I don't know if PCOS and endometriosis are related, but I've been told I have both. The endometriosis can make periods quite painful, though they haven't done that to me since I was a teenager. If I have my facts straight, gross as it is, endometriosis is when there is uterine tissue outside the uterus that also goes through the usual shedding cycle.
Another possibility is that the cysts on her ovaries make the ovaries turn. When I had a cyst rupture (incredibly painful), the surgeon said that there was a risk that the ovary would rotate and lose its blood supply and thus die. I know some people don't get as many cysts as part of PCOS as others do. Maybe it's that.
Just guesses on my part, though.
"If you are not for yourself, who will be." -Hillel
"Take care of your body with steadfast fidelity. The soul must see through these eyes alone, and if they are dim, the whole world is clouded." - Goethe
"Give them nothing! But take from them everything!"
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