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Endometriosis Symptom Checklist, No Quiz

A plain checklist for people searching for an at-home endometriosis test or quiz. It helps you list symptoms before care, but it cannot diagnose endometriosis.

If you searched "at home endometriosis test" or "do I have endometriosis quiz," start here.

This is not a test. It is not a score. It cannot tell you if you have endometriosis.

It is a way to write down what is happening. Bring it to a clinician if your pain, bleeding, bowel symptoms, bladder symptoms, sex pain, or fatigue affect your life.

What this can and cannot tell you

This checklist can help you This checklist cannot Name symptoms in plain words. Diagnose endometriosis. Show if symptoms come near your period. Rule out other causes. Help you remember hard details. Tell you what treatment to use. Help you ask for next steps. Replace a clinician visit.

If symptoms feel severe, new, or unsafe, do not wait to finish this sheet. Contact a clinician.

Quick symptom list

Check what fits. Leave the rest blank.

Pain timing

Cramps stop me from work, school, sleep, or plans. Pain starts before my period. Pain is worst during my period. Pain happens at ovulation. Pain happens between periods. Pain lasts after bleeding stops. Pain has gotten worse over time. Pain medicine does not help enough. Heat, rest, or a position change helps a little. Pain wakes me up.

Where the pain is

Lower belly. One side of the pelvis. Both sides of the pelvis. Lower back. Hips or thighs. Rectum or anus. Bladder area. Deep pain inside the pelvis. Pain moves to more than one place.

Period impact

Question Your notes First day of last period Usual period length Heaviest day Worst pain day Pain score, 0 to 10 Days missed or changed Heavy bleeding or clots Spotting between periods

Use short notes. "Stayed home day 1 and 2" helps more than "bad cramps."

Bowel and bladder symptoms

Pain when having a bowel movement. Rectal pain or pressure. Constipation near my period. Diarrhea near my period. Bloating or nausea near my period. Pain when peeing. Needing to pee more often. Urgent need to pee. Blood in stool or urine near my period. Symptoms get worse before or during bleeding.

These symptoms can have many causes. Write them down. Do not use them to diagnose yourself.

Sex pain, if you want to note it

Skip this section if it does not apply or does not feel safe.

Deep pain during sex. Pain after sex. Pain is worse near my period. I avoid sex because of pain. I want to ask about pelvic pain in private.

You can write "private question" on your visit notes if you do not want details on the sheet.

Fatigue and daily life

I feel wiped out near my period. Pain makes it hard to sleep. I miss work, school, or care tasks. I cancel plans because of pain or bleeding. I feel low or anxious around symptoms. I plan my day around bathroom access. I need help at home during symptoms.

Fertility questions

Only fill this out if it fits your life.

Question Your notes Are you trying to get pregnant? How long have you been trying? Any known fertility care or testing? Main question for care

Endometriosis can be linked with fertility problems, but this sheet cannot tell you the cause.

What changed

Clinicians often ask what is new. Use this table to answer fast.

Change When it started What it affects Pain got worse New pain location New bowel symptoms New bladder symptoms Bleeding changed Sex pain started or changed Fatigue got worse Work, school, sleep, or plans changed

What to bring to care

This checklist. Period start dates, if you know them. Two or three pain examples with dates. Any bowel or bladder pattern notes. Medicines, birth control, supplements, or IUD notes. Pregnancy test notes, if relevant. Questions you want answered. A privacy note if you want part of the visit alone.

Short script for the visit

"I am not asking this checklist to diagnose me. I am using it to show a pattern. My pain or symptoms affect . They are worst around . I also notice . What should we check next?"

If you have a short visit, start with how symptoms change your life. Missed days, sleep loss, bathroom pain, sex pain, and fear all matter.

Privacy note

Endometriosis notes can include sex, fertility, pregnancy, bowel symptoms, bladder symptoms, and location details.

If you keep these notes in an app, check where the data goes. Floriva is built for private cycle notes on your device. Paper also works. Use the format that feels safest for your situation and is easy to bring to care.