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  • CLINICAL PRESENTATION AND MEDICAL HISTORY

  • PRESENTING SYMPTOMS

  • MENSTRUAL SYMPTOMS HISTORY

  • PAIN HISTORY AND SYMPTOMS

  • PAIN WITH YOUR PERIODS
    The following questions ask about different types of pain with your periods (including irregular bleeding or bleeding while on hormonal treatments, but not spotting)

  • PAIN HISTORY AND SYMPTOMS

  • PAIN AT TIMES OTHER THAN WITH YOUR PERIODS
    The following questions ask about different types of pain at times other than with your periods

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  • ENDOMETRIOSIS HISTORY

  • DIAGNOSTIC JOURNEY HISTORY

    (From the first time you sought health care for your symptoms until now)

  • PREGNANCY, OBSTETRIC AND FERTILITY HISTORY

  • MEDICATION HISTORY

  • Hormonal Medication

  • Pain Medication

  • Other Medication

  • Allied and complementary therapies

  • MEDICAL HISTORY

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