Endo Awareness

Potential signs of endometriosis in your charts

As a trained FABM / NFP instructor I’ve been taught to look for certain charting “red flags.” When we see these red flags, we can suggest that a woman consult with her medical care provider for evaluation and any treatment. And we know that possibly something like 10% of our clients may have endometriosis, as that’s the estimated frequency of the condition for women worldwide. The endometrium is the lining inside your uterus. This is what is thickened during your cycle in preparation for a potential pregnancy, and this thickened material is what is shed during your menstrual period. Endometriosis is the presence of endometrial-like lesions outside of the uterus. Endometriosis is a tricky condition. Many women with endometriosis have an overall cycle length that is normal. It’s complex and can present in various ways, so it can be difficult to reach a diagnosis. Charting can provide clues, but the charting indicators for endometriosis can also be indicators for other complaints, so it’s important to get proper medical evaluation. One common symptom of endometriosis is severe menstrual cramps, or other abdominal or lower back pain. The endometrial lesions may not bleed, may bleed during menses, or may bleed at times other than menses. The bleeding outside the uterus from the lesions can cause pain and they can cause bleeding in the tissue they’re attached to. Scar tissue caused by the lesions may bind organs, muscles, and ligaments together, causing pain and inflammation. We can’t see all this on your chart, but you can chart the pain you’re experiencing, and when.

Charting chronic pain, or pain with urination or bowel movements, or pain with intercourse, can be a helpful symptom to show your physician. However, not all women with endometriosis experience severe menstrual cramps or other abdominal pain.

Very heavy periods can sometimes be a sign of endometriosis. One problem is that sometimes women experiencing abnormal flow or period pain aren’t aware that their experience is outside of the normal healthy range. This is where cycle and body literacy education efforts come in. When using BCC to chart, you are always charting any bleeding you observe. BCC materials educate women on what sort of flow can be described as spotting, light, moderate, and heavy. Pre-menstrual spotting, or other abnormal bleeds caused by endometriomas can sometimes be a sign of endometriosis. In BCC you have the option of charting cervical fluid. The average build-up of fertile type fluid to peak is about 5-6 days. A limited amount of cervical fluid, or a lack of cervical fluid, can sometimes be a marker of endometriosis. When using hormonal monitoring, cervical fluid, and/or temps, you can get a good picture of the length of the luteal phase. Abnormalities in luteal phase length (“luteal phase defects”) can also be a sign of an underlying issue, including endometriosis.

Couples charting to conceive and targeting intercourse for the fertile phase without success for six cycles are routinely advised by a BCC instructor to see medical evaluation. Infertility is one of the possible signs of endometriosis.

If using BCC paper charts, or the recommended Read Your Body app, you can also note other factors like bloating, bowel movements, insomnia and energy levels. Fatigue is one possible symptom of endometriosis, as well as a range of other concerns. Constipation and bloating (as well as pain with bowel movements or urination) can be signs of endometriosis too.


All of these charting signs can be related to a variety of other health concerns. It’s important to take the information to a trusted medical care provider who can evaluate the situation further.


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