Difference Between PCOS and Endometriosis

PCOS and Endometriosis are health disorders that affect the reproductive system of a woman. Both these diseases take place when a female has an active menstrual cycle (between age 12 to 52 approximately). The initial symptoms of both PCOS and endometriosis are similar so one has to take medical supervision to detect the exact problem. 

PCOS vs Endometriosis

The main difference between PCOS and endometriosis is that PCOS is a hormonal disorder that leads to enlargement of ovaries and formation of cysts whereas in endometriosis outgrowth of the endometrial layer in other body parts (apart from the uterus) takes place. 

PCOS vs Endometriosis

Polycystic ovary syndrome (PCOS) is a very common hormonal disorder in women who are in their reproductive age. In this disorder, the level of androgen (a male hormone) increases in excess amount in the female body. Excess body hair, acne, and male pattern baldness are common symptoms along with irregular menstrual cycles. 

The endometrium is a type of tissue that lines the inside of the uterus. Endometriosis is a disorder in which the endometrial tissue starts growing in other places of the body. It is a rather painful disorder and the risk of it increases in girls who have got early periods (age 10-11). Dysmenorrhea (painful periods) is a sign of endometriosis. 

Comparison Table Between PCOS and Endometriosis

Parameters of ComparisonPCOSEndometriosis
DefinitionPCOS is a hormonal disorder that leads to enlargement of the ovaries and the formation of small cysts on the outer edge. Endometriosis is a hormonal disorder in which the tissue called endometrium starts growing in other body parts along with the uterus. 
CausesThe most common causes are inflammation, insulin resistance, and hormonal imbalance. Some common causes are endometrial cell transport, retrograde menstruation, and post-surgery implantation. 
SymptomsIrregular menstrual cycle, obesity, excess hair growth, and acne. Pelvic pain and cramps during menstruation, longer periods, and heavy bleeding. 
RiskFamily history of PCOS, obesity, and diabetes increases the risk of having PCOS. Starting periods at an early age, and short menstrual cycles increase the risk for endometriosis. 
DiagnosisMedical history, ultrasound, blood tests, and pelvic exams are common. Imaging tests, pelvic exams, laparoscopy, and blood tests are common. 
TreatmentMedications, weight management, and surgery to remove androgen-releasing tissues. Surgical removal of endometrial tissue growth, hysterectomy, and medications. 
Population AffectedIt affects 4-20 percent of fertile women globally. It affects approximately 10 percent of reproductive women globally. 

What is PCOS?

 Irregular or heavy periods are a very common sign of PCOS. Apart from it, other common symptoms of this hormonal disorder are excess androgen levels in the body and polycystic ovaries. Excess androgen level causes the growth of the body and facial hair (hirsutism) and accompanies acne. The size of ovaries increases and they fail to function normally. 

There are several causes of PCOS that include excess insulin (leads to excess androgen production), low-grade inflammation, and if someone in the family tree has PCOS. Some of the complications that are caused by PCOS are infertility, miscarriage or premature birth, uterine bleeding, type 2 diabetes, etc. 

If PCOS is diagnosed at an early stage, it can be cured with the help of proper medications. Weight management and maintaining a regular healthy diet also helps. In extreme cases, the androgen-releasing tissues are destroyed with the help of surgery. This is considered only when the medications don’t work. 

What is Endometriosis?

 In the case of endometriosis, the endometrial tissue grows on other regions like the outer lining of the uterus and fallopian tubes and they also bleed with each menstrual cycle. Severe pelvic pain is one of the most prominent symptoms of endometriosis. Cramps may begin before the menstrual cycle and can continue for a longer period. Excessive bleeding and pain during urination are the other symptoms. 

There are many causes of endometriosis that include retrograde menstruation (the menstrual blood is trapped inside the body and thickens over time), the transformation of peritoneal cells (these cells convert into endometrial like cells), endometrial cell transport, etc. Early-onset of menstrual cycle and short menstrual cycles (less than 27 days) increase the risk of endometriosis. 

Endometriosis can lead to infertility. This happens because sometimes the thickening of the endometrial layer blocks the fallopian tube so the sperm is unable to fertilize the egg. 

Main Differences Between PCOS and Endometriosis

  1.  PCOS is a hormonal disorder that leads to enlargement of the ovaries and the formation of small cysts on the outer edge whereas in the case of endometriosis, the endometrial tissue grows in other parts of the body than just the uterus. 
  2. The most common causes of PCOS are inflammation, insulin resistance, and hormonal imbalance whereas causes for endometriosis are endometrial cell transport, retrograde menstruation, and post-surgery implantation.
  3. Common symptoms of PCOS are irregular menstrual cycle, obesity, excess hair growth, and acne whereas symptoms of endometriosis are pelvic pain and cramps during menstruation, longer periods, and heavy bleeding. 
  4. Diabetic patients and those with a family history of PCOS increase the risk of the disease. On the other hand, for girls whose menstrual cycle starts early (age 10-11), a short menstrual cycle increases the risk of endometriosis. 
  5. Ultrasounds are used for diagnosing PCOS whereas laparoscopy is used to diagnose endometriosis. 
  6. Apart from medications, laparoscopic ovarian drilling (surgery) is a treatment for PCOS whereas hysterectomy is a known treatment for endometriosis. 
  7. PCOS affects 4-20 percent of reproductive women globally whereas endometriosis affects 10 percent of the same population. 

Conclusion

Both PCOS and endometriosis accompanies irregular menstrual cycle and pain. So, instead of concluding it is better to go to a doctor when the symptoms begin to show up. In any of either disease medical supervision is important and if they are in the early stage can be treated through medications. Sometimes a lifestyle change, maintaining weight, and a healthy diet also helps in reducing the risks of these diseases. 

There are other diseases as well that accompanies pelvic pain similar to endometriosis. They are pelvic inflammatory disease (PID), or ovarian cysts. So, it is always recommended to visit a gynecologist rather than making self-assessments. 

References

  1. https://www.nejm.org/doi/full/10.1056/NEJMcp1000274
  2. https://www.sciencedirect.com/science/article/pii/S0015028208013927
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