Endometriosis Vs PCOS : Symptoms , Causes and Treatment

In the last decade, both Endometriosis and Polycystic Ovarian Syndrome (PCOS) have become increasingly common in women of the reproductive age group.

In India, 10% of adolescents and 30% of women in their 20s have PCOS .

Endometriosis is seen in 10% of women worldwide in the reproductive age group.

Both of them are divergently different conditions though they can occur together in the same individual .

PCOS( Poly Cystic Ovarian Syndrome) :

What is PCOS?

   This widely prevalent issue is due to hormonal imbalance in females .

This syndrome is characterised by

1) excess of female hormone, estrogen,with insulin resistance,leading to excessive weight gain and irregular cycles .

2)Excess testosterone leading to acne , male pattern balding , scalp hair loss with excess body hair and/or

3)Ultrasound showing multiple tiny cysts less than 9 mm in both ovaries.

Why does it occur?

   This condition has become more prevalent in the last two decades and is predominantly due to unhealthy lifestyle. Very rarely, in a small subset of individuals with lean PCOS, it is due to other issues.

How can it be managed ? 

    The first and most long lasting option is lifestyle modification . This includes all aspects including healthy eating, more movement , managing stress and adequate sleep.If lifestyle changes slip back to being unhealthy for more than a month, PCOS tends to recur. Hence long term, sustainable ,healthy lifestyle is key to keeping PCOS at bay.

   In patients with chemical imbalance affecting periods and for fertility issues, medications are available to help with the hormonal imbalance , though not recommended for long term .

  Surgery is very rarely indicated only in highly resistant patients who have trouble conceiving.

ENDOMETRIOSIS 

This condition is increasingly becoming very common amongst women of reproductive age group . It affects 10% of all women and 70% of women with chronic pelvic pain.

What is Endometriosis?

  Endometrium refers to the inner lining of the uterus which is shed every month . This tissue is sometimes found in areas other than the inner layer of uterus. It can be in ovaries , inner lining of the abdomen ,  bladder , intestine or in very rare cases, even spread outside the cavity.

Post cesarean section, sometimes, this can occur on the skin scar leading to a condition called Scar Endometriosis.

Why does it occur ?

  There are various theories but no definitive answers . This ranges from genetic to environmental .

How will I know if I have Endometriosis?

   It is a very painful condition causing various symptoms ranging from painful periods to pain during intercourse, bowel or bladder movements .

70% of women with endometriosis have trouble conceiving .

Less than 5% have this incidentally diagnosed on a routine ultrasound .

What are the treatment options ?

  Even though lifestyle modification does help to a degree, it is not 100% effective as in PCOD.

 Medicines help in keeping the pain symptoms at bay.

 As of today, the most effective way of treating this is via surgery to remove the deposits though chances of recurrence is very high.

The type of surgery varies widely depending on the severity and fertility concerns and needs to specifically tailor made to each individual.

 Like PCOD, Endometriosis also tends to recur till menopause and needs continuous monitoring with early intervention.

In both PCOD and Endometriosis, awareness of symptoms with early detection can go a long way in ensuring a healthy life.