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Wednesday, April 30, 2008 

June 25, 2001 -- For 10 years, Los Angeles resident Vicky O'Too

June 25, 2001 -- For 10 years, Los Angeles resident Vicky O'Toole experienced severe cramping, bloating, and nausea related to her period.

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"Doctors kept telling me it was just PMS, but finally I learned I had endometriosis," a condition in which uterine tissue grows abnormally outside the uterus, she says. "I kept a careful list of all my symptoms for two months, and when they occurred. That convinced my doctor to listen to me. I hope other women will realize these symptoms can be a sign of significant illness. Discuss them seriously with your doctor, and be sure to get a thorough exam."

Alexander Shifrin, MD, agrees.

When patients arrive in his office saying they experience premenstrual syndrome, he first asks them to fill out a detailed questionnaire about their symptoms, including exactly what the symptoms feel like and when they occur. Then he takes a medical history, with a focus on previous obstetrical, gynecological, neurological, and psychological issues. Finally, he does a thorough physical exam.

"You want to rule out anatomical abnormalities such as fibroids and, of course, a disease such as endometriosis, which can masquerade as PMS. It is particularly important to look at the patient as a whole person, not just focus on gynecological symptoms," says Shifrin, an ob-gyn, associate director of residency programs at Long Island College Hospital in Brooklyn, and assistant clinical professor at the State University of New York-Brooklyn.

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