lead-magnets

Endometriosis Tracking Kit

A full endometriosis tracking kit for pain, bowel and bladder symptoms, diet triggers, laparoscopy recovery, pain relief trials, symptom checks, and ultrasound visits.

Use this kit if you have endometriosis symptoms, a diagnosis, or are preparing for a visit or surgery.

It gives you one place for pain, bowel and bladder symptoms, diet notes, pain relief trials, imaging visits, and laparoscopy recovery.

It is a set of tracking sheets and question lists.

It is not medical advice.

It cannot diagnose endometriosis, rule it out, or replace a clinician visit.

If pain is severe, new, or unsafe to wait on, contact a clinician now.

What this kit can do

This kit can help you This kit cannot Name symptoms in plain words. Diagnose endometriosis. Show if symptoms come near your period. Rule out other causes. Help you prepare for a visit or surgery follow up. Tell you what treatment to use. Help you ask for next steps. Replace a clinician visit.

One page visit packet

Fill out the short version first. Bring extra logs only if needed.

Topic Your note Main reason for this visit Date symptoms started Last 3 period start dates Worst pain score, 0 to 10 Where pain shows up Bowel symptoms Bladder symptoms What you miss or change because of symptoms Medicines or steps tried Main question for the clinician

Symptom checklist

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 or between periods. Pain lasts after bleeding stops. Pain medicine does not help enough. Pain wakes me up.

Where the pain is

Lower belly, one or both sides. Lower back, hips, or thighs. Rectum or anus. Bladder area. Deep pain inside the pelvis.

Bowel and bladder symptoms

Pain when having a bowel movement. Rectal pain or pressure. Constipation or diarrhea near my period. Bloating or nausea near my period. Pain when peeing or needing to pee more often. Blood in stool or urine near my period.

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

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

Pain map

Mark each place pain shows up. Add when it happens.

Pain area During period Before period Ovulation time Other days Notes Lower belly or pelvis One side of pelvis Lower back Rectum or deep bowel area Bladder area Hips, legs, or thighs

Daily pain log

Use one row per day. Zero pain days count too. They show when pain is absent.

Date Cycle day Pain location Severity 0 10 Duration (hrs) What helped What worsened Associated symptoms : :

Pain score guide: 0 is no pain. 5 is pain that limits but does not stop normal activity. 10 is pain requiring emergency care. Score resting pain, not pain with movement.

Bowel and bladder symptom log

Use one row per day. Write what happened, not a medical word.

Date Cycle day Bowel movement pain 0 10 Constipation Diarrhea Rectal pain or pressure Urinary urgency Pain when peeing Bleeding Notes : : none, mild, strong none, mild, strong none, mild, strong none, mild, strong none, mild, strong stool, urine, not sure

Blood in stool or urine needs medical advice. Seek urgent care if it feels unsafe to wait. Do not assume bowel or bladder symptoms are endometriosis; infection and other causes need care too.

Diet and symptom trigger log

A food log can show timing, but it cannot prove a food caused pain, bloating, bowel symptoms, or fatigue. Do not cut out whole food groups based on one bad day.

Date Cycle day Meals and snacks Caffeine Alcohol Pain 0 10 Bowel symptoms Bloating Fatigue Notes : : none, some, more than usual none, some none, mild, strong none, mild, strong none, mild, strong

Pain relief trial log

This does not tell you what to try, give dose advice, or say when to start or stop medicine. Ask a clinician or pharmacist first.

Date Cycle day Time started Pain before 0 10 What you tried Pain after 30 min Pain after 1 hr Side effects : : : : heat, rest, medicine, other

Laparoscopy recovery log

Use this after surgery. It is not a recovery plan or timeline. Follow your surgeon's instructions and seek care for urgent or worrying symptoms.

Date Day after surgery Pain 0 10 Incision notes Bleeding notes Bowel and bladder notes Medicine questions Activity and rest : :

Follow up questions

What did you find during surgery? Did it confirm endometriosis? Were bowel, bladder, ovary, or tube areas involved? What symptoms should improve first, and what may take more time? When can I return to work, school, sex, exercise, or lifting? Should I keep tracking pain by cycle day, and my first period after surgery?

Ultrasound question list

Use this before or after imaging. It does not read your scan or diagnose endometriosis.

What will this scan look for? Can it look for ovarian endometriomas or deep endometriosis? What did the scan show, and what did it not show? If my scan is normal, what does that mean? Could symptoms still fit endometriosis? When would referral or laparoscopy make sense? What symptoms mean I should call sooner?

Pattern review

Answer these after one cycle.

Question Your notes Which cycle days were worst? Did symptoms start before bleeding? Did symptoms happen outside the period? Did bowel or bladder symptoms follow a cycle pattern? What symptom changed daily life most? What do you want checked first?

Short visit script

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

If your visit includes sex, fertility, pregnancy, bowel, or bladder details, you can ask to speak alone.

Privacy limited export

Bring the smallest useful record.

Bring Skip unless needed Last 3 to 6 period start dates Full app export Pain score summary and pain map Private notes not tied to care Bowel and bladder summary Sex notes if you do not want to share them Medicines tried Raw screenshots or old data that does not fit this visit

Floriva note

Floriva can help you keep cycle, pain, and symptom notes on your device.

It cannot diagnose endometriosis, choose treatment, or replace your care team.

For visit prep, read Floriva for gynecologist prep. </content