Are Endometriosis, Adenomyosis, and PCOS Autoimmune Conditions?

By Our Daughters Foundation

More and more women are asking an important question: Could my hormone-related illness also be connected to my immune system?

Conditions like endometriosis, adenomyosis, and polycystic ovary syndrome (PCOS) are often discussed in the context of reproductive health or hormonal imbalance. But researchers are beginning to explore deeper connections—specifically, whether autoimmunity plays a role in these diseases.

Let’s break down what the science says—and what questions remain unanswered.

Are Endometriosis, Adenomyosis, and PCOS Autoimmune Conditions?

By Our Daughters Foundation

More and more women are asking an important question: Could my hormone-related illness also be connected to my immune system?

Conditions like endometriosis, adenomyosis, and polycystic ovary syndrome (PCOS) are often discussed in the context of reproductive health or hormonal imbalance. But researchers are beginning to explore deeper connections—specifically, whether autoimmunity plays a role in these diseases.

Let’s break down what the science says—and what questions remain unanswered.

What Is Autoimmunity?

The immune system is designed to protect the body from threats like viruses and bacteria. But in autoimmune diseases, the immune system becomes misguided and starts attacking the body’s own cells and tissues.

Common autoimmune conditions include:

• Lupus

• Rheumatoid arthritis

• Hashimoto’s thyroiditis

• Multiple sclerosis

Symptoms vary widely, but many autoimmune conditions involve chronic inflammation, pain, fatigue, and a pattern of flare-ups.

The Immune System and Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus—causing pain, inflammation, and sometimes infertility. While its exact cause is still debated, many researchers believe that the immune system fails to clear out these rogue cells effectively.

Several studies have found:

• Women with endometriosis often have higher levels of inflammatory markers, like cytokines and prostaglandins.

• Natural killer (NK) cell activity is lower in women with endometriosis, impairing the immune system’s ability to destroy misplaced cells.

• There are elevated autoantibodies in some patients, suggesting an autoimmune component.

Some scientists now consider endometriosis to be a non-classical autoimmune disease—showing many features of one without meeting all diagnostic criteria.

Further reading:

• NIH - Immune dysfunction in endometriosis: https://pubmed.ncbi.nlm.nih.gov/30664929/

• Cleveland Clinic - Endometriosis and the Immune System: https://health.clevelandclinic.org/endometriosis-and-the-immune-system/

What About Adenomyosis?

Adenomyosis is sometimes called the "sister disease" of endometriosis. It occurs when endometrial tissue grows into the muscular wall of the uterus. It's less studied, but immune abnormalities have also been observed.

Research is still emerging, but here’s what we know:

• Women with adenomyosis show immune cell changes and chronic inflammation within the uterus.

• Some studies report increased macrophage and mast cell activity—cells involved in both immune defense and inflammation

• The condition often coexists with endometriosis, raising questions about shared immune pathways.

While it’s too early to label adenomyosis an autoimmune disorder, it may involve an immune imbalance that contributes to symptoms.

Further reading:

• Frontiers in Immunology - Immunopathogenesis of Adenomyosis: https://www.frontiersin.org/articles/10.3389/fimmu.2021.796273/full

PCOS and Autoimmune Overlap

Polycystic ovary syndrome (PCOS) is primarily known as a hormonal disorder involving androgen excess and insulin resistance. However, there’s growing interest in its immune connections, especially in women with chronic inflammation or thyroid issues.

Emerging links include:

• Hashimoto’s thyroiditis (an autoimmune thyroid disorder) is more common in women with PCOS.

• Inflammatory markers like C-reactive protein (CRP) are often elevated in PCOS patients.

• Some PCOS patients have anti-ovarian antibodies, suggesting potential autoimmunity.

Still, the autoimmune theory is more speculative in PCOS than in endometriosis.

Further reading:

Further reading:

• Journal of Clinical Endocrinology & Metabolism - PCOS and Autoimmune Disease: https://academic.oup.com/jcem/article/106/9/e3536/6280755

Why Does This Matter?

