How to prepare for your doctor's appointment

Noting your symptoms over a few cycles before your appointment and arriving with an organised summary makes it easier for the doctor to understand you. The NICE guideline advises telling people with suspected endometriosis that keeping a symptom and pain diary may be useful. ESHRE adds that there is not yet evidence that a diary speeds up diagnosis; it can still help organise the conversation.

What should your diary include?

• Where the pain is, how severe (0 to 10), when it happens and how long it lasts.
• Period dates and how heavy the bleeding is.
• Painkillers and how well they work.
• Bowel and urinary symptoms, pain during sex.
• How pain affects school, work, sleep and social life.

The symptom checklist summarises some of this for you.

What can you ask the doctor?

• What are the possible causes of my symptoms?
• Which examinations and imaging do I need?
• If imaging is normal, what is the next step?
• What are the treatment options, and the advantages and side effects of each?
• How does my plan change if I want to get pregnant?
• When should I come back if my symptoms continue?

The ESHRE guideline recommends that clinicians use shared decision-making that takes account of individual preferences, side effects, cost and availability. In other words, asking your questions is expected.

If you feel unheard

If your symptoms were brushed off as “normal” and your pain continues, asking for a second opinion is a legitimate right. Describing how pain affects daily life with concrete examples helps. NICE advises referral to a gynaecology service for severe, persistent or recurrent symptoms, or when initial treatment is not adequate.

For the steps of the diagnostic path, see the diagnosis page.