(HealthDay News) — Premenstrual spotting for 2 or more days is associated with endometriosis in women with infertility, according to a study published the American Journal of Obstetrics & Gynecology.

Ryan J. Heitmann, DO, from the Madigan Healthcare System in Tacoma, Washington, and colleagues examined the prevalence of endometriosis in women with premenstrual spotting in a retrospective cohort study. Participants included 80 women who presented to the infertility clinic for evaluation and underwent laparoscopic assessment for infertility.

In subfertile women who reported premenstrual spotting for 2 or more days, endometriosis was significantly more prevalent than in women without this symptom (89% vs. 26%; P<.0001). The presence of premenstrual spotting for 2 or more days was significantly associated with the presence of endometriosis and red vesicular lesion type (OR=16 and 52.6, respectively), in multinomial logistic regression analysis.

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


  1. Heitman RJ et al. Am J Obstet Gynecol. 2014;doi:10.1016/j.ajog.2014.04.041.