Endometriosis and Polycystic ovary syndrome (PCOs) are two different conditions that may cause subfertility in a woman. Both are the conditions that may cause menstrual problems in a female. Let’s see the difference between the two.

Polycystic ovary syndrome (PCOs) vs Endometriosis

Definition:

Polycystic ovary syndrome (PCOs):

PCOs is a hormonal disorder that produces abnormal amounts of androgen (a group of sex hormones) causing menstrual irregularities (having periods for very short duration or very long duration). Ovaries contain small fluid filled sacs but females with this condition may or may not develop the cysts.

Endometriosis:

Endometriosis is a female reproductive disease in which normal tissue present inside the uterus is abnormally present outside the uterus. Tissue presents outside the ovaries may become inflamed resulting in scarring and adhesion (pelvic tissues and organs sticking with each other).

Risk factors or causes:

Risk factors are those factors that increase the risk of certain diseases.

Polycystic ovary syndrome (PCOs):

The exact cause for PCOs is not known. The following are the factors that may contribute to the development of PCOs:

  • Family history (positive family history may predispose to develop PCOs)
  • Overweight or obese
  • Insulin resistance
  • Hyperandrogenism
  • Hyperinsulinemia.

Endometriosis:

The followingare the risk factors of endometriosis:

  • Early menarche
  • Nulliparity
  • Family history positive
  • Menstrual cycle less than 27 days
  • Menstruate more than 7 days
  • Retrograde menstruation
  • Increase levels of oestrogen
  • Surgical scars
  • Week immune system
  • Uterine growths (for example polyps or fibroids)
  • Blockage in the vagina or cervix.

Types:

Polycystic ovary syndrome (PCOs):

Following are the different types of PCOs:

  • Inflammatory PCOs
  • Insulin resistant PCOs
  • Drug induced PCOs
  • Idiopathic PCOs.

Endometriosis:

Following are the different types of endometrioses:

  • Endometriomas
  • Abdominal wall endometriosis
  • Superficial peritoneal endometriosis
  • Deeply infiltrating endometriosis (DIE).

Sign and symptoms or clinical presentation:

Polycystic ovary syndrome:

Signs and symptoms may vary depending on the type of PCOs. The most common presentation of PCOs is the following:

  • Menstrual irregularities (irregular cycle, missed menses)
  • Enlarge ovaries
  • Hirsutism (excess body hair growth) on the stomach, chest, and back
  • Acne or pimples
  • Oily skin
  • Skin tags in armpits or neck
  • Skin patches
  • Ovaries containing cysts
  • Infertility.

Endometriosis:

Signs and symptoms may vary depending on the type of endometriosis. The most common presentation of endometriosis is the following:

  • Pelvic pain
  • Dysmenorrhea (pain during periods)
  • Dyspareunia (pain during intercourse)
  • Fatigue
  • Heavy menstrual blood (HMB)
  • Pain during bowel movements or urination
  • Intermenstrual bleeding
  • Infertility.

Investigations or lab tests:

To diagnose and rule out the cause or/ and site or/ and type of the disease your doctor will suggest some lab tests (investigations).

Polycystic ovary syndrome (PCOs):

The following are the investigations to diagnose PCOs:

  • History taking
  • Complete blood count (CBC)
  • Examination of pelvis
  • Fasting cholesterol
  • Oral glucose tolerance test
  • Ultrasound (transvaginal)
  • Anti mullerian hormone (AMH)
  • Lipid profile
  • Glucose test.

Endometriosis:

Following are the investigations to diagnose endometriosis:

  • History
  • Examination of pelvis
  • Magnetic resonance imaging (MRI)
  • Ultrasound (transvaginal)
  • Diagnostic laparoscopy (procedure to view organs inside the abdomen and pelvis).

Treatment:

Polycystic ovary syndrome (PCOs):

Treatment options for PCOs are as follows:

  • Combined oral contraceptive pills (COCPs)
  • Progestin medication (to regulate the menstrual cycle)
  • Metformin
  • Gonadotropin
  • Symptomatic treatment
  • Lifestyle changes (healthy diet, losing weight if overweight or obese, low carbohydrates diet, regular exercise).

Endometriosis:

Treatment options for endometriosis are as follows:

  • Pain killers
  • Medications (combined oral contraceptive pills (COCPs), progestin medicine, gonadotropin releasing hormone (Gn-RH) agonists and antagonists, aromatase inhibitors)
  • Conservative surgery
  • Hysterectomy (surgical removal of the uterus) with oophorectomy (surgical removal of ovaries)
  • Lifestyle changes (heating pads, warm baths, healthy diet).

Complications:

Polycystic ovary syndrome (PCOs):

The following are the complications of PCOs:

  • Type 2 diabetes mellitus
  • Subfertility
  • Miscarriages
  • Prediabetes
  • Endometrial cancer
  • Gestational diabetes
  • Metabolic syndrome
  • Depression
  • Sleep apnea.

Endometriosis:

The following are the complications of endometriosis:

  • Subfertility
  • Ovarian cysts
  • Adhesions
  • Bowel problems
  • Bladder problems
  • Depression.

Conclusion:

Concluding the above discussion PCOs and endometriosis are the reproductive disorders which share some of the similar symptoms but are two very different conditions.