Two very common conditions affecting women of childbearing age are endometriosis and polycystic ovarian syndrome (PCOS). While both cause pain and disruption to your menstrual cycle and complicate female fertility, they have different symptoms and don’t share the same root cause. Here we explain the similarities, differences and when you should call your doctor.
Both Are Common Disorders
Among women ages 14-49, endometriosis is slightly more prevalent and is diagnosed in 12-15 percent of reproductive age females, while PCOS affects 6-12 percent in this same age group. Doctors find both endometriosis and PCOS difficult to detect and fertility concerns are what often leads to diagnosis.
What is Endometriosis?
Endometriosis occurs when cells similar to those found in the lining of the uterus, or endometrium, attach to areas outside of the uterus such as the ovaries, fallopian tubes, exterior of the uterus, rectum, bowel and bladder. These cells grow and create both pain and scar tissue.
Most women find out they have endometriosis when they aren’t able to conceive. Typically your doctor wants you to wait until you’ve had unprotected sex for one year (six months if you’re over age 35) before scheduling an evaluation. But if you’re unable to get pregnant and experience any of the symptoms below, you should alert your doctor.
- Pain and pressure in the abdominal area
- Frequent pelvic pain
- Frequent urination
- Heavy periods
- Painful periods
- Menstrual cramps that occur before and after your period
- Pain in pelvic or lower back area at any time during your cycle
- Painful and/or passing blood in bowel movements
- Painful urination
- Pain during intercourse
- Urinary incontinence
What is PCOS?
PCOS is a hormonal disorder that may start very early in the reproductive years. While doctors aren’t able to pinpoint the exact cause of PCOS, they agree it’s a complex endocrine condition that can be related to factors like diet, lifestyle and genetics.
Obesity is a common and contributing factor to PCOS as fat cells release the male hormone androgen. The overabundance of androgens in your system causes a hormonal imbalance, affecting menstruation and ovulation. Your menstrual cycle depends on balanced hormones for ovulation and menstruation; otherwise, you don’t ovulate normally. This imbalance and infrequent ovulation often creates painful cysts that develop in your ovaries that further complicate things.
Insulin resistance is another common condition seen in females with PCOS. Insulin resistance means higher insulin and blood sugar levels, which can lead to diabetes and obesity as insulin resistance makes it difficult to lose weight.
Other symptoms of PCOS include:
- Missed or irregular periods
- Heavy bleeding
- Excessive hair growth on face, chest, abdomen and back (hirsutism)
- Oily skin
- Thinning hair
- Male pattern baldness
- Dark, thick patches on skin
- Cysts on ovaries
Like endometriosis, fertility complications are usually the first symptom that causes concern. Since PCOS can’t be diagnosed on symptoms alone, your doctor will schedule tests to assess your condition.
Risk Factors for Endometriosis and PCOS
While there are no exact causes that doctors find for either PCOS or endometriosis, there are certain risk factors that may contribute to your odds for having one or the other.
Endometriosis Risk Factors
- Beginning your periods before age 11
- Having periods that last longer than one week
- Less than 27 days menstrual cycle
- A family history of endometriosis
- Studies that show a connection between lean body mass and endometriosis
Risk Factors for PCOS
Aside from obesity, one of the biggest risk factors for PCOS is a family history of a close female relative who has/had PCOS (eg. sister, mother, aunt, grandmother).
If you are diagnosed with PCOS, you need to be aware of certain risks for the following conditions:
- High blood pressure
- Heart disease
- High triglycerides, LDL and low HDL cholesterol
- Sleep Apnea
- Type 2 Diabetes (over half of those diagnosed with PCOS develop Type 2 diabetes by age 40, according to the Centers for Disease Control)
Is There a Connection Between PCOS and Endometriosis?
Although both PCOS and endometriosis contribute to infertility, they are not related. And although rare, you can have both conditions, with recent study showing about 7 percent of women who receive a PCOS diagnosis also have mild endometriosis.
Diagnosing and Treating PCOS and Endometriosis
If you suspect you may have either PCOS or endometriosis–or both–consult your doctor who’ll consider your symptoms, conduct a detailed medical history and exam, and test your blood for hormone levels. You may also need a pelvic ultrasound and any other necessary tests.
Treatment depends on the severity of your condition as well as age, overall health and whether or not you want to have children in the future.
Turn to Halo for Help with PCOS
For more information regarding either PCOS of endometriosis, contact Halo Fertility. We’ll schedule a consultation and discuss options based on your diagnosis. If you’re concerned, don’t wait. Reach out today.