Updated 3 October 2026
At a glance
- A pregnancy log for endometriosis records pain location and 0–10 severity, bleeding or spotting, bowel and bladder changes, flares, fatigue, and approved medicines, each with the date and week of pregnancy.
- A systematic review of 39 studies found that women with endometriosis had an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth compared with women without endometriosis (Breintoft et al., 2021).
- In a retrospective study of 131 women with a live birth after endometriosis surgery, 84% reported at least one moderate-severe pain symptom two years after delivery (Alberico et al., 2018), so entries started in pregnancy stay useful afterward.
- Endometriosis Journey is an endometriosis tracker that keeps daily check-ins, flares, the cycle, medications, and journal notes in one dated history, and its insights show what tends to come before better and worse weeks.
Endometriosis pain can change during pregnancy, and the change differs from person to person. Some people notice relief, some notice the same pain, and some notice new pain that is hard to place among ordinary pregnancy aches. Bleeding, bowel changes, back pain, and fatigue can each have more than one cause at the same time.
This guide explains what to log about endometriosis before, during, and after pregnancy: a baseline of your usual pain, pain by trimester, bleeding and spotting, bowel and bladder changes, urgent warning signs, what to tell your prenatal clinician, and the first months after delivery. It covers logging and visit preparation. Decisions about medicines, monitoring, and birth plans belong with your treating clinicians.
What a pregnancy log covers when you have endometriosis
A pregnancy log for endometriosis records the same short set of fields on the same dates from before conception through the months after delivery, so any change from your usual pattern is visible. A review of the evidence concluded that pregnancy in women with endometriosis is not always associated with improved symptoms, and found no evidence that pregnancy can be expected to generally reduce the size and number of endometriotic lesions (Leeners et al., 2018).
Ultrasound follows lesions, not how you feel. In a University College London cohort of 65 women with deep endometriosis or an ovarian endometrioma, the authors wrote that it remains uncertain how lesion changes affect pain symptoms (Bean et al., 2023). Your dated entries fill that gap.
| What your log records | What your clinicians do |
|---|---|
| Pain, bleeding, bowel, bladder, and energy changes with dates and the week of pregnancy | Examine you, order scans or blood tests, and interpret any change |
| Which days matched your usual endometriosis pattern and which felt new | Decide whether a symptom needs monitoring, treatment, or urgent assessment |
| What you took, when, and which medicines your clinician approved | Advise on medicines and monitoring during pregnancy and birth |
In Endometriosis Journey (by Health Journey Labs), the Daily check-in records pelvic pain, fatigue, bowel and bladder symptoms, sleep, mood, and medications in one guided pass. The same questions in every trimester make a 5 out of 10 in week 8 comparable with a 5 in week 28. The Daily Journal holds notes on new sensations and questions for the next appointment. Insights can show which symptoms stayed close to your usual pattern and which changed after conception.
How to log a baseline of your usual endometriosis pain before or early in pregnancy
A baseline is two to four weeks of entries, including low-pain days, written before pregnancy symptoms blur the picture. The NHS lists severe period pain, heavy periods, pelvic pain, pain when you poo or pee, pain during or after sex, and extreme tiredness among endometriosis symptoms (NHS). Those are the fields to fix in place. From Endometriosis Journey, we recommend keeping the daily fields short enough to finish in two minutes.
The NHS also notes that you will not be given hormones if you are trying to get pregnant. (Source: nhs.uk.) If your clinician changes your treatment plan, record the date and keep logging, because the weeks before and after give a comparison. If you are still trying to conceive, our guides on endometriosis and fertility questions and endometriosis infertility questions cover those visits.
Pre-pregnancy baseline table, by Endometriosis Journey
| Field | How to record it |
|---|---|
| Pelvic pain | Location, 0–10 severity, and one type word such as cramping, stabbing, or dragging |
| Cycle and bleeding | First and last day, flow, clots, and spotting between periods |
| Bowel and bladder | Pain with bowel movements or urination, constipation, diarrhea, any blood |
| Pain with sex | Pain during or after sex, 0–10, or sex avoided |
| Fatigue and sleep | Energy 0–10, hours slept, waking from pain |
| Medication | Name, dose as prescribed, time taken, and effect |
| Daily function | Work, school, or plans changed or missed |
In Endometriosis Journey, the Period Tracker records start and stop dates, flow, and how heavy or light bleeding felt, so each baseline pain entry has a cycle day. The Flare Tracker marks a day clearly worse than your usual hard endometriosis week. Insights can show how often flares happened before conception and in which cycle phase.