If immune dysfunction is part of the puzzle, treatment strategies may need to shift. Many women with endometriosis, adenomyosis, or PCOS are treated solely with hormone suppression—but if autoimmunity is involved, we may also need to address inflammation, gut health, and immune regulation.

There’s also hope that newer treatments—like immunomodulatory therapies or even personalized nutrition and lifestyle interventions—could improve outcomes when tailored to the immune system’s role.

Bottom Line

We don’t yet have all the answers, but the research is evolving. Endometriosis, adenomyosis, and PCOS may not be traditional autoimmune diseases—but they often coexist with immune dysfunction, and the overlap deserves attention. At Our Daughters Foundation, we believe in honoring women’s voices, advocating for deeper research, and pursuing whole-body solutions.

If you’ve experienced overlapping conditions like endo, thyroid disease, or unexplained inflammation—you’re not alone.

What Is Autoimmunity?

The immune system is designed to protect the body from threats like viruses and bacteria. But in autoimmune diseases, the immune system becomes misguided and starts attacking the body’s own cells and tissues.

Common autoimmune conditions include:

• Lupus

• Rheumatoid arthritis

• Hashimoto’s thyroiditis

• Multiple sclerosis

Symptoms vary widely, but many autoimmune conditions involve chronic inflammation, pain, fatigue, and a pattern of flare-ups.

The Immune System and Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus—causing pain, inflammation, and sometimes infertility. While its exact cause is still debated, many researchers believe that the immune system fails to clear out these rogue cells effectively.

Several studies have found:

• Women with endometriosis often have higher levels of inflammatory markers, like cytokines and prostaglandins.

• Natural killer (NK) cell activity is lower in women with endometriosis, impairing the immune system’s ability to destroy misplaced cells.

• There are elevated autoantibodies in some patients, suggesting an autoimmune component.

Some scientists now consider endometriosis to be a non-classical autoimmune disease—showing many features of one without meeting all diagnostic criteria.

Further reading:

• NIH - Immune dysfunction in endometriosis: https://pubmed.ncbi.nlm.nih.gov/30664929/

• Cleveland Clinic - Endometriosis and the Immune System: https://health.clevelandclinic.org/endometriosis-and-the-immune-system/

What About Adenomyosis?

Adenomyosis is sometimes called the "sister disease" of endometriosis. It occurs when endometrial tissue grows into the muscular wall of the uterus. It's less studied, but immune abnormalities have also been observed.

Research is still emerging, but here’s what we know:

• Women with adenomyosis show immune cell changes and chronic inflammation within the uterus.

• Some studies report increased macrophage and mast cell activity—cells involved in both immune defense and inflammation

• The condition often coexists with endometriosis, raising questions about shared immune pathways.

While it’s too early to label adenomyosis an autoimmune disorder, it may involve an immune imbalance that contributes to symptoms.

Further reading:

• Frontiers in Immunology - Immunopathogenesis of Adenomyosis: https://www.frontiersin.org/articles/10.3389/fimmu.2021.796273/full

PCOS and Autoimmune Overlap

Polycystic ovary syndrome (PCOS) is primarily known as a hormonal disorder involving androgen excess and insulin resistance. However, there’s growing interest in its immune connections, especially in women with chronic inflammation or thyroid issues.

Emerging links include:

• Hashimoto’s thyroiditis (an autoimmune thyroid disorder) is more common in women with PCOS.

• Inflammatory markers like C-reactive protein (CRP) are often elevated in PCOS patients.

• Some PCOS patients have anti-ovarian antibodies, suggesting potential autoimmunity.

Still, the autoimmune theory is more speculative in PCOS than in endometriosis.

Further reading:

Further reading:

• Journal of Clinical Endocrinology & Metabolism - PCOS and Autoimmune Disease: https://academic.oup.com/jcem/article/106/9/e3536/6280755

Why Does This Matter?

