Free Endometriosis Symptom Survey and PDF for Your Doctor

The 3-Tier Endometriosis Symptom Self-Survey is a free self-assessment that sorts 36 symptoms into three tiers by how strongly each is associated with endometriosis. Your results include your score, a tier breakdown, and a PDF for your doctor.

Endometriosis diagnosis can be delayed by up to 10 years, according to a 2025 systematic review of diagnostic delay. In an autobiographical case report, one woman describes her own 10-year diagnostic delay.

Periods that put women in the fetal position, dismissed as "normal cramping." Pain with intercourse, attributed to anxiety. ER visits for pelvic pain, sent home without answers. Suppressive medications prescribed for symptoms without any investigation of the underlying disease, masking the condition while it continues to progress in the background.

Women with real, diagnosable endometriosis can wait years before a clinician looks for the disease.

I had endometriosis symptoms for 20 years before my own diagnosis at age 32. I was already four and a half years into my OBGYN training. If that can happen to me, it can happen to anyone.

That is why I built the 3-Tier Endometriosis Symptom Self-Survey.

Where the Endometriosis Symptom Framework Came From

Endometriosis is not rare. About 10 percent of reproductive-age women have endometriosis, according to a 2020 review in the New England Journal of Medicine. The overall prevalence of endometriosis was 18 percent in a 2021 systematic review and meta-analysis. In women with pelvic pain or infertility, around one-third to nearly one-half have endometriosis at laparoscopy, which is what you see in ASRM committee opinions and multiple laparoscopic prevalence studies.

The clinical picture is recognizable once you know what to look for. Certain symptoms cluster reliably in women who go on to have surgically confirmed disease. Tail-end brown bleeding for two or more days at cycle's end. Vomiting with menstrual pain. Emergency room visits for pelvic pain. Deep pain with intercourse. Cramping severe enough to interrupt daily life. Over-the-counter pain medications that accomplish nothing. Suppressive medications that fail to control symptoms.

These are recognizable clinical patterns, developed through careful observation across decades of surgical and clinical practice.

A 2025 systematic review of 17 studies found diagnosis times between 0.3 and 12 years. The review concluded that diagnostic delay "is still present, primarily driven by physicians." Most women encounter careful, pattern-based reasoning only after years of waiting, sitting across from a specialist for the first time, wondering why no one noticed sooner.

The survey is my attempt to make that clinical framework accessible earlier in the journey.

How the Endometriosis Survey Works

Go to rrmacademy.org/endo-survey. You will receive a private link to take the survey, along with occasional educational updates you can unsubscribe from at any time.

The survey presents 36 symptoms organized into three weighted tiers.

Tier 1 (Very High Suspicion): 15 symptoms at 3 points each. These are the patterns most strongly associated with confirmed endometriosis. Vomiting with menstruation. ER visits for menstrual pain. Deep pain with intercourse. Severe cramping that puts you in the fetal position. Tail-end brown bleeding for two or more days. Pain medications that do nothing. Suppressive medications that fail to help.

Tier 2 (High Suspicion): 15 symptoms at 2 points each. Systemic symptoms and co-conditions that frequently accompany the disease. Irritable bowel syndrome. Interstitial cystitis. Migraines. Severe premenstrual bloating. Heavy bleeding with iron deficiency. Short luteal phase. Low-quality cervical mucus.

Tier 3 (Suspicion): 6 symptoms at 1 point each. Lower-specificity markers that add context: fatigue, nickel sensitivity, easy bruising, family history, autoimmune history.

You check everything that applies. The tool calculates a weighted score and shows a breakdown by tier.

What Your Endometriosis Symptom Score Means

A high Tier 1 count gets a direct, clear message: your symptoms fit a strong clinical pattern for endometriosis. A moderate score across multiple tiers gets a different message: this picture is worth investigating. Even a lower score is addressed honestly, with a reminder that certain combinations still deserve a conversation with a clinician who knows this disease well.