How to log endometriosis pain by trimester, including pain that may come from other causes
The NHS describes pregnancy-related pelvic girdle pain as pain over the pubic bone, across the lower back, between the vagina and anus, or spreading to the thighs, often worse with walking, stairs, or turning over in bed, and estimates that it affects up to 1 in 5 pregnant women to some degree (NHS). Recording where a pain sits and what brings it on gives the assessing clinician the details that separate one cause from another.
Lesions can change too. In the University College London cohort, growth in the first and second trimesters followed by regression later was seen in 10 of 34 endometriomas and 27 of 51 nodules followed up, and most lesions shrank by the end (Bean et al., 2023). Lesion size and pain do not always move together, so log how each day felt. One entry per pain episode includes (Endometriosis Journey recommendations):
Logging pain by trimester
Endometriosis Journey records the date, week of pregnancy and location.
- Date and week of pregnancy
- Location: over the pubic bone, lower back on one or both sides, deep in the pelvis, rectum, or one side of the abdomen
- What brought it on: walking, stairs, turning in bed, a bowel movement, sex, or nothing obvious
- Severity 0–10, type word, and how long it lasted
- What eased it and what you had to stop doing
With Endometriosis Journey, the Daily check-in records the 0–10 score and location each day, and custom symptoms let you add labels such as pain turning over in bed. The Daily Journal holds what brought the pain on and how long it lasted. Insights can show whether higher scores cluster in certain weeks of pregnancy, times of day, or after certain activities.
How to log bleeding, spotting, and clots during pregnancy with endometriosis
Tell your clinician about any bleeding during pregnancy. The CDC lists vaginal bleeding that is more than spotting, like a period, and fluid leaking from the vagina among the urgent maternal warning signs that call for medical care immediately (CDC). For heavier bleeding, contact your clinician first and write the record afterward.
For lighter spotting your clinician already knows about, a dated entry takes under a minute and answers the usual questions: when it began, how much, what color, and whether pain came with it. Bleeding and pain patterns before pregnancy give the clinician a comparison.
Bleeding, spotting and clots in pregnancy
Endometriosis Journey notes the amount and the week of pregnancy.
- Date, time, and week of pregnancy
- Amount: a few spots on tissue, a pad liner, or a pad, and how many changes
- Color and any clots, with size compared with a coin
- Pain with it, 0–10, and where
- What you were doing, whether it stopped, and who you called
In Endometriosis Journey, the Daily Journal takes a typed or voice note on when bleeding or spotting started and what came with it. The Daily check-in records pain and fatigue on the same date.
How to log bowel, bladder, back, and fatigue changes that endometriosis may share with pregnancy
The NHS notes that endometriosis symptoms can be similar to those of other conditions, including adenomyosis, fibroids, pelvic inflammatory disease, and irritable bowel syndrome (NHS). The same overlap applies in pregnancy: constipation, urinary changes, back pain, bloating, nausea, and tiredness can have several causes at once, so timing and severity are more useful than a label.
Keep the words you used before pregnancy so entries line up with your baseline: pain with bowel movements, pain with urination, diarrhea, constipation, and any blood. Add the time of day, a 0–10 score, and what you ate or did in the hours before. The CDC lists severe nausea and vomiting, with being unable to drink for more than 8 hours or eat for more than 24 hours, among its urgent warning signs (CDC), so those entries call for contact with your clinician.
In Endometriosis Journey, the Daily check-in asks about bowel or bladder symptoms, fatigue, and sleep on the same dates as pelvic pain. The Food Tracker records meals and drinks that stand out, so nausea or bloating can be placed around a particular meal.
Warning signs in pregnancy with endometriosis that need a clinician right away instead of a log entry
The CDC's urgent maternal warning signs apply during pregnancy and in the year after delivery, and the CDC advises seeking medical care immediately for any of them (CDC). The signs most relevant to a pain and bleeding log include:
List of warning signs in pregnancy, by Endometriosis Journey
- Severe belly pain that does not go away, such as sharp, stabbing, or cramp-like pain
- Vaginal bleeding that is more than spotting, or fluid leaking
- A fever of 100.4°F (38°C) or higher
- Fainting, or dizziness that is ongoing or comes and goes over many days
- A baby who moves less than before
- Chest pain or a fast-beating heart, and trouble breathing
- Severe nausea and vomiting, with being unable to drink for more than 8 hours or eat for more than 24 hours
- Thoughts about harming yourself or your baby
A review of 39 studies reported that spontaneous hemoperitoneum in pregnancy and bowel perforation seemed to be associated with endometriosis, but that the studies were few (Breintoft et al., 2021). That is a reason to say "I have endometriosis" at the start of an urgent call. The CDC adds that its list does not cover every symptom and advises contacting your health care provider if something feels wrong.
