Epidemiological study and clinical consequences of endometriosis and PCOS co-occurrence in a clinical population of women: a cross-sectional study.
Level 4 - case-series / case-control
Cross-sectional observational study
PubMed 41723438 · doi:10.1186/s12905-026-04327-z
What was done
This cross-sectional study analyzed data from 380 patients diagnosed with endometriosis at Amir al-Momenin Hospital in Zabol between 2018 and 2023. Endometriosis was diagnosed clinically and through transvaginal ultrasound or MRI, while PCOS was identified using the Rotterdam criteria. Researchers evaluated infertility, symptom severity via Visual Analog Scale, dyspareunia, and quality of life via the EHP-30 questionnaire using chi-square tests, t-tests, and age-adjusted logistic regression.
What was found
PCOS co-occurred in 24.5% of patients with endometriosis. Patients with both conditions had higher rates of infertility (25.6% vs. 15.4%, p = 0.043) and severe symptoms (84.9% vs. 12.2%, p < 0.001) compared to those with endometriosis alone. After adjusting for age, comorbidity remained significantly associated with higher odds of infertility (adjusted OR = 1.88, 95% CI: 1.01–3.50, p = 0.048) and markedly poorer quality of life (adjusted OR = 91.0, 95% CI: 40.0–206.0, p < 0.001).
Why it matters
This study highlights that PCOS frequently co-occurs with endometriosis and compounds clinical severity, supporting systematic screening for PCOS in clinical populations with endometriosis.
Limits
The single-center, cross-sectional design prevents causal conclusions and limits generalizability. Endometriosis was diagnosed via clinical criteria and non-invasive imaging rather than laparoscopy and histology. Confounder adjustment was limited to age, and the extremely wide confidence interval for the quality-of-life odds ratio suggests potential model instability or sparse data within strata.
Cited by
- contradicts More than 50% of PCOS patients also have endometriosis.