Do I have PCOS or endometriosis? Take the quiz

How can you tell the difference between PCOS and endometriosis?

Step one in the process – working through your PCOS vs endometriosis symptoms. How can you tell the difference? Get going with our symptom checker.

1. Are your periods irregular/missing altogether?

Irregular periods are the most common sign of PCOS. Less so, for endometriosis. As we’ll see from the list below, endometriosis symptoms often increase in severity around your period. It is possible to have endometriosis and an irregular cycle, but more common with PCOS.

Dr. Karacan says – PCOS is one of the most common disorders we see in clinic, but with careful management it’s totally possible to get pregnant. If you have irregular periods – or they’re missing altogether – the first step is a thorough evaluation with your doctor or fertility expert. 

2. During your period, do you bleed heavily?

Heavy or ‘excessive’ bleeding can be tricky to quantify. Very few of us know if we do indeed lose that 1-5 tbsp volume of blood as quoted by the NHS – and it isn’t just endometriosis or PCOS that can make periods heavier.

However, if you’re dealing with excessive bleeding during your periods, you’ll know about it – from soaking through a pad, tampon, cup or period underwear every one to two hours, to planning your diary around heavy bleeding and setting alarms to change your period products in the night (you’re not alone, by the way).

Dr. Karacan says – Excessive bleeding and heavy periods can make life really difficult for our patients. We’ll always build an individual assessment, starting from the beginning to get to the root cause. If endometriosis or PCOS are suspected (or both), we’ll provide specific treatment using the latest research and findings. 

3. Are your periods very painful?

Period pain (dysmenorrhea) is a key symptom of endometriosis, often requiring medication and/or limiting everyday activities. Yes, there can be all sorts of reasons for cramps and pain during your periods, but as we’ll see, pain from endometriosis comes with distinct features.

PCOS treatment may help support ‘normal’ period pain and other discomfort, but the PCOS itself isn’t the underlying cause of pain. You may, however, experience headaches and pain in other areas of your body, related to PCOS.

Dr. Karacan says – Period pain is one of the first symptoms we’ll check with you, when building a possible endometriosis diagnosis, or fertility treatment plan.

If you’re not at that stage yet, do speak to your GP or doctor about period pain – diagnosis can be frustratingly difficult, and you may need a second opinion, if there’s no improvement. 

4. Where is the pain located?

Pain from endometriosis often shows up in these key areas:

• lower back (during period)
• pelvis
• intestines
• thighs and non-pelvic areas (in rare cases)

Dr. Karacan says – Keep a list of all the areas you’re experiencing pain, especially just before and during your period. This will help your specialist build a diagnosis more quickly, and move forward with the most effective treatment plan. And no – thigh pain is not ‘just in your head’! It’s a real aspect of endometriosis for some patients, and we take it seriously. 

5. Do you bleed between your periods?

A number of factors can cause bleeding in-between our periods, including both PCOS and endometriosis. This can be heavy or light bleeding – or, for many women, can show up as ‘spotting’. Spotting really just means very light bleeding outside of your period – you may notice a very small amount of blood when wiping, for example, just once or twice.

So, do I have PCOS or endometriosis?

In endometriosis, bleeding between periods is caused by endometrial-like tissue thickening, breaking down and then bleeding out from your body. Whereas with PCOS, it’s caused by hormonal imbalance.

Dr. Karacan says – Keep a note of any irregular bleeding, too. Knowing your dates and symptom timings month-to-month, as well as the type of bleeding you experience (heavy, spotting, unpredictable, etc) can help speed up that diagnosis, and get treatment rolling.

6. Are bowel movements or urination painful?

Because of where it’s located, endometriosis can often cause painful bowel movements and urination, usually before or during your period. Endometrial-like tissue can also take up residence in the bowel, causing severe pain in this area.

Dr. Karacan says – Painful bowel movements during your period are a key sign of endometriosis. If you’re experiencing this and struggling to get support, or answers, speak to a specialist. They’ll be ready to get right to the root cause, saving time and frustration on getting an initial diagnosis.

7. Any digestive issues or intestinal pain?

Again, this is about where endometriosis is typically located. It’s not unusual to feel pain in your intestines, although this may be tricky to pinpoint, beyond just your upper pelvic area. Endometriosis can cause digestive issues, too, and even nausea.

Dr. Karacan says – It can be difficult during a consult to identify exactly where your pain sits – especially if you’re not experiencing it in the moment. Symptoms like digestive impact, however, can tell us a lot about your symptoms and condition.

8. Have you noticed increased hair growth, or thinning hair?

PCOS affects our hormones – specifically, we present with higher levels of ‘male hormones’, known as androgens. These can often cause increased hair growth on the face and body, and even thinning hair on the head.

