis, how ultrasound technology can confirm a positive diagnosis, and how to manage the conditions.
In this article, we will explore
- What is Polycystic Ovary Syndrome (PCOS)?
- What is Endometriosis?
- PCOS Symptoms vs the Symptoms of Endometriosis
- What causes PCOS vs Endometriosis?
- How to distinguish PCOS and Endometriosis from Ovarian Cysts?
- What are Ovarian Cysts?
- Diagnosing Endometriosis vs PCOS?
- Treatment for PCOS vs Endometriosis
- Book an appointment to get assessed today
What is Polycystic Ovary Syndrome (PCOS)?
Polycystic Ovary Syndrome, or PCOS, is a hormonal disorder that affects the ovaries. It causes an imbalance in female sex hormones, leading to irregular hair growth across the chest and face, weight gain, and infertility.
If you have PCOS, your ovaries are inclined to develop tiny, fluid-filled sacs called follicles. These follicles contain immature eggs, which can make it difficult to get pregnant. It is one of the main reasons behind irregular menstrual cycles or the absence of periods.
What is Endometriosis?
Endometriosis is a condition where the tissue that lines the inside of the uterus (endometrium) grows outside the uterus. It can be found on the ovaries, fallopian tubes, pelvic lining, peritoneum, or other organs in the abdominal cavity. In severe cases, it can affect the appendix, large and small intestine, rectum, lungs and diaphragm.
During the menstrual cycle, hormonal changes can cause the displaced tissue to thicken, leading to inflammation, scarring, and pain.
Endometriosis occurs more frequently than PCOS.
PCOS Symptoms vs the Symptoms of Endometriosis
Do you have Polycystic Ovary Syndrome or Endometriosis? We’ve included a comparison table to help you identify which condition you may have. These are the signs and symptoms to watch for.
PCOS Symptoms
- An irregular menstrual cycle, such as constant bleeding or the absence of periods (amenorrhea).
- Excessive hair growth (hirsutism), often on the face, chest, back, or abdomen.
- Acne breakouts and oily skin.
- Trouble losing weight
- Weight gain despite still being active.
- Loss of hair, particularly thinning on the scalp.
- Insulin resistance and an increased risk of type 2 diabetes.
- Trouble falling pregnant (infertility)
Symptoms of Endometriosis
- Pain in the pelvis, especially during menstruation.
- Extreme pain during periods (dysmenorrhea).
- Pain or discomfort during intercourse.
- Infertility or difficulty conceiving.
- Chronic lower back pain.
- Gastrointestinal symptoms include bloating, diarrhoea, or constipation, especially during menstruation.
It is possible to experience one or two symptoms and not have PCOS or endometriosis. But if you experience several of the symptoms listed above, book a gynaecological visit.
What causes PCOS vs Endometriosis?
The exact cause of PCOS and endometriosis is unclear, but medical research has singled out possible explanations.
What causes PCOS
In the case of PCOS, doctors believe that genetics and insulin resistance play significant roles.
The three primary causes of PCOS are:
- High levels of testosterone due to hormonal imbalances
- Insulin resistance leads to elevated insulin levels. This can stimulate the ovaries to produce more androgens (male hormones) than usual, disrupting the normal hormone balance.
- Excess inflammation can also cause an increase in male hormones.
What Causes Endometriosis
In the case of Endometriosis, there are five potential causes.
- Retrograde menstruation. This occurs when menstrual blood flows back into the pelvis instead of out of the body.
- An immune system dysfunction which fails to regulate retrograde menstruation.
- Genetics. Some people have coelomic metaplasia (cells turn into endometrial cells, resulting in endometriosis).
- Hormonal imbalances.
- Surgical trauma. In women who have had hysterectomies, endometrial cells have been implanted at the surgical site, leading to endometriosis.
How to distinguish PCOS and Endometriosis from Ovarian Cysts?
While PCOS and Endometriosis can be associated with ovarian cysts, they are different conditions.
What are Ovarian Cysts?
Ovarian cysts are fluid-filled sacs that can form on and in the ovaries. They can develop as part of the menstrual cycle or due to abnormal growth. While PCOS and Endometriosis can cause ovarian cysts, you can have either condition without developing ovarian cysts.
Diagnosing Endometriosis vs PCOS?
Doctors use similar methods to diagnose PCOS and Endometriosis. Here’s what to expect.
| PCOS | Endometriosis |
|---|---|
| Medical history – you’ll be asked a series of questions about your family medical history to determine whether female relatives have experienced similar problems. | Medical history – your doctor will ask if you know of any family members diagnosed with endometriosis. They’ll also ask if you have any pre-existing medical conditions that could increase your chance of developing the condition. |
| Blood tests – if you have abnormally high levels of inflammatory markers in your blood, that indicates that you may have PCOS. Doctors will look for testosterone and other levels, such as estrogen or the follicle-stimulating hormone. | Blood tests – doctors use the CA-125 test to check for biomarkers that indicate endometriosis. |
| Pelvic exam – your doctor will look for cysts and abnormal growths. | Pelvic exam – your doctor will check for masses or scarring. |
| An Ultrasound – using imaging technology, doctors will check to see if you have enlarged ovaries, partially developed eggs on your ovaries and a thickened uterus lining. In sexually active women, a transvaginal ultrasound is preferable. In younger girls who aren’t sexually active, an abdominal ultrasound is used. | Imaging tests such as an ultrasound or MRI – doctors use this test to produce an image of your uterus. An MRI uses magnetic waves to create detailed images of your uterus. |
 | Laparoscopy – this is a surgical procedure which doctors perform to examine the organs within the abdominal wall. When looking for signs of endometriosis, the doctor will make a small incision into your abdomen and check for any unusual growths. |
Treatment for PCOS vs Endometriosis
Both conditions are treated with medication and surgery.
Treatment options for endometriosis include:
- Pain Medication: Over-the-counter pain relievers such as ibuprofen can help manage mild pain and discomfort.
- Hormonal Therapy: Hormonal treatments like birth control pills, progestin-only therapy, or GnRH agonists can help reduce the growth of endometrial tissue and relieve symptoms.
- Surgery: A laparoscopic surgery may be performed to remove endometrial growths and scar tissue. For women who don’t want to have children or have had children already, a hysterectomy is advised.
- Lifestyle Changes: Regular exercise, a healthy diet, and managing stress can help improve symptoms and overall well-being.
Treatment options for PCOS include:
- Lifestyle Changes: Weight management and regular exercise can improve insulin sensitivity and hormonal balance.
- Hormonal Birth Control: Oral contraceptives can regulate menstrual cycles and reduce androgen levels.
- Anti-androgen Medications: Medications like spironolactone can help reduce excessive hair growth and acne.
- Insulin-Sensitizing Medications: Metformin may be prescribed to improve insulin sensitivity and help with ovulation.
- Fertility Treatments: Medications like clomiphene or assisted reproductive technologies (ART) are recommended for treating infertility.
Book an appointment to get assessed today
If you suspect you have PCOS or Endometriosis, arrange to see a gynaecologist, as an early diagnosis and treatment are vital to controlling your symptoms. The best way to prevent PCOS and endometriosis is to arrange yearly check-ups with your gynaecologist.
To arrange for an ultrasound at ERAD, book an appointment here.
Sources:
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