The self-test

Could my symptoms indicate endometriosis?

Answer the questions truthfully.

Do you experience severe pain during your period (stomach or back)? Yes No

Do you have pain around your ovulation? Yes No I don't know

Do you experience pain in the week before period? Yes No

Do you have pain during bowel movements during your period? Yes No

Do you have pain while urinating during your period? Yes No

Do you feel nauseous or vomit during your period? Yes No

Do you experience gastrointestinal issues during your period? Yes No

Do you experience (chronic) fatigue? Yes No

Do you have pain during or after sexual intercourse? Yes No Not applicable

Do you avoid sexual intercourse due to pain? Yes No Not applicable

Have you had difficulty getting pregnant? Yes No Not applicable

Have you had multiple miscarriages? Yes No Not applicable

Are there family members with endometriosis? Yes No I don’t know

Do you plan your life around your period? Yes No I don’t know

Do your symptoms get worse every year? Yes No

Reinier de Graaf, Location: “De Gravin”
Reinier de Graafweg 5
2625 AD Delft, The Netherlands

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Reinier de Graaf, Location: “De Gravin”
Reinier de Graafweg 5
2625 AD Delft, The Netherlands

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