Introduction
At first glance, PCOS and endometriosis can look like two very different conditions. Yet many women live with both—and it can feel overwhelming. The good news: with the right plan, you can reduce pain, support hormonal balance, and feel more in control. This guide explains why PCOS and endometriosis can co-exist, how endometriosis is diagnosed, and evidence-informed ways to manage both day to day.
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Can you have PCOS and endometriosis together?
Yes. Research suggests women with chronic pelvic pain are more likely to be diagnosed with both conditions, and a notable minority of those with endometriosis also meet criteria for PCOS. While mechanisms differ, both are multifactorial (hormonal, genetic, inflammatory, environmental), and early life hormonal exposures may influence risk profiles later on.
How they differ (in short):
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Endometriosis: chronic inflammatory, oestrogen-sensitive condition with lesions outside the uterus; common symptoms include debilitating period pain, pelvic pain (during/ outside menses), pain with sex or urination, and heavy bleeding.
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PCOS: hormonal/metabolic condition with insulin resistance and/or hyperandrogenism, often causing irregular/long cycles, acne, hirsutism, androgenic hair loss, weight changes, and fatigue.
How they overlap: chronic inflammation, pelvic pain, mental-health burden, sleep disruption, and reduced quality of life—all of which respond to a whole-person approach.
How endometriosis is diagnosed (what to expect)
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Clinical history & exam: discussion of pain type, intensity, timing (including dyspareunia, urinary/bowel symptoms), plus pelvic exam.
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Pelvic/endo-vaginal ultrasound: first-line to visualise ovaries/uterus; particularly useful for ovarian cysts. Ideally performed by a sonographer/radiologist trained in endometriosis.
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MRI (where indicated): assesses deep infiltrating disease and nodules. Normal imaging doesn’t rule out endometriosis—lesion depth doesn’t always match pain intensity.
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Emerging tests: Saliva-based biomarker tests exist privately in some centres; discuss with a specialist to understand pros/cons and suitability.
Helpful UK resources: BSGE accredited centres; Endometriosis UK for support and signposting.
Managing PCOS and endometriosis together: what actually helps
1) Lower chronic inflammation
An anti-inflammatory lifestyle benefits both conditions.
Nutrition (anti-inflammatory focus):
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Prioritise whole foods: colourful veg/fruit, legumes, herbs/spices.
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Regular omega-3 sources (oily fish, eggs, walnuts) or consider a high-purity omega-3 supplement.
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Reduce ultra-processed foods, alcohol, and excess added sugar.
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Identify personal triggers (some find benefit trialling reduced gluten/dairy/FODMAPs under professional guidance), especially if digestive symptoms are prominent.
2) Support metabolic & hormonal balance (PCOS)
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Protein-rich breakfasts, low-GI carbs, and fibre help stabilise blood sugar.
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Gentle daily movement (even 10–20 min post-meal walks) improves insulin sensitivity.
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Inositol (myo + d-chiro) can support cycles, ovulation, and insulin function; active folate (Quatrefolic®), vitamin D, magnesium, zinc, and B12 are commonly useful—ideally guided by labs.
👉 Many start with Ovastart (myo- & d-chiro-inositol + B-vitamins + zinc) to support cycles and skin, and Sugar Balance (chromium) for blood-sugar support. Use our product quiz to tailor your plan.
3) Target pelvic pain & fatigue (endometriosis)
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Movement as medicine: regular, tolerable exercise supports anti-inflammatory pathways and may lower circulating oestrogens.
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Mind-body tools: diaphragmatic breathing, yoga, and meditation may reduce pain perception (GABA pathways) and calm the stress axis.
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Pelvic-health physio/osteopathy: can ease pelvic floor dysfunction and visceral restrictions.
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At-home comfort: heat therapy, TENS devices, and gentle abdominal self-massage (check safety if TTC or pregnant).
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Soothing rituals: herbal infusions (e.g., yarrow, raspberry leaf, chamomile) can be calming adjuncts; check contraindications if pregnant/breastfeeding.
4) Care for mental health
Living with two chronic conditions is emotionally heavy. Consider:
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Pacing and realistic habit building (one change at a time).
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Counselling/CBT, peer support groups, or coaching.
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Sleep hygiene: morning light exposure, wind-down routines, and screen curfews to improve restorative sleep.
Practical testing to discuss with your GP/Specialist
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For PCOS: fasting glucose/insulin, HbA1c, lipids; review cycles/ovulation tracking.
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For endometriosis: specialist ultrasound ± MRI when indicated.
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Inflammation: hs-CRP (discuss interpretation with your clinician).
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Thyroid (common in PCOS): TSH, free T4, free T3, thyroid antibodies; aim TSH < 2.5 mIU/L when TTC/early pregnancy.
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Micronutrients (case-by-case): vitamin D, B12, ferritin/iron, iodine (method per clinician).
Gentle Reminder
This article is educational and not a substitute for medical care. If your pain is severe, cycles are very long/irregular, or symptoms are escalating, please seek clinical support. You deserve relief and a plan that fits your body.
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Scientific references
