Hello! I’m Dr. Santoshi Nandigam from The Birthwave Clinic in Chennai. In this post, we will demythologize two common but complex conditions: PCOS and Endometriosis. We’ll look at how they overlap, the latest developments in diagnosis, and how our holistic care model treats each condition differently.
1. What Are PCOS and Endometriosis, and Why Are They Important?
Up to 8–13% of women of reproductive age suffer from PCOS, a metabolic and hormonal condition. It is characterized by at least two of the following: polycystic ovarian appearance on ultrasound, increased androgen levels, or irregular ovulation. Menstrual irregularities, insulin resistance, acne, excessive hair growth, and weight gain are all common side effects of PCOS.
Conversely, endometriosis affects roughly 10–15% of women, particularly those who experience chronic pelvic pain, and is characterized by endometrial-like tissue growing outside the uterine cavity, usually on the ovaries, pelvic lining, or bowel.
Both PCOS and Endometriosis can seriously reduce fertility and quality of life, despite having different mechanisms-PCOS is hormonally and metabolically driven, while endometriosis is estrogen-driven and inflammatory.
2. How Do PCOS and Endometriosis Connect?
PCOS and Endometriosis were once thought to be distinct conditions, but new research suggests that they may be related:
Overlap of genes: Large genomic studies suggest shared risk genes in the uterus, endometrium, and fallopian tubes.
Co-occurrence in infertile women: Women with PCOS may also have endometriosis, especially with pelvic pain or infertility.
Hormone profiles: PCOS involves androgen excess and insulin resistance, while endometriosis is estrogen-driven-but both share inflammatory pathways.
This means symptoms like irregular cycles, pelvic discomfort, and fertility challenges may overlap.
3. Shared Symptoms of PCOS and Endometriosis
| Symptom | PCOS | Endometriosis |
|---|---|---|
| Menstrual Irregularity | Irregular or absent periods | Heavy bleeding, painful menses |
| Pelvic Pain | Mild in some cases | Severe cramping, chronic pain |
| Infertility | Ovulatory dysfunction | Anatomical distortion, inflammation |
| Hormones | Androgen excess, insulin resistance | Estrogen-driven inflammation |
Both PCOS and Endometriosis may also raise cardiovascular and vascular risks due to systemic inflammation.
4. Diagnosis of PCOS and Endometriosis
PCOS Diagnosis:
We use the Rotterdam criteria-irregular ovulation, hyperandrogenism, or ultrasound morphology-along with thyroid, lipid, and insulin resistance screening.
Endometriosis Diagnosis:
Pelvic MRI and transvaginal ultrasound are now first-line tools, with hormonal treatments prioritized before surgery. At The Birthwave Clinic, we integrate psychological and physical therapy as part of holistic care.
5. Advanced Treatments for PCOS and Endometriosis
Managing PCOS:
Lifestyle changes: Mediterranean diet, exercise, and weight management
Medications: OCPs for cycles, metformin or GLP-1 for insulin resistance, ovulation inducers for fertility
Mental health screening for anxiety, depression, or low self-esteem
Managing Endometriosis:
Hormonal therapy (progestogens or contraceptives) for pain and bleeding
Surgery if required, preferably excisional techniques
Psychological and physiotherapy support integrated with treatment
When Both Coexist:
Combined imaging for lesions and ovarian morphology
Hormonal regulation for PCOS + pain management for endometriosis
Tailored fertility planning with IVF or ovulation induction
6. Innovations in PCOS and Endometriosis Care
AI-enhanced imaging: Deep learning models can detect endometriosis in scans with up to 90% accuracy.
Genetic insights: Research may soon enable combined therapies targeting shared pathways.
Updated guidelines: Emphasize mental health support, lifestyle care, and early intervention.
7. Why Early Care for PCOS and Endometriosis Matters
Early diagnosis and treatment of PCOS and Endometriosis:
Prevents years of untreated pain or infertility
Reduces long-term metabolic and cardiovascular risks
Improves overall physical and mental health outcomes
Provides better fertility planning and success rates
8. A Patient Story
A woman in her late 20s with irregular cycles, acne, and pelvic pain was initially treated for PCOS. Despite improvements, pelvic pain persisted—an MRI confirmed endometriosis. With combined therapy including metformin, hormonal suppression, physiotherapy, and lesion excision, she regained regular cycles and began fertility planning with improved well-being.
9. Our Treatment Path at The Birthwave Clinic
Hormonal & lifestyle assessments
Imaging for PCOS and Endometriosis
Diet and lifestyle counseling
Medications or ovulation induction for PCOS
Hormonal therapy and surgery when needed for endometriosis
Physiotherapy and mental health support
Fertility interventions tailored to the patient
Ongoing preventive screenings
10. Why Choose The Birthwave Clinic
Evidence-based care following latest PCOS and endometriosis guidelines
Advanced imaging like MRI and ultrasound
Multidisciplinary approach: gynecology, physiotherapy, nutrition, and counseling
Personalized fertility guidance
Long-term health and wellness support
Conclusion
Both PCOS and Endometriosis are common yet underdiagnosed conditions that can deeply impact fertility and quality of life. New research shows stronger links between them, making early, evidence-based, and holistic care crucial. At The Birthwave Clinic, we combine advanced diagnosis, tailored treatments, and compassionate support to help women manage these conditions and regain control over their health.
