This document contains a non-working example of the work-in-progress TiNMAN exploratory questions used to help identify the existance of endometriosis. The list is being compiled in a back-to-front order so the actual endometriosis questions will be the last to go in. This is so that all of the symptom overlaps are correctly built in.
Important things to be aware of:
- The first assessment asks all questions in strict order. After that questions are asked in random order but a dynamic skip list lets you keep it relevant by bypassing any that might not apply or are at a scoring extreme based on previous results. If a question is allocated to more than one study area then it will only be asked once.
- There is no time limit on how long someone takes to complete an assessment.
- This is neither a competition nor a test so there are no right or wrong answers.
- Registered users would need to complete an assessment between every three and fourteen days to build their timeline.
To show any additional detailed question supporting text tap on the question's blue bubble.
The circadian rhythm controls the cycles your internal body clock repeats about every twenty four hours that tell you when it is time to sleep or wake.
Your body tries to synchronise your sleep-wake cycle to cues from the environment, such as seasonally adjusting to when it gets light or dark outside, when you eat, and when you are physically active.
Disruption of the circadian rhythm can affect
- how well you sleep
- when you are able to sleep
- how well you function when awake.
Circadian rhythm misalignment is associated with a higher risk of developing endometriosis.Rate the disruption to your sleep preparations as a result of a misaligned body clock?
Sleep is a critical component of mental and physical health and disruption can lead to a worsening state of mental and physical wellbeing.
Insomnia can surface through
- endometriosis-related pain, inflammation, and anxiety, often worsened where pain spikes at night
- overthinking or rumination, the repetitive and persistent thinking for more than a few idle minutes that usually involves repeating a negative thought or trying to solve an evasive problem
- racing thoughts, which are fast-moving and often repetitive thought patterns that bounce around the mind uncontrollably without allowing time to fully process or complete any single thought
- intrusive thoughts, persistent unwanted, distressing and disturbing thoughts that often revolve around specific fears, themes, or concerns and can be graphically explicit or violent and upsetting
- earworms, songs or parts of songs that become stuck in your head and are difficult to dislodge.
Common symptoms include
- difficulty falling asleep and staying asleep
- unsatisfying sleep and trouble waking up in the morning or waking up fatigued and unrefreshed
- excessive daytime tiredness and difficulty focusing or being motivated
- mood changes, particularly depression or being easily upset.
Insomnia is associated with a higher risk of developing endometriosis.How would you describe the impact of sleep-disrupting mental turbulance and any resulting tiredness on your daily functioning and emotional stability?
“The self” refers to an individual's concept of identity. It develops over time and is shaped by personal experiences, social interactions, and internal thought processes.
Your self-esteem includes your sense of self-value and how you manage life challenges. Low self-esteem describes a depleted way a person feels about their inner self as a person, for example
- feelings of worthlessness and a belief of being “not good enough” or deserving of affection and care
- making comparisons with others that lead to feelings of inferiority or inadequacy
- avoiding social interaction and feeling like an outsider
- unnecessarily accepting responsibility for things that go wrong and excessive apologising.
Your self-confidence controls how you see your strengths and weaknesses, how you approach challenges, set goals and how much you believe in your ability to succeed. Low self-confidence describes a lack of trust in personal abilities, capacities, and judgments, for example
- having noticeably reduced motivational drive or enthusiasm to pursue goals
- avoiding new challenges as a result of a persistent conscious or subconscious fear of failure
- questioning personal abilities, decisions, and self-worth
- downplaying achievements or having difficulty accepting compliments
- being an overly harsh critic of the self.
Low self-worth can also incubate negative thoughts about the self or the world that are not always based in reality and can maintain fear or distress, for example
- strong feelings of anger, fear, guilt, horror, and shame
- threat-oriented patterns of thought and behaviour, developed through experience, that lead to a heightened sense of threat and a loss of trust in others
- a sense of worthlessness or helplessness leading to a loss of confidence
- inflexible thoughts that prevent a person from processing events naturally and reduce their ability to manage their emotions.
How would you rate your combined levels of self-esteem
, the overall opinion and feeling you have about yourself as a person, and self-confidence
, the level of inner belief you have in your abilities, skills, and judgment?
The expression “emotional stability” is used here to define the ability to maintain a calm and balanced emotional state and manage stress and challenges without extreme reactions or mood swings.
Anxiety is the internal emotional and physical state that involves persistent worry and a prolonged, internal feeling of apprehension or dread concerning imminent or imagined future events and can exist without a clear cause.
Symptoms of anxiety can include- persistent worry about potential problems or negative outcomes and exaggerating potential consequences
- dwelling on negative thoughts or events, even when they are not directly present
- difficulty with racing thoughts, concentration, memory, and decision making
- panic attacks, overwhelming rushes of intense mental and physical symptoms that come on very quickly, often without any obvious trigger, and last a few minutes.
