Endometriosis symptom check · symptom guide
Painful periods (dysmenorrhea)
Period pain is common, which is exactly why severe period pain gets waved away. The distinction clinicians draw is not "pain" against "no pain" but pain that affects daily activities: days off work or school, plans cancelled, pain that ordinary painkillers do not bring down, pain that starts before the bleed and outlasts it.
Not a diagnosis. This page explains one symptom group that published guidance says should prompt a clinician to consider endometriosis. No symptom, score or checklist can tell you whether you have it; only a clinician can assess you. If pain is severe or sudden, seek medical help.
What the guidelines say
NICE guideline NG73 tells clinicians to suspect endometriosis in anyone presenting with period-related pain (dysmenorrhoea) affecting daily activities and quality of life, with or without any other symptom. ACOG lists painful periods first among the signs of endometriosis and notes the pain may begin before and extend past the period. The Office on Women's Health adds that pain which gets worse over time, or that does not respond to over-the-counter relief, is a reason to see a clinician.
How to describe it at an appointment
- Where it is: low in the pelvis, one side, across the back, down the legs.
- How many days of each cycle, and whether it starts before the bleed.
- What it stops you doing, with numbers: "two days in bed most months".
- What you take for it, the dose, and how much it helps.
- Whether it has got worse over the years.
What to track before you go
A pain score every day, not just on the bad ones, so the pattern shows: a dated run of 8s around each period against 1s and 2s the rest of the month is a far stronger statement than "my periods are really bad". Mark the days you missed. Wrenly's daily log does this in one tap and the doctor PDF lines it up by date.
Check your whole pattern
This symptom is one of 14 questions in the free endometriosis symptom self-check. It scores your answers against the six NICE symptom groups and ends in a one-page prep sheet you can print for your doctor. Nothing you enter leaves your browser.
Frequently asked questions
How painful is too painful for a period?
There is no number. The guideline test is whether the pain affects your daily activities and quality of life. If you plan your month around it, miss work or school, or ordinary painkillers do not bring it under control, that meets the description NICE uses for suspecting endometriosis and is worth a work-up.
Do painful periods mean I have endometriosis?
No. Painful periods have many causes and most people with period pain do not have endometriosis. They are one of the symptom groups that should prompt a clinician to consider it, especially alongside pelvic pain between periods, pain with sex, or cyclical bowel or bladder symptoms. Only a clinician can assess you.
What should I bring to the appointment?
A dated record of pain scores, bleeding days and the days you missed, plus the painkillers and doses you have tried. The symptom self-check on this site turns your answers into a one-page prep sheet you can print.
Sources
- NICE guideline NG73, Endometriosis: diagnosis and management, section 1.3 (when to suspect endometriosis). nice.org.uk/guidance/ng73
- American College of Obstetricians and Gynecologists, Endometriosis patient FAQ. acog.org
- NIH Office on Women's Health, Endometriosis. womenshealth.gov
Wrenly paraphrases these in its own words. It does not reproduce any licensed questionnaire and is not a medical device.
Keep the record in Wrenly
Log pain, bleeding, energy and mood in a tap, paint where it hurts on a body map, and bring a dated symptom PDF to your appointment. Free, private, no account; Wrenly+ adds the doctor PDF and patterns. Not a medical device.