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Fibroid Symptom Checklist, No Diagnosis
A plain checklist for tracking possible fibroid symptoms before a doctor visit. It cannot diagnose fibroids.
Fibroid symptoms can be hard to sort out. Heavy bleeding may show up first. Pressure, bladder changes, or bowel changes may come later.
This checklist helps you bring clear notes to care. It is not a quiz. It cannot tell you if you have fibroids.
If bleeding is heavy, sudden, or scary, seek urgent or emergency care. Do the same if you feel faint, short of breath, pregnant, or unsafe waiting.
One page symptom check
Mark what changed. Add dates when you can.
Symptom Check Notes Periods are heavier than usual Periods last longer than usual Clots are new or more common Bleeding between periods Stronger cramps or pelvic pain Pelvic pressure or heaviness Lower belly fullness Pants feel tighter at the lower belly Frequent urination Trouble emptying your bladder Constipation Rectal pressure Lower back pain Pain with sex, if relevant Trying to get pregnant, if relevant
What changed
Use this section before the visit.
Question Your notes When did the change start? What was normal for you before? What is different now? What symptom bothers you most? What makes daily life harder? What do you want checked first?
Short notes count. "I pee twice at night now" helps. So does "I plan errands around bleeding."
Bleeding notes
You do not need perfect numbers. Use the same words each cycle.
Date Period day Flow Products used Clots Leaks Pain 0 to 10 : : light, medium, heavy, very heavy none, small, quarter size, larger
Bring product counts if you have them. If you use a cup or disc, note the amount if you know it.
Pressure and pain notes
Fibroid symptoms are not only bleeding. Pressure details can matter too.
Date Pressure or pain Where What was happening What helped none, mild, medium, strong pelvis, lower belly, back, rectal area period, bowel movement, sex, exercise, rest
Do not force a pattern. Write what happened.
Bladder and bowel notes
Use this if pressure symptoms are part of the problem.
I pee more often than I used to. I wake at night to pee. I feel pressure on my bladder. I have trouble emptying my bladder. I am constipated more often. I feel rectal pressure. These symptoms get worse during my period. These symptoms happen all month.
What to bring
This checklist. Your last few period start dates, if known. A list of medicines and supplements. Birth control, IUD, implant, or hormone details. Pregnancy test result, if relevant. Prior ultrasound, MRI, or visit notes, if you have them. A short list of your top questions.
Questions to ask
Could my symptoms fit fibroids? What else could cause this pattern? Do I need an exam today? Do I need an ultrasound? What symptoms should make me call right away? Should I be checked for anemia? Could fibroids affect pregnancy or fertility for me? What should I track before the next visit?
Privacy note
Fibroid notes can include bleeding, sex pain, pregnancy, fertility, and location details. Before you store them in an app, check where the data is kept and who can access it.
Floriva can keep notes on your device. Paper works too. Pick the record you can bring to care and keep private enough for your life.