Somatic relates to the body and physiological refers to its normal functions, processes, and mechanisms. Somatic anxiety describes the physiological response to cognitive anxiety and symptoms can be single, multiple or varying and range from mild to severe, and can include- dizzying or painful headaches
- a racing heart or chest pains
- intense breathing or shortness of breath
- abdominal pains, stomachache or an upset stomach
- uncontrollable bodily trembling or shaking
- profuse sweating, even when cold
- fatigue or weakness
- tight muscles and muscle tension
- aching in one or more groups of muscle
- panic attacks, overwhelming rushes of intense mental and physical symptoms that come on very quickly, often without any obvious trigger, and last a few minutes.
How would you describe the impact of mental anxiety and any consequent anxiety-driven physical stress on your daily functioning and emotional stability?
Being depressed is the normal but temporary feeling of sadness in response to occasional misery or when something goes wrong. It lasts for no more than a few hours or days before a return to relative normality.Depression is a persistent and severe condition whereby a person suffers from a heavy mental state of sadness and low mood which continues without any meaningful respite for weeks or more and significantly interferes with all aspects of daily life.
Symptoms can include- being uncharacteristically weepy or crying with little or no obvious cause
- an increase in the number and severity of mood swings or becoming uncharacteristically irritable
- a lack of enthusiasm for things that would normally bring pleasure
- seeming overly tired or having less energy than usual
- expressing feelings of extreme tiredness that are actually indicators of severe emotional exhaustion and a desire to escape emotional pain
- increasingly severe or frequent repetitive and compulsive behaviours
- self-harmful urges or behaviours.
A person who is predisposed to long-term depression may become increasingly drawn to- suicidal ideation, the thought process of having ideas or repetitive thinking about the possibility of dying by killing themselves
- strengthening urges to kill themselves, to the point whereby they actively start to form a plan of action
- actual attempts to commit suicide.
To what extent were you affected by a state of low mood, lack of motivation and loss of interest in even the most basic activities?
The accumulated long-term strain of living with endometriosis can lead to a deep, persistent state of low physical and mental energy in response to the body's psychological and physiological resources being overworked for an extended period of time.
If the fatigue continues uninterrupted it will lead to burnout, a state of physical, mental, and emotional exhaustion following an extended episode of severe stress and physiological disruption and markers include- increased prevalence of exhaustion, depression and a potentially increased risk of suicidal ideation or intent
- increased levels of anxiety and stress, including suffering from headaches, gastrointestinal problems or physical pain
- increasingly disrupted diet, rest and sleep patterns
- noticeably increased sensory sensitivity
- increased difficulty with concentration, memory or making choices
- becoming increasingly withdrawn and isolated, possibly to the point of physically shutting down
- an increase in both the number of meltdowns and the time needed to recover from them.
An overwhelm “hangover” refers to the lingering psychological and physical effects on the body's mental and physical resources and symptoms include- profound feelings of fatigue or exhaustion
- lethargy, tiredness and sleepiness
- bodily aches and pains and muscle soreness
- trembling and shaking
- headaches or brain fog
- pain in the chest region
- gastrointestinal discomfort
- a strong desire to isolate from others
- a persistent sense of discomfort or unease.
Recovery time can vary according to the individual, but often lasts anything from several hours to a few days or, in more extreme cases, over a week.How would you describe the amount of physical and emotional energy you are able to muster to tackle your everyday with interest, motivation and confidence?
Adenomyosis is a long-lasting gynecological condition in which the endometrial tissue, the tissue that lines the inside of the uterus, grows into the muscle wall of the uterus, causing it to enlarge and bleed during menstruation. It is more commonly diagnosed in women over the age of thirty but can affect anyone who has periods.This first question concerning adenomyosis focuses on symptoms that are not automatically shared with endometriosis, in particular- intense, direct uterine pain
- heavier bleeding
- located within the uterine muscle it often makes the uterus feel enlarged and boggy.
It is possible to have adenomyosis and endometriosis at the same time.
To what extent have you experienced the non-overlapping symptoms of adenomyosis?
The second question concerning adenomyosis focuses on pain or discomfort you may have experienced as a result of any symptoms that are not automatically shared with endometriosis, in particular- intense, direct uterine pain
- heavier bleeding
- located within the uterine muscle it often makes the uterus feel enlarged and boggy.
To what extent have the non-overlapping symptoms of adenomyosis caused you pain or discomfort?
Bladder pain syndrome, also known as interstitial cystitis, is a condition that causes pain in the lower abdomen or back that leads to a persistant feeling of needing to urinate.This first question concerning bladder pain syndrome focuses on symptoms that are not shared with endometriosis, in particular- discomfort that is often constant or triggered by the consumption of food and drink
- pain that decreases after urination
- symptoms are not cyclical and do not coincide with or worsen during menstruation.
It is possible to have bladder pain syndrome and endometriosis at the same time.
To what extent have you experienced the non-overlapping symptoms of bladder pain syndrome?