If you have thoughts of harming yourself or feel unsafe, call your local emergency number (for example, 911) or a crisis line where you live (for example, 988). The National Institute of Mental Health advises: “If you are suicidal or in emotional distress, consider using the 988 Suicide & Crisis Lifeline.” (NIMH)
After you have been seen, the Daily Journal in Endometriosis Journey holds what happened, when it started, and what you were told. The Flare Tracker records the onset and intensity of the episode as its own entry. Insights can show whether similar episodes appeared earlier in your history.
What to tell your prenatal clinician about endometriosis, and how to turn the log into a one-page summary
A meta-analysis of 24 studies covering 1,924,114 women found higher rates of preterm birth, miscarriage, placenta previa, small-for-gestational-age infants, and cesarean delivery in women with endometriosis, with no difference in gestational hypertension or preeclampsia (Zullo et al., 2017). The 39-study review above reported an increased risk of hypertension and pre-eclampsia, so findings vary by study. These are group results, and your clinician applies them to your own history.
Most studies in the 2017 meta-analysis made the diagnosis after surgery, so bring how yours was confirmed. For a visit with limited time, see our guide on how to prepare for a short endometriosis doctor visit.
Briefing a prenatal clinician
Endometriosis Journey starts with how the diagnosis was confirmed.
- Diagnosis date and how it was confirmed (symptoms, scan, or surgery)
- Where the endometriosis was found, such as ovaries, bowel, or bladder, and any surgery dates
- Treatments you have used and the dates they started or stopped
- Your baseline pain pattern and the weeks of pregnancy when it changed
- Bleeding or spotting episodes with dates, and two or three written questions
In Endometriosis Journey, My Care Team stores your obstetric and endometriosis clinicians with short visit notes, so you can prepare questions and review answers. The Doctor Report exports a one-page summary of your logged history, including dates, pelvic pain, cycle timing, and daily function.
How to log endometriosis in the first months after delivery and while breastfeeding
In a retrospective study of 131 women who had a live birth after endometriosis surgery, 49 (37%) had a clinically relevant recurrence needing medical or surgical treatment, and 84% reported at least one moderate-severe pain symptom two years after delivery (Alberico et al., 2018). A prospective study followed 123 women with endometriosis who breastfed for 2 years after delivery: dysmenorrhea fell in proportion to how long they breastfed, chronic pelvic pain fell only in women who breastfed exclusively, and pain with sex showed no significant improvement (Prosperi Porta et al., 2021).
The first months after birth
Endometriosis Journey dates the return of periods and pain by cycle day.
- Date your period returns, flow, and clots
- Pain by cycle day, including pain with sex, bowel movements, and urination
- Flares, with onset and how long they lasted
- Feeding method and sleep, since both change across the weeks
- Medicines taken, as directed by your clinician
The CDC lists bleeding that soaks through one or more pads in an hour, and clots bigger than an egg, as urgent signs after pregnancy (CDC). Contact your clinician right away for either.
In Endometriosis Journey, the Period Tracker records the date your period returns and how heavy or light bleeding felt. The Daily check-in keeps pain, fatigue, and sleep on the same dates. Insights can show whether pain returned with the first cycle or later.
How Endometriosis Journey can help
A notebook can hold pregnancy entries. The harder step is relating them over months: seeing whether pain, bleeding, and fatigue in each trimester followed the same pattern as your baseline, and which weeks limited daily life most. A dated history that already holds your cycle, flares, and medications makes that comparison faster. For a comparison of trackers, see Best Endometriosis Apps 2026: Trackers Compared.
Endometriosis Journey is a personal endometriosis tracker from Health Journey Labs on the App Store and Google Play. On this angle, it lets you record pelvic pain, bleeding, flares, bowel and bladder symptoms, and medications on the same dates from before conception through the months after delivery. Below is what you can use and how each part helps.
- Daily check-in — A short guided pass across physical symptoms, emotional state, nutrition, sleep, exercise, meds, and external factors, so insights can show links memory misses.
- Daily Journal — Freer notes, including voice when pain makes typing hard, that give insights context scores cannot carry.
- Flare Tracker — Mark a day clearly worse than your usual hard endometriosis week, so insights can separate a one-off spike from a repeating pattern.
- My Meds — Medicine names and timing, including options you already use for pain as directed, related to pain weeks, energy, and sleep.
- My Labs — Result dates for imaging, bloodwork, or other tests, weighed against the pain and function of that week.
- Weekly Goals — Set one small aim and see whether it held, which shows whether a habit change helped.
