Polycystic ovary syndrome (PCOS) and endometriosis are two of the most common, and often misunderstood, gynaecological conditions in the UK. They both affect people of reproductive age and can cause a range of symptoms, from pain and irregular periods to fertility issues.
But what happens when you’re diagnosed with one and suspect you might have the other? Is it possible to have both PCOS and endometriosis at the same time? And what might that mean for your chances of getting pregnant?
Let’s take a closer look at both conditions, what links them (and what doesn’t), and how we can help if you’re dealing with one or both.
Polycystic ovary syndrome (PCOS) is a hormonal condition that affects how your ovaries function. If you have PCOS, your ovaries might not release an egg regularly, or at all. Instead, they often develop multiple small follicles, which can look like cysts on an ultrasound, and may produce higher-than-normal levels of androgens (like testosterone).
Common symptoms of PCOS include:
Read more about the symptoms of PCOS here
PCOS can show up in different ways depending on your individual hormone patterns and health history. Some people have insulin-resistant PCOS, where high insulin levels affect hormone balance and can lead to weight gain. Others may have inflammatory PCOS, which is linked with ongoing low-grade inflammation and symptoms like fatigue or skin breakouts.
Understanding the type of PCOS you have can help shape your treatment approach, whether that means improving insulin sensitivity, encouraging ovulation or managing symptoms. At Care Fertility, we look closely at your results and experiences to guide the right next steps for you.
Endometriosis is a condition where tissue similar to the lining of the womb grows in places it shouldn’t, such as the ovaries, fallopian tubes, bowel or bladder. Each month, this tissue behaves like womb lining, thickening, breaking down and bleeding. But because it’s outside the womb, the blood has nowhere to go, which can lead to inflammation and sometimes painful scar tissue.
Typical symptoms of endometriosis include:
Read more about endometriosis here
Endometriosis is usually classified into four stages: minimal, mild, moderate and severe. These stages are based on how much tissue is present, where it's located and how deeply it has grown into surrounding areas. In the early stages, there may be a few small patches of tissue or surface-level implants. In more advanced stages, the tissue may form cysts on the ovaries (known as endometriomas), scar tissue or adhesions that stick organs together.
It’s important to remember that the stage of endometriosis doesn’t always match the level of pain or symptoms. Some people with stage one may experience severe discomfort, while others with stage four may have very few symptoms. A laparoscopy is often needed to confirm the stage and decide the best course of action.
PCOS and endometriosis are separate conditions with different causes. PCOS is driven by hormone imbalance, while endometriosis is linked to inflammation and misplaced endometrial-like tissue. That said, it is possible to have both at the same time, and it may be more common than previously thought.
For example, you might have irregular periods from PCOS and pelvic pain from endometriosis. Because the symptoms can overlap, diagnosis isn’t always straightforward. And that can be frustrating, especially when you’re left without clear answers.
There’s no definite answer here, and research is ongoing. Some studies suggest that people with PCOS may be less likely to have endometriosis, possibly because of differences in hormone levels or fewer menstrual cycles. But it’s also true that people with ongoing menstrual health concerns are more likely to dig deeper into their symptoms, which can lead to a diagnosis of both.
So, while having one doesn’t automatically mean you’ll develop the other, it’s not unusual for both conditions to co-exist.
Both conditions can affect fertility, but in different ways.
If you’re not ovulating regularly, or at all, that naturally means fewer chances to conceive each cycle. Even when ovulation occurs, hormonal imbalances can impact egg quality and how well the womb lining prepares for implantation.
With endometriosis, inflammation and scar tissue can affect how the egg and sperm meet, and how well a fertilised egg implants in the womb. In more severe cases, the fallopian tubes or ovaries may also be affected.
The good news is, many people with one or both conditions go on to conceive, either naturally or with help from fertility treatment.
If you’re dealing with symptoms of PCOS, endometriosis or both, you don’t have to wait for things to get worse before seeking help.
At Care Fertility, we start with a full fertility assessment. This includes blood tests, an ultrasound scan and sometimes further investigations based on your history. These are booked by our patient enquiry team when you first get in touch. When you attend your consultation, your doctor will already have your test results and can explain what’s going on in detail.
We’ll help you understand what’s happening in your body, and build a treatment plan that’s personalised to your needs and goals.
Depending on your results and your symptoms, we might explore:
We’ll always explain every option clearly, and work with you to find the right way forward.
Trying to get pregnant when you’re navigating one, or both, of these conditions can feel daunting. There’s the physical strain, the emotional toll and the pressure of time. But you don’t have to face it on your own.
Our team of fertility experts are here to support you with tailored advice, compassionate care and treatment options that put you in control.
Whether you’re ready to move forward or just want to talk things through, we’re here to listen. We’ll book your tests, explain your results and support you every step of the way.