PMOS / PCOS vs. Endometriosis: Comparing Symptoms & Treatments

PCOS and endometriosis are two common — and commonly confused — conditions that affect women of reproductive age. Around 10% of women have either endometriosis or polycystic ovary syndrome (PCOS), now called polyendocrine metabolic ovarian syndrome (PMOS). A small percentage of women have both. 

Both PMOS and endometriosis can affect your period and ability to get pregnant. However, their symptoms, impact on daily life, and treatment options differ. In this guide, we break down the differences between endometriosis vs. PMOS.

What Is PMOS / PCOS?

Formerly known as polycystic ovary syndrome (PCOS), polyendocrine metabolic ovarian syndrome (PMOS) is a hormonal disorder characterized by irregular periods, insulin resistance, and changes in your skin, hair, and body weight. PMOS affects up to 10% of women during their childbearing years. Most women discover they have it in their 20s or 30s. 

While the exact cause of PMOS is unknown, it’s likely due to a hormonal imbalance — specifically, an increase in androgen and insulin levels. 

• Androgens are male sex hormones. While both men and women have them, their levels are naturally higher in men. In women with PMOS, higher androgen levels can cause symptoms like increased body hair or acne on the face or chest. They can also disrupt ovulation, leading to irregular periods, one of the telltale signs of PMOS. 
• Insulin helps your body process sugar for energy. Insulin resistance is another hallmark feature of PMOS, meaning that your body doesn’t respond to insulin as well as it should. People with insulin resistance may have higher blood glucose levels or diabetes.

Genetics may also play a role in whether you have PMOS. If you have a mom, aunt, or sister with PMOS, that may mean you’re more likely to have it, too.

Ovarian cysts can be another common feature of PMOS. When higher androgen levels prevent the ovaries from releasing an egg, it can lead to the development of small fluid-filled sacs called follicles (or cysts) along the edge of the ovaries. However, not every woman with PMOS develops these cysts, which is one of the reasons why PCOS has been renamed to PMOS for increased accuracy.

What Is Endometriosis?

Endometriosis, also commonly called “endo,” causes tissue similar to your uterine lining (the endometrium) to grow outside of your uterus. It may grow on the ovaries, fallopian tubes, and outside of the uterus, as well as the vagina, bowel, bladder, and other areas. 

Endometriosis affects just over 10% of women in the United States. It’s more commonly diagnosed in women in their 30s and 40s. Like PMOS, researchers don’t know exactly what causes endometriosis. Possible causes include genetics, estrogen levels, immune system health, and retrograde menstruation (where some of the tissue shed during your period flows up into the pelvic area instead of out).

The most common symptom of endometriosis is pain, especially during sex, menstruation, or bowel movements. However, some women may not have or notice any symptoms, and only learn of their endometriosis during testing for infertility.

PMOS / PCOS vs. Endometriosis Symptom Comparison

Not everyone with PMOS or endometriosis will experience all of these symptoms. Symptoms unique to PMOS include hair and skin changes, and weight gain. Meanwhile, pain is a defining feature of endometriosis, both during the menstrual cycle as well as during sex, bowel movements, and urination. 

Periods and Fertility With PCOS / PMOS vs. Endometriosis

Fertility issues are common with both conditions, as are menstrual symptoms. However, PMOS is characterized more by irregular or skipped periods, while endometriosis causes extremely painful or heavy periods. 

How PMOS / PCOS vs. Endometriosis Is Diagnosed

Healthcare providers use several diagnostic tools to determine if someone has PMOS or endometriosis. Here’s a quick look at how the testing compares for PMOS vs. endometriosis:

If you think you have PMOS or endometriosis, schedule an appointment with your OBGYN. They will likely use a combination of the following methods to pinpoint what’s causing your symptoms: 

• Symptom analysis: Your provider will ask you questions about your personal and family medical history, menstrual symptoms, weight changes, and other symptoms.
• Pelvic exam: This is similar to the pelvic exam performed during an annual OBGYN appointment. Your provider will use their fingers to feel for any growths, masses, scarring, or painful spots behind your uterus.
• Vaginal ultrasound: During this type of ultrasound, a provider places a wandlike device inside your vagina to look for any abnormalities in your ovaries or uterus. This test may be ordered to diagnose either PMOS or endometriosis.
• Blood test: Blood testing is typically only ordered if your provider suspects you have PMOS. It can help them check your androgen, fasting glucose, and insulin levels.
• MRI: If your provider suspects you have endometriosis, they may order an MRI to see the size and locations of endometrial tissue growth outside of your uterus.
• Laparoscopy: This is a surgical procedure that can be used as both a diagnostic and treatment tool for endometriosis. First, you’ll be placed under general anesthesia. Then, the surgeon will make a tiny cut near your belly button and insert a thin camera to view, biopsy, and remove as much endometrial tissue as possible.