The score does not diagnose endometriosis. Only a thorough clinical evaluation, and when appropriate, surgery can do that, which is the standard reflected in current guidelines that still treat laparoscopy as the gold standard for confirming the diagnosis. A lower score cannot exclude endometriosis, because some women have less typical symptom patterns that only become clear with expert evaluation.

What the survey does is give you language and organized data for the conversation with your provider. You are not going in empty-handed. You are going in with a summary of your symptoms, your score, a tier breakdown, and a PDF for your doctor.

You are not crazy. Your symptoms tell a story worth investigating.

The Endometriosis Survey PDF Report

After completing the survey, you can download a personalized PDF. This is the part I most want you to use.

The report includes your total score, tier-by-tier breakdowns, and every symptom you selected, organized by tier. Print it. Bring it to your next appointment. Hand it to your clinician and let that clinical picture open the conversation you deserve to have.

Here is a simple way to use it:

1. Take the survey and download your PDF.
2. Highlight the symptoms and patterns that worry you most.
3. Schedule a visit with a clinician experienced in endometriosis and bring the report.

Your Endometriosis Survey Data Stays Private

The PDF is generated on your device. No tracking pixels. No third-party advertising profiles. No selling of health data.

RRM Academy is a 501(c)(3) nonprofit. Your information supports research and education, full stop.

The survey costs nothing, because recognizing an endometriosis symptom pattern should not depend on who you know or what you can afford.

Why Endometriosis Treatment Timing Matters

Those ten years are not neutral time.

Suppressive medications do not reliably stop endometriosis lesions from progressing, which is why Cochrane reviews and other summaries describe them as symptom-suppressing rather than disease-eradicating therapies. They mask symptoms. The disease can continue to advance beneath the surface, and in many cases, so can associated adhesion formation and fertility impact.

When surgery is indicated, the approach matters enormously. Laparoscopic excision that aims to remove endometriosis at its root is associated with meaningful long-term reductions in pain and improved quality of life for many patients years after expert excision. Proper adhesion prevention is part of that equation too. Half of the outcome is the excision itself. The other half is the reconstruction and adhesion prevention work that follows.

The treatment exists. The path to it begins with recognizing the pattern and getting the right evaluation. That is what this survey is designed to help you do.

Take the survey. Download the PDF. Bring it to your next appointment. The conversation you deserve to have starts there.

rrmacademy.org/endo-survey

For more on endometriosis, restorative reproductive medicine, and what the published research actually shows, visit our Research Library. You can also follow me on Instagram at @napro_fertility_surgeon.

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References

1. Frankel LR. A 10-Year Journey to Diagnosis With Endometriosis: An Autobiographical Case Report. Cureus. 2022;14(1):e21329. PMC

2. De Corte P, Klinghardt M, von Stockum S, Heinemann K. Time to Diagnose Endometriosis: Current Status, Challenges and Regional Characteristics-A Systematic Literature Review. BJOG. 2025. PMC

3. Karavadra B, Semlyen J, Morris E, Thorpe G. 'I don't know what normal has been': a grounded theory exploration of the journey to endometriosis diagnosis. BMC Women's Health. 2025. PMC

4. Moradi Y, Shams-Beyranvand M, Khateri S, et al. A systematic review on the prevalence of endometriosis in women. Indian J Med Res. 2021. PMC

5. ASRM Practice Committee. Endometriosis and infertility: a committee opinion. Fertil Steril. 2012. ASRM

6. Rindos NB, Fulcher IR, Donnellan NM. Pain and Quality of Life after Laparoscopic Excision of Endometriosis. J Minim Invasive Gynecol. 2020. PubMed

7. McDonnell R, Gollow J, Nathan E, Doherty D, Majumder K, Wilkinson E, McElhinney B, Karthigasu K, Hart R. Endometriosis Quality of Life Cohort Study: Long-term Impact of Radical Laparoscopic Excision of Endometriosis. Gynecol Minim Invasive Ther. 2025;14(1):57-65. PMC

8. Reducing Endometriosis Diagnostic Delay. AMA Journal of Ethics. AMA

9. Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382(13):1244-1256. PubMed