Premenstrual spotting: its association with endometriosis but not luteal phase inadequacy

Of 32 patients with diagnosed luteal phase inadequacy, only 2 patients had premenstrual spotting, 1 of whom was known not to have endometriosis. Of 23 patients diagnosed to have endometriosis, 8 (35%) reported premenstrual spotting of 3 or more days, and 5 of these patients had endometrial histology in phase with the next menses. Although recent reviews have suggested an association of premenstrual spotting with luteal phase inadequacy, we have found this to be rare in such patients, and commonly seen in individuals ultimately diagnosed to have endometriosis, thus providing a clinical clue to its presence.