What is on the sheet
- My top 3 concerns
- Main symptoms: since when, how often, worst pain from 0 to 10, and what each one stops you doing
- What you have tried: medicine or treatment, dose, how long, and if it helped
- About you: periods, contraception, pregnancies, other conditions and family history
- Questions about tests, treatment and referral, with tick boxes
- What we agreed: tests, treatment, referral, and when to come back
How to fill it in
- Print both pages a week before your appointment.
- Fill in a few lines a day. Use your pain diary or symptom tracker for the details.
- Tick the questions you want to ask, and add your own.
- At the start of the appointment, hand page 1 to the doctor.
- Keep page 2, and write down what you agreed before you leave.
Why this helps
Keeping a pain and symptom diary can aid discussions with your doctor. This sheet puts the main points of that record on one page.
Your GP is trained to deal with thousands of conditions, not endometriosis in particular. A pain and symptoms diary helps you remember the relevant information during the appointment.
Endometriosis in a first-degree relative, such as your mother or sister, makes endometriosis more likely, so the sheet asks about it.
For more questions and what else to bring, read what to bring to your gynecologist appointment. If you have felt dismissed before, read what to say about medical gaslighting.
When to get urgent help
Do not wait for an appointment if your pain is severe. Get emergency help if you have pelvic pain and it is severe or getting worse, you feel faint, dizzy or lightheaded, or you have heavy bleeding from your vagina.
Questions
What should I bring to a doctor appointment for pelvic pain?
This sheet, your pain diary or symptom tracker, a list of the medicines you take, and your questions.
Should I really hand this to my doctor?
Yes. Offer page 1 at the start, and ask your doctor how they prefer to see your symptom history.
Is this medical advice?
No. The sheet is a record to share with your doctor. It does not diagnose any condition or replace care from a doctor.
Related guides
Prefer your phone?
Endolog, a pain and symptom diary app keeps the same records on your iPhone and makes a PDF report for your doctor.
Sources
- Endometriosis: diagnosis and management (NG73), recommendations, NICE
- Visiting your doctor, Endometriosis UK
- Pelvic pain, NHS
This printable is for keeping a record. It does not diagnose any condition or replace care from a doctor. Read how we write and check our content in our editorial policy.
