What Will We Learn if We Start Listening to Women with Menses-Related Chest Pain?

Background. Thoracic endometriosis is thought to be the most common form of endometriosis occurring outside of the pelvis. We aimed to characterize thoracic symptoms of endometriosis in a population of patients not necessarily suffering from catamenial pneumothorax, which is most commonly identified as a symptom of thoracic endometriosis. Material and methods. We used a web-based survey addressed to users of two Polish endometriosis patient advocate organizations. The factor that qualified patients for the study was the presence of symptoms in the chest related to the menstrual cycle. Results. A total of 92 respondents were questioned. In this group, 96% (88/92) of patients were previously diagnosed with pelvic endometriosis, 20% (18/92) with thoracic endometriosis, and 18% (17/92) with diaphragmatic endometriosis. The percentage of patients diagnosed with both thoracic and diaphragmatic endometriosis was 15% (14/92). Ninety-eight percent of patients suffered from pain. The four most common symptoms reported by patients were chest pain, dyspnea, cough, and stunned limb, occurring in 96%, 67%, 52%, and 33%, respectively. The feeling of a stunned, weakened limb occurs in older women at 38.4 vs. 35.5 years of age (p = 0.021). There is a trend that women who suffer pain (36.7 vs. 31.3 years of age p = 0.053) and hemoptysis (41.0 vs. 36.2 years of age p = 0.059) are older than women without these symptoms. We identified two unique symptoms of thoracic endometriosis-pouring liquid sensation (13%) and popping sensation (12%)-which can be related to a small amount of gas and fluid in the pleural cavity. Conclusions. Patients who have endometriosis suffer from a constellation of thoracic symptoms related to menses.