The second question concerning bladder pain syndrome focuses on pain or discomfort you may have experienced as a result of any symptoms that are not shared with endometriosis, in particular- discomfort that is often constant or triggered by the consumption of food and drink
- pain that decreases after urination
- symptoms are not cyclical and do not coincide with or worsen during menstruation.
To what extent have the non-overlapping symptoms of bladder pain syndrome caused you pain or discomfort?
Irritable bowel syndrome is a long-lasting functional disorder of the gut-brain interaction. It affects the digestive system and causes long-lasting abdominal pain, bloating, and bowel habit changes.This first question concerning irritable bowel syndrome focuses on symptoms that are not shared with endometriosis, in particular- mucus in the stool
- pain that improves after a bowel movement
- pain that is often higher in the abdomen and worsens after eating
- symptoms are not cyclical and do not coincide with or worsen during menstruation.
It is possible to have irritable bowel syndrome and endometriosis at the same time.
To what extent have you experienced the non-overlapping symptoms of irritable bowel syndrome?
The second question concerning irritable bowel syndrome focuses on pain or discomfort you may have experienced as a result of any symptoms that are not shared with endometriosis, in particular- mucus in the stool
- pain that improves after a bowel movement
- pain that is often higher in the abdomen and worsens after eating
- symptoms are not cyclical and do not coincide with or worsen during menstruation.
To what extent have the non-overlapping symptoms of irritable bowel syndrome caused you pain or discomfort?
Pelvic inflammatory disease is an infection of the upper female reproductive system - the uterus, fallopian tubes and ovaries - and can affect anyone with a womb, although not everyone with the disease will have symptoms.This first question concerning pelvic inflammatory disease focuses on symptoms that are not shared with endometriosis, in particular- bleeding between periods or after sexual intercourse
- pelvic pain during sexual intercourse
- vaginal discharge that looks, smells or feels unusual
- symptoms are not cyclical and do not coincide with or worsen during menstruation.
It is possible to have pelvic inflammatory disease and endometriosis at the same time.
To what extent have you experienced the non-overlapping symptoms of pelvic inflammatory disease?
The second question concerning pelvic inflammatory disease focuses on pain or discomfort you may have experienced as a result of any symptoms that are not shared with endometriosis, in particular- bleeding between periods or after sexual intercourse
- pelvic pain during sexual intercourse
- vaginal discharge that looks, smells or feels unusual
- symptoms are not cyclical and do not coincide with or worsen during menstruation.
To what extent have the non-overlapping symptoms of pelvic inflammatory disease caused you pain or discomfort?
Polycystic ovary syndrome is a hormonal disorder affecting reproductive-aged women.The first question concerning polycystic ovary syndrome focuses on symptoms that are not shared with endometriosis, in particular- irregular periods or no periods at all
- excessive hair growth, usually on the face, chest, back or buttocks
- thinning hair and hair loss from the head
- weight gain
- oily skin or acne.
- increased insulin resistance.
It is possible to have polycystic ovary syndrome and endometriosis at the same time.
To what extent have you experienced the non-overlapping symptoms of polycystic ovary syndrome?
The second question concerning polycystic ovary syndrome focuses on pain or discomfort you may have experienced as a result of any symptoms that are not shared with endometriosis, in particular- irregular periods or no periods at all
- excessive hair growth, usually on the face, chest, back or buttocks
- thinning hair and hair loss from the head
- weight gain
- oily skin or acne.
- increased insulin resistance.
To what extent have the non-overlapping symptoms of polycystic ovary syndrome caused you pain or discomfort?
Uterine fibroids are solid non-cancerous muscular tumors that grow in or on the uterus, often during reproductive years and mainly affect women who have not been through the menopause. Not everyone will have symptoms.This first question concerning uterine fibroids focuses on symptoms that are not shared with endometriosis, in particular- fibroid growth is restricted to the uterus
- fibroids frequently cause persistent pelvic pressure or heaviness and can grow large enough to compress adjacent structures like the bladder or rectum
- urinating more often than usual, not being able to control when to or a frequent need to urinate
- problems emptying the bowels such as bloating or being unable to defacate or pain when doing so
- fibroids can cause a bulging abdomen by enlarging the uterus
- symptoms are not cyclical and do not coincide with or worsen during menstruation.
It is possible to have uterine fibroids and endometriosis at the same time.
To what extent have you experienced the non-overlapping symptoms of uterine fibroids?
The second question concerning uterine fibroids focuses on pain or discomfort you may have experienced as a result of any symptoms that are not shared with endometriosis, , in particular- fibroid growth is restricted to the uterus
- fibroids frequently cause persistent pelvic pressure or heaviness and can grow large enough to compress adjacent structures like the bladder or rectum
- urinating more often than usual, not being able to control when to or a frequent need to urinate
- problems emptying the bowels such as bloating or being unable to defacate or pain when doing so
- fibroids can cause a bulging abdomen by enlarging the uterus
- symptoms are not cyclical and do not coincide with or worsen during menstruation.
To what extent have the non-overlapping symptoms of uterine fibroids caused you pain or discomfort?
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