What is on the sheet
- Year view: 12 months by 31 days, with bleeding from spotting to heavy
- Cycle length and days bled for each month
- Month view: cycle day and bleeding for each day
- Symptoms from 0 to 3: pelvic pain, period pain, pain during or after sex, pain when you poo, pain or blood when you pee, bloating and tiredness
- Two blank rows for your own symptoms
- Pain medicine, missed work or plans, and hours of sleep
- Monthly totals and 3 things to tell your doctor
How to fill it in
- On the year view, write a letter in each day you bleed: S, L, M or H.
- When your next period starts, count the cycle length and write it in.
- On the month view, fill in one column each evening, on days without symptoms too.
- Rate each symptom from 0 to 3 by what it stopped you doing.
- At the end of the month, fill in the totals and the 3 things to tell your doctor.
Why this helps
Day 1 of your cycle is the first day of your period, and the cycle runs to the day before your next period. Cycles of 21 to 35 days are normal.
Irregular periods, or long gaps between periods, are a main symptom of PCOS, which the NHS now calls PMOS. The year view makes gaps easy to see. See a doctor if heavy periods affect your life, or if you bleed between periods or after sex.
The symptom rows follow NICE guidance. A doctor should suspect endometriosis when you have chronic pelvic pain, period pain that affects daily life, deep pain during or after sex, or period-related bowel or bladder symptoms, in particular painful bowel movements, pain passing urine or blood in your urine.
Keeping a pain and symptom diary can aid discussions with your doctor. For pain in more detail, use the pain diary and the period pain scale.
When to get urgent help
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
How do I work out my cycle length?
Count from the first day of one period to the day before the next one. Day 1 is the first day of your period.
What is a normal cycle length?
Cycles of 21 to 35 days are normal. Tell your doctor about long gaps between periods, or bleeding between periods or after sex.
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
- Periods and fertility in the menstrual cycle, NHS
- Polyendocrine metabolic ovarian syndrome (PMOS), NHS
- Heavy periods, NHS
- Endometriosis: diagnosis and management (NG73), recommendations, NICE
- 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.



