PCOS vs. Endometriosis: What’s the Difference?
Before you can even begin to make sense of your symptoms and figure out what’s going on inside your body, it’s important to have a basic understanding of what PCOS (Polycystic Ovary Syndrome) and endometriosis actually are and how they differ.
Here’s a brief explanation of each in case you’re unsure or unfamiliar with these conditions.
PCOS: It’s All About Hormonal Imbalance
PCOS is a hormone disorder. It affects up to 13% of women of reproductive age worldwide, and the most common hormones affected by PCOS include:
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Androstenedione
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Anti-Müllerian hormone (AMH)
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Dehydroepiandrosterone Sulfate (DHEA-S)
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Estrogen
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Follicle-stimulating Hormone (FSH)
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Insulin
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Luteinizing Hormone (LH)
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Progesterone
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Testosterone
When these hormones are out of balance due to PCOS, this can lead to insulin resistance, irregular menstrual cycles, excess facial or body hair, acne, and weight changes. If you’re actively TTC with PCOS, you may also struggle to get pregnant. This is because ovulation may be inconsistent, and your periods may also be difficult to keep track of.
Endometriosis: When Tissue Grows Outside the Uterus
Unlike PCOS which is a hormonal condition, endometriosis is a physical condition. It occurs when tissue similar to the uterine lining (i.e. the endometrium) grows outside the uterus, in places like the:
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Bladder
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Bowel
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Ovaries
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Pelvis
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Uterine tubes
Just like the uterine lining, excess tissue caused by endometriosis also responds to hormonal changes throughout the menstrual cycle. And just like the uterine lining (which is shed during your period), this excess tissue due to endometriosis also thickens ahead of menstruation and attempts to shed. However, because the excess tissue has no way to exit the body, it causes inflammation and scarring. This can cause painful periods, pelvic pain, digestive issues, and even fertility challenges if left untreated.
Key Differences in Symptoms and Fertility Impact
Both PCOS and endometriosis can interfere with fertility and make it more difficult to conceive. However, there are key differences to be aware of when navigating your symptoms and a potential diagnosis:
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PCOS often presents with hormonal symptoms, such as irregular or absent periods, acne, changes in hair growth, and/or metabolic issues.
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Endometriosis typically presents with physical symptoms, especially in the pelvic area, which can feel like intense cramping before and during your period, painful intercourse, and digestive issues.
Recognizing how these symptoms differ can help you better understand your own individual symptoms and experiences.
PCOS or Endometriosis Quiz: Navigating Your Symptoms
We know just how frustrating it is to experience symptoms, but have no clue what’s actually going on with your body. You may be confused about what’s ‘normal’, what deserves medical attention, and what kind of support you may need in the future, especially if you’re looking to plan a pregnancy at some point.
Although this quiz isn’t a diagnostic test, it can still help you take a step back, reflect on your symptoms in a structured way, and identify potential patterns worth discussing with your healthcare provider.
PCOS vs Endometriosis Quiz Results: What Your Answers Might Indicate
After you’ve taken the signs of endometriosis vs signs of PCOS quiz, you’ll receive your results as either leaning toward PCOS, leaning toward endometriosis, or a mix of both. Here’s what your results may indicate, along with practical steps for what to do next to look after your health.
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PCOS vs Endometriosis: What Your Results Mean |
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Results lean towards PCOS. |
If your answers lean towards PCOS, this indicates your symptoms may be rooted in hormonal imbalance. Common symptoms of hormone imbalance include:
Next Steps:
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Results lean towards endometriosis. |
If your answers lean towards endometriosis, this indicates your symptoms may stem from inflammation and abnormal tissue growth in and around the pelvis. Common symptoms of endometriosis include:
Next Steps:
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Results are mixed. |
If your results show a blend of symptoms, this indicates you could be dealing with both conditions at once or an entirely different condition. In any case, a more in-depth evaluation is the next best step. Next Steps:
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PCOS Symptoms vs. Endometriosis Symptoms
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PCOS Symptoms Vs. Endometriosis Symptoms: What’s Common? |
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Symptom |
PCOS |
Endometriosis |
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Irregular periods |
Common |
Less common |
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Severe menstrual cramps |
Rare |
Very common |
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Excess facial/body hair |
Common (due to high androgen levels) |
Rare |
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Chronic pelvic pain |
Rare |
Common |
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Cysts on ovaries |
Often present |
May appear (but not required for diagnosis) |
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Bloating or bowel issues |
Common |
Frequently reported |
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Trouble losing weight |
Common |
Less common |
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Pain during intercourse |
Sometimes |
Very common |
How to Get a Clear Diagnosis
Quizzes and symptom checkers are definitely a good starting point if you think you may have PCOS or endometriosis, but online quizzes still can’t provide you with a definitive answer. Only your doctor can run the tests and assessments necessary for an accurate, reliable diagnosis.
Common Diagnostic Tools and Tests
Before you speak with your doctor, it can be helpful to have a basic understanding of the types of tests and diagnostic tools they may use to assess your situation.
Here’s a brief overview of what you can expect and what you may have some questions about:
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Blood hormone tests, which can evaluate your levels of LH, FSH, AMH, DHEAS, 17-OH progesterone, testosterone, prolactin, thyroid hormones, insulin, and glucose.