Can You Have PMOS / PCOS and Endometriosis At The Same Time?

Yes, you can have PMOS and endometriosis at the same time, though this concurrency is rare. Research suggests that around 5% to 8% of women have both endometriosis and PMOS.

When Symptoms May Be Something Else Entirely

While endometriosis and PMOS are common conditions affecting women, it’s possible that your symptoms are caused by something entirely different. For example, PMOS and endometriosis can share symptoms with:

• Ectopic pregnancy: This occurs when a fertilized egg implants outside the uterus. It causes severe pelvic pain and abnormal bleeding. It is a life-threatening medical emergency that requires immediate care.
• Thyroid issues: Both an underactive or overactive thyroid can cause irregular periods, weight fluctuations, and hair thinning. Healthcare providers may order a blood test to differentiate a thyroid disorder from PMOS.
• Perimenopause and menopause: The transition into menopause causes irregular periods, weight gain, and hormonal changes that can mimic PMOS. Perimenopause generally begins in your late 30s or 40s.
• Endometrial cancer: Endometrial cancer causes abnormal bleeding, spotting between periods, and pelvic pain. Women with PMOS, diabetes, or obesity have a higher risk of this cancer. Any new and unusual bleeding should be promptly evaluated by a doctor.

Whether you have PMOS, endometriosis, or one of the conditions above, it’s important to get your symptoms evaluated promptly. Seek emergency medical attention if you experience:

• Severe pelvic pain
• Fainting or dizziness
• High fever
• Heavy blood loss (e.g. large clots, soaking through a pad or tampon every hour)

Treatment For PMOS / PCOS vs. Endometriosis

There is no cure for endometriosis or PMOS, but symptoms can be managed with the right treatment plan. For PMOS, treatment largely focuses on regulating hormones and managing metabolic health. Your healthcare provider may recommend:

• Lifestyle changes: Weight management is often the first priority in any PMOS treatment plan. Regular exercise and a reduced-calorie diet can help you both lose weight and prevent weight gain in the future. Losing just 5% of your body weight can help regulate menstrual cycles, relieve fertility issues, and improve insulin resistance. 
• Medications: Providers generally plan a treatment regimen for PMOS based on your symptoms. For example, metformin and GLP-1s address blood sugar level imbalances as part of diabetes treatment, which may also help with the insulin resistance that is present in many PMOS cases. Spironolactone can help clear acne and reduce the formation of excess facial or body hair. 

For endometriosis, treatment mainly focuses on pain management and tissue removal. Your healthcare provider may recommend:

• Medications: Over-the-counter or prescription pain relievers can manage pain. Hormonal therapies — including birth control pills, progestin therapy, or GnRH agonists (which induce temporary menopause) — can stop the ovaries from producing hormones, which may slow down the growth of endometrial tissue. 
• Surgery: Depending on the severity of your endometriosis, your provider may recommend laparoscopy or other surgery (including a hysterectomy) to remove the lesions. 

The treatment options for endometriosis and PMOS differ in many ways, but both may utilize hormonal birth control. Combination birth control pills, patches, or hormonal IUDs are commonly prescribed for both conditions. 

• In PMOS, birth control regulates menstrual cycles and lowers androgen levels. 
• In endometriosis, birth control prevents the monthly buildup and shedding of tissue, which can significantly reduce pain and heavy bleeding.

Getting the Right Treatment

If you already know what treatment you need to manage your PMOS or endometriosis symptoms, waiting months to see a specialist for a renewed prescription can be a hassle. Fortunately, managing these conditions has become more accessible. Digital pharmacy platforms like TelyRx offer a convenient way to get FDA-approved hormonal birth control and other medications shipped directly to your door.

