Can You Have PCOS and Endometriosis at the Same Time?
Managing hormone and reproductive health can feel like an uphill battle. Many women spend years searching for answers, only to be given partial explanations for their symptoms. The truth is that reproductive and hormonal conditions are rarely clear-cut. They overlap, intersect, and blend together. They can be challenging for even the most seasoned doctor and certainly can’t be solved with a one-size-fits-all approach.
You deserve to work with a doctor who listens carefully, takes the time to understand your unique experience, and looks beneath the surface to uncover the root causes of your symptoms.
A common question women ask is whether it is possible to have both polycystic ovary syndrome (PCOS) and endometriosis at the same time. Since both conditions affect reproductive hormones, cycles, and fertility, the overlap can be confusing. Understanding how they differ, how they sometimes coexist, and how to test for them can help you move closer to answers and effective care.
Let’s dive in.
Hormonal Conditions Often Overlap
Hormones regulate many systems in the body, from reproduction to metabolism and energy. When hormones fall out of balance, the effects ripple across the body. This is why women rarely deal with just one isolated condition. For example, a woman may be told she has PCOS because of irregular cycles, but she may also suffer from severe pelvic pain, which is more typical of endometriosis.
These blurred lines lead many to wonder whether they might have both.
The reality is that it is possible to live with PCOS and endometriosis at the same time. While they are separate conditions with different underlying mechanisms, some of the same risk factors—such as genetics, chronic inflammation, and environmental stressors—can make women more susceptible to developing both.
What Is PCOS?
Polycystic ovary syndrome (PCOS) was not a common condition before the
80’s but today it is one of the most common hormonal conditions in
women of reproductive age. This change is directly related to the
weight and BMI of the nation, which is on a steady rise along with
increasing light pollution. Therefore, PCOS is primarily a disorder
of ovulation and hormone imbalance. The hallmark features of PCOS
include the following:
Irregular or absent menstrual cycles due to a lack of a proper ovulatory cycle
Excess androgen hormones can cause acne, hair loss, or excess
hair growth on the face and body
Polycystic ovaries are seen on ultrasound, which are small, fluid-filled
sacs that reflect disrupted ovulation in that many follicles “pop” in
the same cycl,e competing in the race for proper ovulation. This super
cystic ovary is the result of high insulin levels that cause the
ovaries to become very sensitive to the time factor for reproduction.
To the ovary, a high insulin level suggests stress and inflammation
, and therefore the ONLY organ that is sensitive to the action of
insulin is the ovary, as it is seen as the chance for the species to
propagate before disease or rapid aging sets in. Communication of
insulin with other hormones leads to the delicate balance on whether
reproduction happens or not.
Beyond reproductive symptoms, PCOS is closely tied to insulin
resistance, weight fluctuations, metabolic concerns, and increased
risk for conditions such as type 2 diabetes and cardiovascular
disease. This is because all other organs, unlike the ovary, are
RESISTANT to the action of insulin, creating a “pre-diabetic” condition
in the body known as metabolic syndrome. Increasing weight, with its
corollary of inflammation and light pollution with blue light that we
humans expose ourselves to beyond a reasonable time frame, is what
leads to insulin resistance. A classic example of this is used in the
chicken farming industry. Lights are kept on 24-7. This leads the hens
to lay more eggs than normal, but also lessens their lifespan from
weight and inflammation.
However, chicken farmers see it as a way to
get eggs to the market at a speed that would not be possible without
light stimulation. This is exactly what is happening to us women as we
stay awake longer and longer into the night using our phones, tablets
, and computers, and eat our way to increasing weight and BMI and/or to
increasing inflammation. This also explains why some skinny women
have PCOS. This is caused by inflammation and lack of optimal lean
muscle mass.
PCOS is ultimately an issue of imbalance. The ovaries and other
endocrine glands produce hormones in proportions that disrupt
ovulation and create a cascade of effects throughout the body. Because
of this, treatment typically focuses not only on regulating the
menstrual cycle but also on improving metabolism, lowering
inflammation, and restoring whole-body balance.