If immune dysfunction is part of the puzzle, treatment strategies may need to shift. Many women with endometriosis, adenomyosis, or PCOS are treated solely with hormone suppression—but if autoimmunity is involved, we may also need to address inflammation, gut health, and immune regulation.

There’s also hope that newer treatments—like immunomodulatory therapies or even personalized nutrition and lifestyle interventions—could improve outcomes when tailored to the immune system’s role.

Bottom Line

We don’t yet have all the answers, but the research is evolving. Endometriosis, adenomyosis, and PCOS may not be traditional autoimmune diseases—but they often coexist with immune dysfunction, and the overlap deserves attention. At Our Daughters Foundation, we believe in honoring women’s voices, advocating for deeper research, and pursuing whole-body solutions.

If you’ve experienced overlapping conditions like endo, thyroid disease, or unexplained inflammation—you’re not alone.

Join Us: Make a Difference Today

Your support can transform lives. Every donation helps us fund research, advocate for better care, and provide essential grants to women facing debilitating conditions.

Join Us: Make a Difference Today

Your support can transform lives. Every donation helps us fund research, advocate for better care, and provide essential grants to women facing debilitating conditions.

© Our Daughters Foundation - All Rights Reserved

Allison

My Story: Allison

August 13, 20253 min read

Allison

"I honestly can’t remember a time when my monthly cycles felt “normal.” From early on, they were always painful—something I learned to dread every single month. I had symptoms that I now know aren’t normal, but back then, I just assumed this was how it was supposed to be.

My symptoms affected both my physical and mental health. The abdominal pain and cramping would leave me doubled over, sometimes unable to move. I experienced nausea, vomiting, dizziness, and terrible headaches. But even more difficult were the days when anxiety took over so completely that the simple act of getting out of bed would trigger a panic attack. All I could do was lay there, waiting for the wave to pass, hoping I could eventually function at even the most basic level.

Over time, this pattern began to erode my daily life. I was told over and over again that I just had “bad cycles,” and that hormonal birth control was the only option. I tried it and quickly realized it wasn’t sustainable for me. The other response I often got was silence—or worse: “suck it up,” “push through it,” “this is just part of being a woman.” So I did what I thought I had to do: I learned to silently suffer, white-knuckling my way through each month.

By the time I reached my thirties, after having my two sweet kids, I only had about 5 or 6 days each month where I could carry out everyday tasks without pain or debilitating symptoms. I was barely making it through. That’s when I knew something had to change—I couldn’t keep living like this.

I hadn’t considered endometriosis until my twin sister, who had gone through very similar experiences, was diagnosed after several surgeries. Her story opened the door for me to seek answers of my own. With the support of a trusted doctor, I underwent testing. They suspected both endometriosis and adenomyosis.

A few months later, I had surgery. It confirmed both diagnoses. My uterus was removed due to adenomyosis, and endometriosis was also found and excised. That surgery gave me my life back. And I don’t say that lightly. For the first time in decades, I wasn’t confined to my bed. I didn’t have to plan my life around pain. I could move, breathe, think, and live. My kids had their mom back. 

Some symptoms have returned in recent months, but this time I’m not doing it alone. I’m working closely with two practitioners—one addressing things holistically, the other exploring surgical options if needed. I feel supported, seen, and hopeful.

What I’ve learned through all of this is that far too many women are suffering in silence—dismissed, minimized, and left without answers. We’re told that this is just the way it is. But it doesn’t have to be.

That’s why I’m so incredibly grateful for Our Daughters Foundation and for people like Kara, who are bringing attention, support, and real solutions to parts of women’s health that have been ignored for far too long. Being told to “tough it out” leaves one feeling isolated. Knowing something’s wrong but not being sure if anyone will help you—that’s a different kind of pain.

Awareness changes that. Advocacy changes that. Community changes that.

Thank you, Our Daughters Foundation, for fighting for us—for helping women everywhere feel less alone, and for making it known that “just a bad period” is never something we should accept."

-Allie

Personal StoriesHopeExcisionEndometriosis
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