- Learn — Short education topics on endometriosis themes such as cycle pain, fatigue, pacing, and visit prep.
- AI companions — Clara and specialist companions answer with your logged history in view.
- My Care Team — Add clinicians and visit notes to prepare questions and review answers.
- Doctor Report — Export a one-page summary from your logged history when a written summary helps a short visit.
- My Assessments — Structured check-ins that give insights more context about your life.
- Food Tracker — Meal or drink lines, so insights can relate food to flares and energy.
- Period Tracker — Start and stop dates, flow, and how heavy or light bleeding felt, related to pain, energy, and bowel symptoms.
- Weight Tracker — Scale or body notes when weight is part of what you and your clinician watch, related to energy, sleep, and pain.
Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.
We make Endometriosis Journey at Health Journey Labs. This guide is educational and does not replace medical advice. Diagnosis, medication decisions, and urgent care decisions belong with your treating clinicians.
Sources
- CDC — Urgent Maternal Warning Signs and Symptoms (HEAR HER campaign)
- NHS — Endometriosis
- NHS — Pelvic pain in pregnancy
- Leeners B, et al. The effect of pregnancy on endometriosis—facts or fiction? Hum Reprod Update. 2018
- Bean E, et al. Natural history of endometriosis in pregnancy: ultrasound study of morphology of deep endometriosis and ovarian endometrioma. Ultrasound Obstet Gynecol. 2023
- Zullo F, et al. Endometriosis and obstetrics complications: a systematic review and meta-analysis. Fertil Steril. 2017
- Breintoft K, et al. Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis. J Clin Med. 2021
- Alberico D, et al. Potential benefits of pregnancy on endometriosis symptoms. Eur J Obstet Gynecol Reprod Biol. 2018
- Prosperi Porta R, et al. Effects of Breastfeeding on Endometriosis-Related Pain: A Prospective Observational Study. Int J Environ Res Public Health. 2021
FAQ
The answers below draw on the sources cited in this guide, and the app they mention is Endometriosis Journey (by Health Journey Labs).
Does endometriosis pain get better during pregnancy?
It varies. A 2018 review concluded that pregnancy in women with endometriosis is not always associated with improved symptoms, while a retrospective study of 131 women concluded that symptom relief occurs during and immediately after pregnancy, with symptoms rapidly recurring in most. Your own dated pain scores show what happens for you.
In Endometriosis Journey, the Daily check-in records the same 0–10 pain score and location through every trimester. Insights can show whether your pain moved away from your pre-pregnancy baseline, and in which weeks.
What should I log if I am still trying to conceive?
Keep your usual endometriosis fields: pain location and severity, cycle days and bleeding, bowel and bladder symptoms, pain with sex, fatigue, and medication timing as prescribed. Add the date of any treatment change your clinician makes, so later pregnancy entries have a baseline to be compared with.
The Period Tracker in Endometriosis Journey keeps cycle start and stop dates, and the Daily check-in holds the rest of the daily fields. Insights can show how your pain and energy varied by cycle phase before pregnancy.
Is pelvic pain in pregnancy an endometriosis flare?
A log cannot answer that, and only an assessment can. The NHS describes pregnancy-related pelvic girdle pain, which affects up to 1 in 5 pregnant women to some degree, as pain over the pubic bone, across the lower back, or spreading to the thighs. Record the place, trigger, and timing of each pain for your clinician.
In Endometriosis Journey, the Daily Journal holds what brought each pain on, and the Flare Tracker marks days clearly worse than usual. Insights can show whether pain follows movement or position or appears on its own.
Which pain or bleeding during pregnancy needs urgent care?
The CDC lists severe belly pain that does not go away, bleeding that is more than spotting, fluid leaking from the vagina, a fever of 100.4°F or higher, fainting, and a baby who moves less than before among the urgent maternal warning signs. Contact your clinician or emergency services right away and mention your endometriosis history.
Once you have been seen, the Daily Journal in Endometriosis Journey can hold what happened, when it started, and what you were told. Insights can then show whether similar episodes appeared before.
Should I tell my midwife or obstetrician about my endometriosis?
Yes. Reviews of cohort studies link endometriosis with higher risks of several pregnancy complications, including preterm birth and placenta previa, so your history helps your prenatal team plan monitoring. Bring your diagnosis date, how it was confirmed, where the endometriosis was found, past surgeries, and your usual pain pattern.
In Endometriosis Journey, My Care Team stores clinicians and visit notes, and the Doctor Report exports a one-page summary of your logged history. Insights can show which symptoms repeated across weeks.
How do I log spotting during pregnancy?
