Late, painful and irregular periods are signs of serious gynaecological conditions such as endometriosis and polycystic ovarian syndrome (PCOS). But without proper checkups and diagnoses, most women are not able to differentiate between the two as the symptoms overlap.

Here are some insights on what sets these conditions apart, treatment options, and next steps.

Irregular and painful periods

According to consultant obstetrician and gynaecologist Dr Farah Leong Rahman from Sunway Medical Centre Velocity, PCOS is related to abnormal hormone levels in the body, including high levels of insulin.

Common symptoms include infrequent or irregular periods, weight gain, an oily face, as well as unwanted body hair or acne caused by the increased production of male hormones.

Endometriosis, on the other hand, happens when the tissue lining the womb starts to grow elsewhere, such as on the ovaries, uterus, fallopian tubes, bowels, or – rarely – even the lungs.

“Symptoms can vary, but they often present with painful periods, pain during or after sex, or a constant pain at the lower tummy or back,” Leong Rahman says.

Other signs include pain related to bowel or bladder movements, or difficulty getting pregnant.

Susceptibility

Endometriosis affects one in 10 women worldwide, usually those of reproductive age, consultant obstetrician and gynaecologist Dr Ashley Chung Soo Bee explains.

Meanwhile, research has shown that genetics play a factor in developing PCOS – 25-30% of afflicted women have a mother or sister with the condition as well.

“Family members of someone with PCOS are at a higher risk of developing the same metabolic abnormalities,” she says.

Patients can develop both conditions at the same time, which makes it all the more important for them to seek proper medical counsel.

Ability to conceive

Women with PCOS or endometriosis are able to conceive naturally but some may require assistance.

“PCOS patients have irregular or infrequent periods, which makes it difficult to determine their fertile window,” Leong Rahman says.

As for women with endometriosis, “they might have a distorted anatomy of the pelvis, and scar tissue around the ovaries and fallopian tubes, making the environment less conducive for pregnancy”.

Long-term effects

Endometriosis cysts can cause bleeding that in turn leads to pain, inflammation, scarring, and possible organ damage.

And with a PCOS diagnosis, “you will be at higher risk of getting long-term health problems such as diabetes, high blood pressure, depression and psychological issues, and cancer of the womb”, Chung says.

Treatments and next steps

Leong Rahman says while there is no permanent cure for both conditions, there are treatments to help ease the symptoms.

“Women with PCOS need to change their lifestyles by maintaining an optimal weight, eating a healthy and well-balanced diet, and exercising regularly,” she points out.

“For those with endometriosis, management and treatment depends on the severity of symptoms and how it affects one’s quality of life.”

Surgery might be required if medical treatment doesn’t prove effective, she adds, bearing in mind whether the patient intends to get pregnant.

Both doctors recommend that women with any of the above symptoms, or who have concerns, speak to a trusted medical professional who can advise on steps that need to be done for a proper diagnosis, from pelvic ultrasounds to hormonal blood tests.

With proper diagnoses, treatment and care, women can enjoy a high quality of life despite these conditions.

This article was prepared by Sunway Medical Centre Velocity in conjunction with International Women’s Day today and Endometriosis Awareness Month.