Pelvic Pain Support Tool Startpress Enter Over the last year, how often have you been bothered by the following problems? Pelvic pain not linked to periods * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) You have had time off work or cancelled plans because of pelvic pain * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Pelvic pain that affects or interferes with your ability to work * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Low mood, mood swings, irritability, anger, crying spells, nervous tension/anxious, social withdrawal * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Poor concentration, confusion, memory problems, clumsiness * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Difficulty falling asleep and/or staying asleep * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Bleeding between periods * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Bleeding after sex * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Pain during or after sex * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Change and/or offensive (smelly) vaginal discharge * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Tiredness, shortness of breath, rapid heart rate * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Weight gain – especially around the tummy * Yes No Weight loss without changing your diet or exercise * Yes No Feeling of heaviness or pressure in your lower tummy * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Fever * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Change in bowel habit e.g. constipation, blood, mucus or diarrhea etc. * Never Sometimes (1 – 3 times per month) Often (4 – 14 times per month) Frequently (more than 15 days a month) Submit If you are human, leave this field blank. ContinueSubmit Use Shift+Tab to go back