Write the date and time, how much (a few spots on tissue or a pad liner), the color, any pain with it, and what you were doing. Tell your clinician about any bleeding in pregnancy; the CDC lists bleeding that is more than spotting, like a period, as a sign to seek medical care immediately.
The Daily Journal in Endometriosis Journey takes a quick typed or voice note when it happens, and the Daily check-in records pain and fatigue on the same date. Insights can show whether bleeding days came with higher pain.
Does endometriosis raise the risk of pregnancy complications?
Studies report associations. A meta-analysis of 24 studies covering 1,924,114 women found higher rates of preterm birth, miscarriage, placenta previa, small-for-gestational-age infants, and cesarean delivery, and a review of 39 studies added gestational hypertension, pre-eclampsia, placental abruption, and stillbirth. Your clinician applies these group findings to your own history.
Endometriosis Journey keeps your pain, bleeding, and symptom history dated, so the Doctor Report can give your prenatal clinician a one-page summary at the start of a visit. Insights can show how your symptoms moved through pregnancy.
How do I record pain medicine in pregnancy?
Record only what your clinician has approved: the medicine name, the dose as directed, the time taken, and how much the pain changed afterward. Ask your prenatal clinician before taking any medicine for endometriosis pain, and write down the answer so the plan stays in one place.
My Meds in Endometriosis Journey stores medicine names and timing, including options you already use for pain as directed. Insights can relate that timing to pain, energy, and sleep, which shows whether relief matched the schedule your clinician set.
Will endometriosis symptoms come back after delivery?
For many people they do. In a retrospective study of 131 women who had a live birth after endometriosis surgery, 37% had a clinically relevant recurrence needing medical or surgical treatment, and 84% reported at least one moderate-severe pain symptom two years after delivery. Individual courses differ.
The Period Tracker in Endometriosis Journey records when your period returns and how heavy or light bleeding felt, and the Daily check-in keeps pain on the same dates. Insights can show how soon after delivery your usual pain pattern returned.
Does breastfeeding change endometriosis pain?
In a prospective study of 123 women with endometriosis who breastfed, dysmenorrhea fell in proportion to how long they breastfed, and chronic pelvic pain fell only in women who breastfed exclusively. Pain with sex showed no significant improvement. Your own log shows whether your pattern follows this.
In Endometriosis Journey, the Daily Journal can hold how you are feeding and sleeping, and the Daily check-in records pain and fatigue each day. Insights can show whether pain eased as feeding changed.
How do I log nausea, bloating, and fatigue when pregnancy causes them too?
Log them anyway, with the same 0–10 scale and the time of day, and add what you ate or did beforehand. Several endometriosis symptoms, including extreme tiredness and bowel symptoms, have other causes as well, so timing and severity give your clinician more to work with than a label.
The Food Tracker in Endometriosis Journey records meals and drinks that stand out, and the Daily check-in records fatigue and bowel symptoms on the same dates. Insights can relate meals to nausea or bloating across the weeks you logged.
How often should I log, and what if I miss days?
A short entry at the same time each day works best, including low-pain days, because they make high-pain days easier to read. If you miss days, resume the next day and record a missed day only if you remember it clearly. Review the pattern weekly rather than after every entry.
The Daily check-in in Endometriosis Journey takes a short guided pass, and Weekly Goals can set one small aim, such as logging every pain day this week. Insights become more useful as weeks accumulate.
What if my endometriosis was never confirmed by surgery?
Tell your prenatal clinician what you know: who suspected it, which scans or tests were done, and which symptoms led there. The 2017 meta-analysis noted that in most of its studies the diagnosis had been made histologically after surgery. A dated symptom log supplies the detail your clinician needs.
In Endometriosis Journey, the Daily check-in and Period Tracker build a dated record of pelvic pain, bleeding, and bowel or bladder symptoms. Insights can show which symptoms cluster together, which gives your clinician a clear timeline to work from.
How do I log mood and anxiety during pregnancy with endometriosis?
Add a 0–10 rating for low mood and one for anxiety to your daily entry, plus one line about what was on your mind. The NHS lists low mood and anxiety among the problems that can come with endometriosis. For thoughts of harming yourself or your baby, the CDC advises seeking medical care immediately.
In Endometriosis Journey, the Daily check-in records emotional state alongside pain and sleep, and Clara and the specialist AI companions already see your logged history. Insights can show whether low-mood days follow poor sleep or high-pain days.
How do I keep privacy in check with my health log?
Bleeding, sex and fertility notes are personal, and others may share your device. Lock it and choose which entries go to the visit.
Entries you add to Endometriosis Journey are your own health notes. Check the app's privacy policy for how data is stored and handled. Nothing in this article is medical advice.