If you’re experiencing a range of symptoms—painful periods, irregular cycles, unexplained weight gain, or infertility—you may be wondering whether it’s possible to have more than one underlying condition. The short answer: yes, you can have both PCOS and endometriosis. In fact, research shows that approximately 8% of women with PCOS are also diagnosed with endometriosis. While they are two distinct conditions, they can overlap in complex ways—especially when it comes to reproductive health and chronic inflammation. Let’s break down what each condition involves and how they can coexist in the same individual.
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What is Endometriosis & PCOS?
What is endometriosis? Endometriosis is when the lining of the uterus grows and shed outside the uterus in response to hormones causing pain. This tissue can grow in the fallopian tubes, ovaries, pelvic floor, event the vaginal, rectum, and even bladder. This causes scarring, inflammation, and subsequent pain. Endometriosis affects around 10% of women globally.
What is PCOS? Polycystic Ovarian Syndrome is a chronic metabolic disease affecting 10-20% of all women globally characterized by excess androgens leading to hyperandrogenic symptoms such as unwanted hair, scalp hair thinning, acne, irregular cycles, infertility, mood swings, weight gain, and insulin resistance. Testosterone drives up insulin resistance leading to increased fat deposition and weight gain, particularly around the abdomen.
Comparing Symptoms of PCOS & Endometriosis
PCOS (Polycystic Ovary Syndrome)
Note: Not all women with PCOS experience every symptom below.
Irregular cycles (sometimes heavy)
Hirsutism (excess facial/body hair)
Obesity or abdominal weight gain
Insulin resistance
Mood swings
Scalp hair loss
Acne
Endometriosis
Note: Not all women with endometriosis experience every symptom below.
The predominant symptom of endometriosis is pelvic pain due to uterine tissue growing outside the uterus.
Painful menstrual cramps (often radiating into the lower back or abdomen)
Pelvic pain during or after sex
Pelvic pain occurring outside of menstruation
Painful urination or bowel movements
Constipation or diarrhea (especially if endometrial tissue spreads to the bladder or intestines)
Symptoms typically worsen during menstruation
Shared Symptoms
Heavy menstrual flow and/or spotting between periods
If you’re experiencing pelvic pain, start with imaging. Don’t assume it’s caused by PCOS—pain is not typically associated with PCOS. Co-existing conditions like uterine fibroids or endometriosis may be involved and should be ruled out.
Curious if you might need to seek a diagnosis for PCOS? Use our free PCOS Screening Tool. This quick and easy tool is not meant to diagnose, but it can help you know if you should pursue a diagnosis.
What is the treatment for Endometriosis and how do I find an endometriosis specialist I can trust?
Endometriosis treatment is generally started conservatively by attempting to halt the abnormal uterine tissue from shedding outside the uterus using hormone therapy such as birth control (progesterone only preferred) or Gonadotropin-releasing hormone agonists which also works to suppress ovulation and reduce estrogen levels.
If treatment with medication is ineffective, a vetted endometriosis specialized surgeon may recommend surgery to remove the endometriosis tissue.
It can be difficult to find an endometriosis surgeon you can trust. That’s why PCOS Sisters has partnered with Icarebetter.com, a directory dedicated to helping you find a vetted endometriosis specialist from pelvic floor therapists to surgeons. Everyone is on your team to help you fight your endometriosis.
FAQ: Endometriosis & PCOS
1. Can you have both PCOS and endometriosis?
Yes, it’s possible to have both. Around 8% of women with PCOS are also diagnosed with endometriosis.
2. What’s the main difference between PCOS and endometriosis?
PCOS is a hormonal and metabolic disorder, while endometriosis involves painful growth of uterine tissue outside the uterus.
3. Is pelvic pain a symptom of PCOS?
Not typically. Pelvic pain is more commonly associated with endometriosis or other conditions like fibroids.
4. Can both PCOS and endometriosis cause infertility?
Yes. Both conditions are linked to infertility, and many women with one or both may struggle to conceive.