In addition, while many digital pharmacy platforms require a current prescription, TelyRx offers the option to skip the waiting room entirely by getting a new prescription entirely online from an independent healthcare provider licensed in your state. 

But when looking into online options, be aware that not all digital pharmacy platforms are safe. Protect yourself from scams and counterfeit medication by following this quick checklist to keep yourself safe. A legit online pharmacy will:

• Have a real address and telephone number: A licensed pharmacy platform will have a physical presence in the U.S. with real customer support that can answer any questions or concerns you may have. TelyRx’s main office and pharmacy is headquartered in Clearwater, Florida and also operates a pharmacy in Irving, Texas.
• Require a valid prescription from a licensed medical provider. Any platform that claims you may receive medication before getting a prescription is operating illegally. While you do not need an active prescription to place an order through TelyRx, all orders are reviewed by an independent provider licensed in your state. If approved, the provider writes a new prescription, which our pharmacy fills.
• Be licensed through your state’s Board of Pharmacy. All pharmacies must meet each state’s criteria for safety and operation to receive licensure in that state. TelyRx is currently licensed in all U.S. states except North Carolina and Arkansas, and also services Puerto Rico.
• Have LegitScript certification. This third-party certification ensures the digital platform adheres to all state and federal regulations, industry best practices, and operational transparency. TelyRx holds LegitScript certification.

Your Next Steps

While they may share some symptoms, PMOS and endometriosis have different root causes and require different approaches to treatment. 

Now that you understand the key differences between these two conditions, you can feel more confident advocating for yourself. You do not have to live with debilitating period pain or unexplained hair growth, loss, or weight gain. Document your symptoms, track your cycle, and reach out to a licensed healthcare provider to discuss your treatment options.

Research & References

Allaire, C., Bedaiwy, M. A., & Yong, P. J. (2023). Diagnosis and management of endometriosis. Canadian Medical Association Journal, 195(10), E363–E371. https://doi.org/10.1503/cmaj.220637

Dinsdale, N. L., & Crespi, B. J. (2021). Endometriosis and polycystic ovary syndrome are diametric disorders. Evolutionary Applications, 14(7), 1693–1715. https://doi.org/10.1111/eva.13244

MedlinePlus. (2025). Endometriosis. https://medlineplus.gov/endometriosis.html

MedlinePlus. (2024). Polycystic Ovary Syndrome. https://medlineplus.gov/polycysticovarysyndrome.html

Office on Women’s Health. (2025). Endometriosis. US Department of Health & Human Services. https://womenshealth.gov/a-z-topics/endometriosis

Office on Women’s Health. (2025). Polycystic ovary syndrome. US Department of Health & Human Services. https://womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

Parasar, P., Ozcan, P., & Terry, K. L. (2017). Endometriosis: Epidemiology, Diagnosis and Clinical management. Current Obstetrics and Gynecology Reports, 6(1), 34–41. https://doi.org/10.1007/s13669-017-0187-1

Pundir, C., Deswal, R., Narwal, V., & Dang, A. (2020). The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. Journal of Human Reproductive Sciences, 13(4), 261. https://doi.org/10.4103/jhrs.jhrs_95_18

Rashid, R., Mir, S. A., Kareem, O., Ali, T., Ara, R., Malik, A., Amin, F., & Bader, G. (2022). Polycystic ovarian syndrome-current pharmacotherapy and clinical implications. Taiwanese Journal of Obstetrics and Gynecology, 61(1), 40–50. https://doi.org/10.1016/j.tjog.2021.11.009

Schliep, K. C., Ghabayen, L., Shaaban, M., Hughes, F. R., Pollack, A. Z., Stanford, J. B., Brady, K. A., Kiser, A., & Peterson, C. M. (2023). Examining the co-occurrence of endometriosis and polycystic ovarian syndrome. AJOG Global Reports, 3(3), 100259. https://doi.org/10.1016/j.xagr.2023.100259

Singh, S., Pal, N., Shubham, S., Sarma, D. K., Verma, V., Marotta, F., & Kumar, M. (2023). Polycystic ovary Syndrome: etiology, current management, and future therapeutics. Journal of Clinical Medicine, 12(4), 1454. https://doi.org/10.3390/jcm12041454