HealthDay News — Premenstrual spotting for two or more days is associated with endometriosis in women with infertility, according to a study published in the American Journal of Obstetrics & Gynecology.

To assess the prevalence of endometriosis in female patients with premenstrual spotting and to determine the predictive value of this symptom into the diagnosis of endometriosis, Ryan J. Heitmann, DO, of the Madigan Healthcare System in Tacoma, Wash., and colleagues conducted retrospective cohort study. Participants included female patients who presented to the infertility clinic for evaluation and underwent laparoscopic assessment for infertility (n=80).

In subfertile women who reported premenstrual spotting for two or more days, endometriosis was significantly more prevalent compared with women without this symptom (89% versus 16%; P<0.0001).

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The presence of premenstrual spotting for two or more days was significantly associated with the presence of endometriosis (odds ratio, 16) and red vesicular lesion type (odds ratio,52.6), in multinomial logistic regression analysis.

“In this cohort of women with infertility, premenstrual spotting of ≥ two days was associated strongly with histologically confirmed endometriosis and a better predictor than dysmenorrhea or dyspareunia of finding endometriosis at laparoscopy,” concluded the researchers.


  1. Heitmann RJ et al. American Journal of Obstetrics & Gynecology. 2014; doi: 10.1016/j.ajog.2014.04.041