Most tracking advice is built around the calendar. When did it start, how long was the cycle, when is the next one due. If you have endometriosis, or you suspect you do, the calendar is not the part that matters. The pain is, and pain is the thing period apps record worst.
This guide covers what endometriosis does, why a dated pain record is worth the effort even though no app can diagnose anything, what to log, and what to do with it when you finally get an appointment.
What endometriosis is
The American College of Obstetricians and Gynecologists describes endometriosis as a chronic condition in which the type of tissue that forms the lining of the uterus grows outside it, usually inside the pelvis. About 1 in 10 women of reproductive age develop it. That tissue responds to the same hormonal changes the lining does, so it grows and bleeds with the cycle, and because the blood has nowhere to go the surrounding tissue becomes inflamed and can scar.
The most common symptom is chronic pelvic pain. ACOG also lists pain during periods that often gets worse over time, pain during sex, pain when urinating or during bowel movements, digestive problems such as constipation and bloating, and infertility. The NHS adds severe period pain that stops you doing normal activities, heavy periods, lower back and pelvic pain, extreme tiredness, and low mood or anxiety.
One line from ACOG should shape how you read your own log. The amount of pain does not always match the severity of the condition. You can have slight pain with extensive lesions, or severe pain with very few. So a pain record is evidence of what you are living with. It is not a measure of how bad the disease is, and a mild month is not reassurance.
Why the log is worth keeping
The honest reason is the diagnostic path. The NHS says plainly that it can take a long time to diagnose endometriosis, partly because the symptoms overlap with adenomyosis, fibroids, pelvic inflammatory disease, and irritable bowel syndrome. The NICHD at the National Institutes of Health is blunter still. Surgery, usually a laparoscopy, is currently the only way to confirm the diagnosis. Ultrasound and MRI can find larger cysts and nodules but miss small lesions and adhesions.
Nothing in a phone changes that. What a record changes is the conversation that decides whether you get referred at all. A GP asking about your symptoms is trying to establish a pattern, and patterns are exactly what nobody can reconstruct from memory across a year of bad months and ordinary ones. Six months of dated entries answers the question in the appointment instead of after it.
It also protects you from your own recall. Pain that recurs every month becomes normal. People routinely describe years of it as manageable, then look at a log and find they lost four days out of every twenty-eight.
What to log
Pain, on the day, whether or not you are bleeding
This is the record. Log the type, since cramping, back pain and headache point in different directions, and log the day it happened even if it happened in the middle of your cycle. Period pain on period days is what everyone has. Pelvic pain on day 16 is a finding.
If your app offers no way to say how bad it was, keep your own shorthand and be consistent about it. A workable one is whether the pain changed what you did that day. Took painkillers, stayed home, left work, could not stand up straight. Those are facts a clinician can weigh, and unlike a number out of ten they mean the same thing in January and in June.
Flow, using the definition rather than the feeling
Heavy periods are on both the ACOG and NHS symptom lists, and heavy is a word people apply very differently. The NHS gives a concrete test. Needing to change a pad or tampon every one to two hours, or bleeding through to your clothes. Note which of those happened and when. Our guide on how long a period should last covers what falls outside the usual range.
Bowel and bladder symptoms, tied to the cycle
Pain when you poo or pee, constipation, and bloating all appear on the symptom lists, and they are the ones most often filed under a bad stomach and never mentioned. The detail that makes them meaningful is whether they cluster around your period. A log shows that. A memory of feeling bloated does not.
Fatigue and mood
The NHS lists extreme tiredness and low mood or anxiety as part of the condition, not as separate problems you brought along. Log them, and say them out loud in the appointment.
Pain during sex
ACOG lists dyspareunia among the common symptoms. It is easy to leave out of a written record and it is one of the more specific things on the list, so find somewhere to note it, even if that is a line in the notes app rather than a tick box.
Bleeding between periods
Spotting outside your period has many causes and belongs in the record with its dates, which turns it into something answerable. Our guide on what causes bleeding between periods goes through them.
Taking it to a GP
The NHS advice is to see a GP if you think you might have endometriosis, if your symptoms are affecting your everyday life, work and relationships, or if you have had treatment and the symptoms are no better or getting worse. The appointment involves questions about your symptoms and about whether close relatives have had endometriosis, and may include a physical examination and blood tests, then a possible referral to a gynaecologist.
Bring three things out of your log. How many days in a typical month the pain changes what you do, which symptoms happen away from your period, and how heavy the bleeding gets by the change-every-one-to-two hours test. Those three sentences do more than a printout of everything.
Treatment is worth knowing about before you go, because it changes what you should say. The NHS says there is currently no cure, and that medicines are usually first, painkillers and hormonal options including the combined pill. Hormonal treatment is not offered while you are trying to get pregnant, so say so if that is the case. Surgery to remove areas of endometriosis is an option if medicines are not working, if there is a lot of it, or if it is affecting your ability to have children.
Two things to keep straight
A tracker is not a test. No app, and no pattern in one, can tell you whether you have endometriosis. Treat the log as material for the appointment, not as a verdict you can reach at home.
A quiet month is not progress. Since the pain does not track the extent of the disease, a mild stretch is a mild stretch. It is not evidence that anything has resolved, and it is not a reason to cancel the referral.
How Plum handles this
We build Plum, so here is what it actually does, with the gaps named.
Logging works on any day, not only period days, which is the part that matters here. Pain is its own category with cramps, headache, back pain and breast tenderness, and you can pick more than one on the same day. Flow is light, medium or heavy. Digestion covers bloating, gassiness and nausea, there are separate entries for stool and for urination, and energy runs from high down to exhausted. Mood has its own category. So most of the symptom list above has somewhere to live, and it is a couple of taps per day rather than a form.
What Plum does not have is a free-text note on a day, or a severity scale on pain. It records that cramps happened, not how bad they were, and there is no tick box for pain during sex. Keep those somewhere else and bring both to the appointment. We would rather say that than let you find out in month four.
The insights screen counts which symptoms show up most and where they fall in your cycle, which is the view that makes an away-from-period pattern visible. Our guide on keeping a period diary covers the habit side of doing this for long enough to be useful.
Plum shows no ads and never sells personal data. It does require an account and syncs your data to our servers, encrypted in transit and at rest, so we will not claim it stays on your phone. You can delete your account and everything in it from inside the app whenever you want. If you are weighing apps on privacy, our checklist for choosing a private period tracker applies to any of them, ours included.
