PCOS and endometriosis are two of the most common reproductive disorders in women that are caused by hormonal imbalance and can lead to infertility, but the two conditions affect the female reproductive organs differently and it’s important to understand the difference in their symptoms. In endometriosis, tissues similar to the lining of the uterus grow outside the uterus while PCOS is a hormonal disorder causing enlarged ovaries with small cysts on the outer edges. PCOS primarily affects the ovaries and is linked to excess androgens, commonly considered male hormones. Endometriosis is associated with higher levels of the female hormone oestrogen. It can affect the ovaries, the uterus, and other organs in the lower abdominal cavity, such as the bladder and intestines. (Also read | Millets for PCOS: Amazing benefits, how to add to diet, and 2 healthy recipes)

Is it PCOS or endometriosis? Know difference in symptoms(Freepik)

Dr Sriprada Vinekar, Senior Consultant, Minimal Invasive Gyna ecologist, Cloudnine Group of Hospitals, Malleshwaram, Bangalore in an interview with HT Digital talks about the two disorders in detail, explaining the difference between their symptoms.

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Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome affects hormones and causes irregular periods, excess hair growth, acne and infertility. Women suffering from it are at higher risk of a range of disorders and diseases including diabetes and high blood pressure. Women with PCOS may experience a range of symptoms, which can vary in severity.

Some common symptoms include:

Irregular menstrual cycles: Women with PCOS may have irregular periods or may even experience infrequent periods, which can make it difficult to predict ovulation and conceive.

Ovarian cysts: PCOS is often associated with the presence of multiple small cysts on the ovaries. These cysts are not harmful but can contribute to hormonal imbalances.

Excess androgen production: Elevated levels of androgens can lead to symptoms such as acne, hirsutism (excessive hair growth on the face, chest, or back), and male-pattern baldness.

Insulin resistance: Many women with PCOS also have insulin resistance, a condition in which the body’s cells do not respond effectively to insulin, leading to high levels of insulin in the blood. Insulin resistance can contribute to weight gain, difficulty losing weight, and an increased risk of type 2 diabetes.

Weight gain: Women with PCOS are more likely to struggle with weight management, and excess weight can exacerbate symptoms of the condition.


Endometriosis is a chronic and often painful condition where tissue similar to the lining of the uterus, called the endometrium, grows outside the uterus. This tissue can be found on other pelvic organs such as the ovaries, fallopian tubes, outer surface of the uterus, and the lining of the pelvic cavity. During menstrual cycle, this tissue responds to hormonal changes by thickening, breaking down, and bleeding. However, because this tissue is located outside the uterus, it has no way to exit the body. This can lead to inflammation, scar tissue formation, and adhesions (bands of fibrous tissue) between organs.

Endometriosis affects women primarily during their reproductive years, typically between the ages of 15 and 49. The exact cause of endometriosis is not fully understood, but several theories exist, including retrograde menstruation (where menstrual blood flows backward through the fallopian tubes into the pelvic cavity), immune system disorders, and genetic factors.

Common symptoms of endometriosis

Pelvic pain: This is the most common symptom and can vary in intensity. It may occur before and during menstruation, during intercourse, during bowel movements or urination, or even during ovulation.

Heavy menstrual bleeding: Women with endometriosis may experience heavier periods than usual, along with clotting.

Painful intercourse: Pain during or after intercourse is common in women with endometriosis.

Infertility: Endometriosis can lead to fertility problems, although not all women with endometriosis will experience infertility. Other symptoms may include fatigue, gastrointestinal symptoms such as diarrhoea, constipation, bloating, or nausea, especially during menstruation.

Difference between PCOS and endometriosis symptoms

Both PCOS and endometriosis require medical evaluation and management by gynaecologists. Treatment approaches may vary depending on the severity of symptoms, reproductive goals, and individual patient factors. It’s essential for women experiencing symptoms suggestive of either condition to seek medical attention for proper diagnosis and treatment. Both PCOS (Polycystic Ovary Syndrome) and endometriosis are significant issues concerning women’s physical health.

PCOS (Polycystic Ovary Syndrome): PCOS is characterised by hormonal imbalances that can lead to irregular menstrual cycles, infertility, excessive hair growth (hirsutism), acne, and weight gain. Not all women with PCOS will develop ovarian cysts, but these cysts are common in some cases.

Endometriosis: Endometriosis occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterus, commonly on the ovaries, fallopian tubes, and other pelvic organs. Its symptoms often include pelvic pain, especially during menstruation, heavy menstrual bleeding, painful intercourse, and infertility. Endometriosis can also cause gastrointestinal symptoms like painful bowel movements or urinary symptoms.


PCOS: Diagnosing PCOS typically involves a combination of physical examination, medical history review, blood tests to measure hormone levels (such as testosterone, LH, FSH), pelvic ultrasound to check for ovarian cysts, and ruling out other conditions.

Endometriosis: Diagnosis of endometriosis often requires a laparoscopic surgical procedure, during which a surgeon inserts a tiny camera through a small incision near the navel to view the pelvic organs directly. However, diagnosis may begin with a thorough medical history review, pelvic examination, and imaging tests such as ultrasound or MRI.


PCOS: Treatment for PCOS aims to manage symptoms and prevent complications. It often involves lifestyle changes such as weight management through diet and exercise, hormonal birth control to regulate menstrual cycles, anti-androgen medications to manage symptoms like hirsutism and acne, and fertility treatments if needed.

Endometriosis: Treatment for endometriosis depends on the severity of symptoms and the woman’s reproductive goals. It may include pain management with over the counter or prescription medications, hormonal therapies (such as birth control pills, progestins, or GnRH agonists) to suppress menstruation and reduce endometrial growth, and surgery (laparoscopy) to remove endometrial implants or scar tissue, particularly in cases of severe pain or infertility.

While both PCOS and endometriosis are complex conditions affecting women’s reproductive health, they have distinct symptoms, diagnostic approaches, and treatment strategies.


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