Endometriosis vs PCOS

Written by ROBYN MACLARTY

These two conditions both affect women’s periods and fertility – but have different causes and treatments.

Endometriosis and polycystic ovary syndrome (PCOS) are disorders that affect women of reproductive age. Endometriosis is often confused with polycystic ovarian syndrome because both are related to the womb and cause menstrual problems, which can lead to heavy bleeding. They can also make it difficult to fall pregnant. But these two conditions are not the same at all, and have different symptoms and treatments, so it’s important to get a proper diagnosis.

What is Endometriosis?

What do Lena Dunham, Chrissey Tiegan and Amy Schumer have in common? They suffer from endometriosis, a condition caused by excess estrogen that can result in debilitating pain and that may need to be treated with surgery.

“Prevalence of endometriosis in South Africa is about 1 in 10 women and the prevalence of PCOS is 1 in 5, which is similar to the prevalence of these conditions in other countries around the world,” says gynaecologist and endoscopic surgeon Dr Natalia Novikova, who has practices in both Cape Town and Johannesburg.

Endometriosis gets its name from the tissue that lines a woman’s uterus – the endometrium. A woman’s body typically grows a new lining each menstrual cycle in preparation for a fertilised egg (the blood-like discharge during your period is a portion of this endometrium being discharged). Endometriosis occurs when this tissue grows where it shouldn’t – outside of the uterus – affecting the fallopian tubes, ovaries and potentially other organs like the bladder, cervix and even (rarely) the lungs. Complications can arise when this tissue stays in the body, instead of being discharged, and cysts form around the ovaries, eventually developing into scar tissue.

“Symptoms of endometriosis can include painful menstrual periods, pelvic pain a few days before menstrual periods, pelvic pain during sexual intercourse, heavy and sometimes irregular menstrual periods, bloating, and difficulty falling pregnant,” says Dr Novikova “Endometriosis is also often associated with irritable bowel syndrome.”

What is PCOS?

While endometriosis is linked to excess estrogen, a female hormone, PCOS is caused by excess androgens, or male hormones. PCOS occurs when numerous (poly) cysts form in the ovaries. They do this when an excess of androgens interferes with regular ovulation (there are cases of PCOS, though, that do not include the formation of cysts). PCOS can be accompanied by pain, but isn’t usually. More often,

“PCOS symptoms include irregular or missed menstrual periods, excess body hair, acne, and difficulty falling pregnant,” says Dr Novikova.

Are you at risk?

Risk factors for both conditions include a family history. Additional risk factors for PCOS include insulin resistance or being overweight. For endometriosis, heavy and/ or irregular periods, as well as beginning menstruation before the age of 11 can increase your risk.

Getting Help

If you’re concerned that you might be suffering from either of these conditions, Dr Novikova recommends seeing a specialist gynaecologist for a full assessment and discussion of the symptoms and exploration of treatment options. For both conditions taking medication like the contraceptive pill can help reduce oestrogen in endometriosis, or androgens in PCOS. Other treatment options for endometriosis includes pain relief, surgical removal of endometrial tissue and even hysterectomy. For PCOS you might be put on medication to reduce acne or hair growth and if medication doesn’t help, surgery to reduce androgen-releasing tissue in the ovaries.

“A healthy lifestyle with a balanced diet, physical activity, good sleep and stress management is very important in keeping the symptoms under control of both conditions,” says Dr Novikova, “in addition to the diagnosis and treatment of the condition.”

This article appeared on the Clicks ClubCard magazine, April 2023 issue – written by ROBYN MACLARTY