---
title: Is spotting before the period a sign of endometriosis? | Niyora
description: Yes. Women with premenstrual spotting lasting 2 or more days were much more likely to have endometriosis, making this symptom a strong predictor of the condit
url: https://niyora.com/research/papers/premenstrual-spotting-of-2-days-is-strongly-associated-with-histologically-2014/
---

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- Is spotting before the period a sign of endometriosis?

Cohort study, 2014

# Is spotting before the period a sign of endometriosis?

Yes. Women with premenstrual spotting lasting 2 or more days were much more likely to have endometriosis, making this symptom a strong predictor of the condition.

 Moderate study design

80 women with infertility referred to an infertility clinic, some with pelvic pain

## What they did

Retrospective cohort study. 80 women at an infertility clinic underwent laparoscopy (surgery to look inside the pelvis). Doctors checked for endometriosis in women with and without premenstrual spotting lasting 2 or more days.

## What they found

Endometriosis was found in 89% (34 of 38) of women with spotting for 2 or more days, compared to 26% (11 of 42) of women without this symptom. Spotting for 2 or more days was strongly linked to endometriosis (odds ratio 16, 95% CI 3.9-65.4, p < .01) and to a specific type of lesion (odds ratio 52.6, 95% CI 8.6-323.1, p < .001). Spotting was a better predictor than period pain or painful intercourse.

## What it means for you

If you have spotting 2 or more days before your period, you may be more likely to have endometriosis. This study was only in women seeking fertility treatment, so findings may not apply to all women. Also, not all women with spotting will have endometriosis.

89%

Women with spotting ≥2 days who had endometriosis

26%

Women without spotting who had endometriosis

16

Odds ratio for endometriosis with spotting

## About the study

Original title Premenstrual spotting of ≥2 days is strongly associated with histologically confirmed endometriosis in women with infertility Authors Heitmann RJ, Langan KL, Huang RR et al. Journal American journal of obstetrics and gynecology Year 2014 Study design Cohort study Participants 80 What was tested None - observational study Read the paper [doi.org/10.1016/j.ajog.2014.04.041](https://doi.org/10.1016/j.ajog.2014.04.041)

## Topics

[Dysmenorrhea and period pain](https://niyora.com/research/topics/condition-dysmenorrhea/)[Endometriosis](https://niyora.com/research/topics/comorbidity-endometriosis/)

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