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Pelvic ultrasound, which can identify cysts related to endometriosis or other physical indicators associated with PCOS, such as enlarged ovaries with multiple follicles.
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Laparoscopic surgery, which can identify, assess, and/or remove potential lesions or scar tissue associated with endometriosis.
The uncertainty of it all can feel a bit scary, but it’s important to get a clear diagnosis so you can get effective treatment.
What to Do Next: Support Options and Tracking Tools
When you’re faced with confusing symptoms, the most powerful thing you can do for yourself is to start paying close attention to your body and seek help when you need it.
Start by acknowledging that your symptoms are valid and deserve attention. From there, it’s all about gathering information, tracking changes, and connecting with the right healthcare professionals.
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Further Support and Next Steps Following a PCOS or Endometriosis Diagnosis |
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If You’ve Been Diagnosed With PCOS… |
If You’ve Been Diagnosed With Endometriosis… |
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Lifestyle Changes |
Focus on a low-glycemic, nutrient-dense diet that supports blood sugar balance. Incorporate moderate physical activity such as walking, yoga, or strength training. Prioritize stress management and sleep hygiene to reduce hormonal disruptions. |
Adopt an anti-inflammatory diet rich in omega-3s and low in processed foods, dairy, and sugar. Engage in gentle movement like yoga or Pilates to ease pelvic tension. Use heat therapy to manage menstrual cramps and pain. |
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Supplements |
Inositol (Myo and D-Chiro) may improve insulin sensitivity and support ovulation. Vitamin D is often low in PCOS patients, and supplementation may support hormonal balance. Mira’s PCOS Supplements offer the ideal ratio of Myo and D-Chiro Inositol to promote hormone balance in PCOS patients. |
Omega-3 fatty acids may help reduce inflammation. Magnesium can ease cramping and support relaxation. Herbal teas such as Mira’s Fertility Tea offer calming support. |
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Medications and Procedures |
Birth control pills can help regulate periods. Metformin may be helpful for insulin resistance. Ovulation-inducing medications like Letrozole or Clomid may be recommended if you are actively TTC. |
Over-the-counter NSAIDs (such as ibuprofen) can help manage pain. Hormonal therapies such as birth control, progestins, or a hormonal IUD may ease symptoms. Laparoscopic surgery can confirm diagnosis and remove lesions. |
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Tracking |
Visualize symptoms and cycle trends with the Mira App. Test hormones regularly at home with the Mira Monitor, which allows for real-time hormone tracking for LH, FSH, PdG, and E3G. Check key hormonal markers with Mira’s Panorama Lab Test. Attend all doctors’ appointments, making sure to ask about ultrasounds and blood tests to monitor ovarian health and hormone levels. |
Visualize symptoms and cycle trends with the Mira App. Track pain in a pain diary to advocate effectively during doctor visits. Attend all doctors’ appointments, making sure to ask about ultrasounds and laparoscopic surgery. |
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Clinical Support |
Seek advice from medical specialists, such as a reproductive endocrinologist or integrative medicine specialist. Seek expert TTC advice and emotional support from a hormone health expert in Mira’s Hormone Health Clinic. |
Work closely with a gynecologist or endometriosis specialist to manage care and symptoms. |
The goal here isn’t just to get a label, it’s to understand your body better, find solutions that work for your lifestyle and fertility goals, and build a support network of qualified professionals who can help you.
You Are Not Alone
If your body is sending you mixed signals, it’s only normal to feel frustrated, confused, and alone. PCOS and endometriosis are both complex conditions, and it can be disheartening if your condition or symptoms disrupt your ability to conceive.
If you are actively TTC and looking for further support on navigating pregnancy alongside a PCOS or endometriosis diagnosis, you may find the following articles on our website helpful:
Remember — you don’t have to navigate this path alone. But you do need to advocate for yourself. Learning how to recognize your symptoms, track patterns, and seek expert advice with confidence are powerful steps toward gaining some clarity and getting the right care.
Frequently Asked Questions
Do I have PCOS or endometriosis?
Only a healthcare provider can diagnose PCOS or endometriosis. This typically involves a combination of blood testing, pelvic exam, and in some cases of endometriosis, laparoscopic surgery.
Can PCOS cause endometriosis?
No. PCOS and endometriosis are different conditions with different underlying causes. However, it’s possible to be diagnosed with both, especially if symptoms overlap or evolve over time.
Does having ovarian cysts mean I have PCOS?
Not necessarily. Ovarian cysts are common and can occur for many reasons. A PCOS diagnosis involves multiple criteria, including hormone levels, menstrual cycle patterns, and the appearance of ovaries on ultrasound. If you are concerned about your symptoms or test results, consult with your healthcare provider.
Is this endometriosis symptoms vs PCOS symptoms quiz an official diagnosis?
No. This PCOS and endometriosis symptoms quiz is not a diagnostic tool, but is instead a tool that provides space for you to reflect on your symptoms and symptom patterns. Only a medical professional can confirm a PCOS or endometriosis diagnosis.
Is unwanted facial hair a symptom of endometriosis?
No. Unwanted facial hair is more commonly associated with PCOS, due to elevated androgen levels. The most common symptoms of endometriosis include painful periods, pain during sex, chronic pelvic or lower back pain, and digestive discomfort. Another key sign of endometriosis is that symptoms tend to worsen in the days leading up to your period.
