Guide · printable
Endometriosis symptoms checklist
The six symptom groups that NICE guideline NG73 tells clinicians should prompt them to consider endometriosis, plus the context questions ACOG and the Office on Women's Health raise, written as a checklist you can tick and take to an appointment.
This is not a diagnosis. A checklist cannot tell you whether you have endometriosis and neither can a score. It organizes what you have noticed so a clinician can assess it. If pain is severe or sudden, seek medical help.
The six symptom groups (NICE NG73, section 1.3)
NICE tells clinicians to suspect endometriosis in anyone presenting with one or more of these. Tick a line if it has been true most months over the last few months.
- Period pain that affects daily life. Days off, plans cancelled, pain that starts before the bleed or outlasts it. More
- Pelvic pain between periods, or with no period. Six months or longer counts as chronic pelvic pain. More
- Deep pain during or after sex. Inside, with depth or position, sometimes lasting afterwards. More
- Bowel symptoms that follow the cycle. Especially pain opening the bowels around a period; also cyclical bloating, diarrhoea or constipation. More
- Bladder symptoms that follow the cycle. Especially pain passing urine or blood in the urine around a period. More
- Trouble conceiving, together with any of the above. A year of trying without success, alongside pain or cyclical symptoms. More
Context clinicians weigh
These do not count toward the six groups, and they belong on the sheet because they change how the pattern reads.
- Ordinary painkillers do not bring the pain down to manageable.
- Days missed from work, school or plans because of the pain in the last three months: ____
- Exhaustion around the pain or the period. More
- A parent or sibling with endometriosis.
- How long this has gone on: under 6 months · 6 to 12 months · 1 to 5 years · over 5 years
- Blood in urine or from the bowel around a period (mention this on its own; it needs its own check).
How to use it
- Tick for the last few months, not the worst day you remember. Clinicians are assessing a pattern.
- Add numbers next to every tick: days a month, years, what it stops you doing.
- Bring a dated record. A diary of pain scores and bleeding days, or the Wrenly doctor PDF, carries more weight than a checklist alone.
- Ask plainly. "My pattern matches the symptom groups NICE lists for suspecting endometriosis. Can we talk about a work-up?" If the first visit does not lead anywhere, ask what would change the recommendation and whether a referral to gynaecology is possible.
Prefer it scored for you?
The free endometriosis symptom self-check asks these same questions, counts the groups, grades impact and duration, and prints a one-page prep sheet. It runs in your browser; nothing you enter is sent anywhere.
What a work-up can involve
A history and examination first. NICE suggests transvaginal (or, where that is not suitable, transabdominal) ultrasound as an early investigation, and notes that a normal scan does not rule endometriosis out. Laparoscopy remains the definitive diagnostic step for many people. Treatment options, from pain relief and hormonal treatment to surgery, are decisions for you and your clinician; this guide stops at helping you get the conversation started.
Frequently asked questions
What are the main symptoms of endometriosis?
Guidelines group them as: period pain that affects daily life, pelvic pain between periods (chronic pelvic pain), deep pain during or after sex, bowel symptoms that follow the cycle (especially painful bowel movements), bladder symptoms that follow the cycle (especially pain passing urine or blood in the urine), and difficulty conceiving together with any of those. Fatigue, family history and pain that painkillers do not touch are common context.
How many symptoms do I need to have?
NICE tells clinicians to suspect endometriosis with one or more of the symptom groups. The checklist is not a threshold test: one group that disrupts your life is enough to ask for a work-up.
Can a checklist diagnose endometriosis?
No. Diagnosis involves a clinician taking a history, examining you, and often imaging or laparoscopy. A checklist organizes what you have noticed so the conversation starts from facts rather than memory.
Is there a quiz version?
Yes. The symptom self-check on this site asks the same questions, scores them against the six groups, and prints a prep sheet. It runs in your browser and stores nothing on our servers.
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.
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