Can You Have PCOS And Endometriosis?

Can You Have PCOS And Endometriosis?

Can You Have PCOS And Endometriosis?
by Tallene Posted December 11, 2023

Both endometriosis and polycystic ovary syndrome (PCOS) are common among women of reproductive age. Plus, since they both have to do with a woman’s reproductive system, there are plenty of endometriosis and PCOS symptoms that overlap. Because of this, women with either PCOS or endometriosis at some point find themselves wondering if they have one disorder, the other, or maybe both. 

Today, we’re going to look into the similarities and differences between PCOS and endometriosis. So if you’re in The Cysterhood and diagnosed with PCOS, you can get answers to other symptoms or questions you have. Here’s what you need to know about endometriosis and PCOS:

Can You Have PCOS And Endometriosis?

Can You Have PCOS And Endometriosis?

Yes, you can have endometriosis and PCOS! Though they both have to do with the reproductive system, the conditions don’t directly affect one another. (Though they may indirectly affect each other.) Endometriosis is primarily a physical issue whereas PCOS is hormonal, so they impact your body in different ways. 

There are both similarities and differences in symptoms, treatments, risk factors, and long-term complications of PCOS and endometriosis. We’ll compare and contrast the two disorders below, but you can hear more about what it’s like to be diagnosed with endometriosis and PCOS from Laura Fletcher of Selah Fertility in this episode of A Cyster and Her Mister.

What is Endometriosis? 

Endometriosis is a condition where endometrial tissue grows outside of the uterus on the ovaries, fallopian tubes, and the lining of the pelvis. These tissues can turn to scar tissue and adhesions that can bind pelvic tissues and organs together.  

What is PCOS?

Polycystic ovarian syndrome is a hormonal condition where imbalances in sex hormones can cause other problems throughout the body like insulin resistance, inflammation, and thyroid problems. 

Similarities Between PCOS And Endometriosis

Similarities Between PCOS And Endometriosis

Difficult and Irregular Periods

Both women with PCOS and endometriosis often have challenging menstrual cycles. They can be extremely heavy, painful, and irregular. With PCOS, these “bad” periods are due to high androgen and insulin levels which can lead to really heavy periods. With endometriosis, it’s because of all the excess tissue trying to shed during your cycle, which can make the pain really intense.

Ovarian Cysts

Ovarian cysts are something that can also pop up with both endometriosis and PCOS. Women with PCOS get polycystic ovaries because often they don’t have the right hormones to ovulate, causing multiple small follicles to accumulate on the ovaries due to the failure of mature egg release. You may also develop cysts with endometriosis, because of the extra tissue that naturally develops throughout the woman’s cycle. The most common type of cyst with endometriosis is known as an endometrioma. These form when endometrial tissue grows inside the ovaries, leading to pelvic pain and discomfort.

Fertility Issues

It probably comes as no surprise that conditions that affect the uterus also affect fertility! Egg quality and ovulation are hindered in both circumstances because of scar tissue and hormonal challenges! (If you’re struggling in this area, here’s how to improve fertility with PCOS.) 

Digestive Problems

With endometriosis, some of that uterine tissue can actually get into the intestines, rectum, and other parts of the bowels, causing lots of digestive problems like constipation, bloating, and gas. Women with PCOS, on the other hand, have similar digestive problems that come from insulin resistance and bacteria imbalances that stem from those hormonal issues. 

Weakened Immune System

A weakened immune system is present in both endometriosis and PCOS. With PCOS, low levels of progesterone can cause antibodies that attack healthy cells, potentially causing immune problems. In endometriosis, doctors aren’t exactly sure why the immune system doesn’t work properly in that condition, but it doesn’t! Because after all, if the immune system was doing its job, it would be taking care of that extra tissue before it became a problem. 

Lack of Cure

Unfortunately, for both women with endometriosis and PCOS, there are no known cures at this time. Both can be managed and reversed, but there’s no quick fix! Here’s how to naturally manage polycystic ovarian syndrome (PCOS.)

Differences Between PCOS And Endometriosis 

Differences Between PCOS And Endometriosis 

Physical vs. Hormonal Source

If you haven’t noticed by now, the key difference between PCOS and endometriosis is that PCOS is primarily hormonal and endometriosis is primarily physical. These can cause similar symptoms, but the source of the problem is very different–which is why you can have both PCOS and endometriosis.


Both conditions can cause aches, but endometriosis causes significant back and pelvic pain. As you can imagine, the adhesions and scar tissues can be very painful. PCOS pain can show up as overall body aches, headaches, ovarian pain, and sometimes painful cramps during the menstrual cycle do to hormonal imbalances.

Acne and Skin Issues

PCOS as a hormonal disorder can cause acne and dark patches of skin. These aren’t endometriosis symptoms, since endometriosis doesn’t predominantly affect the endocrine system. 

Hair Loss and Hirsutism 

The high testosterone associated with PCOS can lead to excessive hair growth on the body while leaving hair thinning on the top. Excess androgens (hormones) are to blame for that, meaning you won’t experience this with endometriosis. 

Weight Gain

Insulin resistance linked with PCOS can cause weight gain in Cysters. It’s also very difficult to lose weight with PCOS, but this is not a symptom of endometriosis. (Of course, you may still struggle with weight gain, but it’s not directly related to an endometriosis diagnosis.) 

Risk Factors

The risk factors linked with endometriosis include:

  • Starting your period young
  • Short menstrual cycles
  • Heavy menstrual cycles
  • High levels of estrogen in the body
  • Low BMI
  • Genetics

You’ll notice the risk factors of having PCOS are pretty different:

  • High androgen levels
  • Insulin resistance
  • Poor diet and sedentary lifestyle 
  • High BMI 
  • Genetics
Long-Term Complications

The long-term complications associated with each disorder do have some overlap, but they do differ! Endometriosis could lead to melanoma, asthma, and breast cancer. PCOS could lead to type 2 diabetes, sleep apnea, and gum disease/gingivitis. They both have links to long-term complications like cardiovascular disease, endometrial cancer, and ovarian cancer. 

Treatment Options

Both PCOS and endometriosis have medications that doctors can prescribe. However, many of them mask symptoms instead of improving them. Cysters can heal their symptoms using diet, exercise, and other lifestyle changes. Women with endometriosis can also find relief with some natural remedies (like cutting gluten!), which you can learn more about from Melissa Turner of Endo Empowered in our episode of A Cyster and Her Mister called “Living Symptom-Free with Endometriosis.”

PCOS and endometriosis do have similarities but also important differences. 

If you’ve wondered about the contrast between PCOS and endometriosis, I hope this post helped you understand each disorder separately. Both can be super difficult for a woman, and the first step towards healing is finding the right diagnosis and community to help you to your goals. If you have PCOS, download The Cysterhood App for an experience curated to help you reverse your symptoms and get to living life again! For all you endometriosis fighters, comment below and I’d be happy to help guide you to helpful resources. We’re here to do this together!

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