What Is Endometriosis?
Endometriosis is a chronic condition where tissue similar to the uterine lining (endometrium) grows outside of the uterus. These tissue implants can develop on the ovaries, fallopian tubes, pelvic lining, and sometimes even in areas beyond the reproductive organs. Each month, this misplaced tissue responds to hormonal changes in the same way as the uterine lining: It thickens, breaks down, and bleeds. Unlike normal menstrual blood, however, the blood from endometriosis implants has nowhere to go.
This process leads to inflammation, scarring, and adhesions, which are bands of tissue that can cause organs to stick together. Symptoms of endometriosis include the following:
Severe pelvic pain, especially during menstruation
Pain with intercourse or bowel movements
Heavy menstrual bleeding
Infertility in some women
Endometriosis is not simply a reproductive disorder. It is also an inflammatory and immune-related condition that can affect overall quality of life.
Why Some Women Have Both PCOS and Endometriosis
Although PCOS and endometriosis are distinct, they share overlapping factors that can increase the likelihood of developing both.
Hormonal imbalances: PCOS often involves high androgen levels and disrupted ovulation, while endometriosis is linked to estrogen dominance and inflammatory responses. These imbalances can coexist, creating a more complex hormonal environment.
Genetic predispositions: Family history plays a role in both conditions. If relatives have had PCOS, endometriosis, or other reproductive issues, your risk increases.
Lifestyle and environmental influences: Diet, stress, toxin exposure, and chronic inflammation can fuel the development of both conditions.
Metabolic stress: Insulin resistance in PCOS contributes to systemic inflammation, which may worsen endometriosis symptoms.
The combination of these factors means that some women do in fact have both PCOS and endometriosis, complicating both diagnosis and treatment.
Dr. Rathod says, “You might have more than two hormone-related conditions. We often think of diagnoses as tidy boxes and clear-cut definitions, but that’s rarely the case. Every woman who walks through my door deserves one-on-one care, a tailored wellness plan, and lots of testing!”
How to Test for PCOS and Endometriosis
Because symptoms overlap, testing is crucial to distinguish whether you have PCOS, endometriosis, or both.
Testing for PCOS
There is no single test for PCOS. Diagnosis typically involves the following:
A comprehensive review of your medical history and menstrual patterns
Bloodwork to check hormone levels, including androgens, estrogen, and insulin
Ultrasound to look for the presence of polycystic ovaries
The diagnosis is usually confirmed if at least two of the following are present: irregular ovulation, excess androgens, or polycystic ovaries.
Testing for Endometriosis
Endometriosis is more difficult to confirm because symptoms can mimic other conditions. Steps may include the following:
A pelvic exam to identify abnormalities
Ultrasound or MRI imaging to detect cysts or lesions
Laparoscopy, a minimally invasive surgical procedure, which is the gold standard for diagnosis
Because testing for both PCOS and endometriosis requires a comprehensive look at your health, it is important to work with a physician who takes the time to evaluate your entire hormonal picture.
Let’s Get to the Root Cause
Living with PCOS or endometriosis is difficult enough. Living with both can feel overwhelming. Many women are told to manage symptoms with birth control or pain medication without ever addressing what is happening beneath the surface.
At FAIM, we believe that you deserve more than symptom management. The key is to uncover the root causes—whether those are hormonal imbalances, immune dysfunction, inflammation, or environmental triggers—and address them with a personalized plan.
Dr. Varsha Rathod, M.D., brings expertise in functional and integrative medicine to help women navigate these complex conditions. She understands that no two women are alike, and that effective care requires time, attention, and a commitment to understanding your unique health story.
By combining advanced testing with a holistic approach, Dr. Rathod works with you to restore balance, ease symptoms, and support long-term wellness. Whether you are struggling with irregular cycles, pain, or fertility concerns, she will help you explore every layer of what may be driving your condition.