Dr. Karacan says – This is a visible symptom, and you may suspect PCOS as a result, without a blood test. Do let your doctor know what’s normal for you, and we can dig a little deeper to support your fertility journey

9. Sex – is it painful?

Sadly, endometriosis can make sex really painful. Whether or not you’re trying to get pregnant, this can be a traumatic aspect for so many people. And, frustratingly, pain can show up before, during or after sex.

Dr. Karacan says – Painful sex is another really common symptom for patients with endometriosis. Many couples will avoid sex, as a result. Our team are here to listen, answer any question, and from there help support your condition, treatment and goals.

10. Is your skin affected?

Back to PCOS – those androgenic hormones we talked about may be behind oilier than usual skin and acne. This is because higher androgen levels cause enlarged oil glands, which in turn produce more sebum.

PCOS can also cause darkening, thickening skin patches known as ‘tags’.

Dr. Karacan says – Again, this is a symptom you will have the best handle on, as the patient – you know what’s normal for your body and skin. If you’re noticing increased acne, or oily skin – or other physical changes to your skin texture, you and your doctor may start looking into PCOS. 

That said, any changes to your skin (beyond acne or oily skin) should be checked out with your GP, to rule out anything serious.

11. Are your symptoms worse just before/during your period?

From lower back and pelvic pain to digestive impact and nausea, endometriosis symptoms will almost always be more severe just before, or during your period. With PCOS, a flare-up can come at almost any time, especially if your periods are irregular and your cycle becomes tricky to pin down.

Dr. Karacan says – Timing is really important, when it comes to these conditions. Knowing your cycle, what’s ‘normal’ for you and keeping consistent track of your symptoms will help us get straight to the point, when building your treatment plan.

12. Are you struggling to get pregnant?

Trying to conceive (TTC) can be more difficult with both PCOS and endometriosis. If you’re trying to have a baby, fertility struggles can be the first symptom to show up – for example, if you have silent endometriosis, or unexplained infertility (check out the groundbreaking BCL6 test, if this sounds like you).

On the other hand, if you’ve been coping with PCOS symptoms or endometriosis for years, problems conceiving can be the very last check in the box. And, of course, it’s never that simple.

Dr. Karacan says – IVF Turkey are highly experienced in treating patients with PCOS, endometriosis, both conditions at once, and ‘silent’ cases where you may have no symptoms at all, beyond infertility. Connect with the team today, to start getting to the bottom of your unique case, and set out next steps. 

Does endometriosis get misdiagnosed as PCOS?

Yes, endometriosis can sometimes be misdiagnosed as PCOS – often because both conditions can cause irregular periods, pelvic pain, and fertility issues.

However, they are distinct disorders with different causes – endometriosis involves tissue similar to the uterine lining growing outside the uterus, while PCOS is a hormonal condition characterised by irregular ovulation, high androgen levels, and ovarian cysts.

Misdiagnosis can occur because symptoms overlap, and diagnosing endometriosis often requires testing and/or laparoscopic surgery, whereas PCOS is typically identified through hormone tests and ultrasounds.

If you suspect a misdiagnosis, seeking a second opinion from a specialist, tracking symptoms, and requesting further testing can help ensure you receive the correct diagnosis and treatment.

How do you test for endometriosis or PCOS?

Diagnosing endometriosis and polycystic ovary syndrome (PCOS) typically involves a combination of medical history, symptom assessment, imaging, and lab tests.

PCOS is usually identified through blood tests measuring hormone levels and ultrasound imaging to assess ovarian cysts and irregularities. However, for individuals struggling with unexplained infertility, traditional testing methods may not always uncover the underlying causes.

ReceptivaDx® is the only test capable of identifying key causes of unexplained infertility in a single sample, including endometriosis, progesterone resistance, and endometritis.

Unlike standard diagnostic approaches that may require invasive procedures or fail to detect subtle inflammatory conditions, ReceptivaDx offers a non-surgical, highly sensitive option for those seeking answers.

By measuring BCL6, a biomarker linked to endometrial inflammation and progesterone resistance, this test helps pinpoint fertility challenges that might otherwise go undiagnosed, providing clearer treatment pathways for those on their conception journey.

For endometriosis, doctors may also perform a pelvic exam, ultrasound, or MRI to identify cysts or abnormalities. However, in many cases, a laparoscopic procedure is required for a definitive diagnosis, as it allows for direct visualization and biopsy of endometrial-like tissue outside the uterus.

Patients and families across the globe recommend IVF Turkey for their PCOS and endometriosis expertise and world-leading success rates.

Book a consultation with the team today, or for UK-wide support, touch base with TFP Fertility. 

Before you go

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