Living with endometriosis means managing more than just physical pain. The emotional toll—anxiety, frustration, mood swings, and the mental exhaustion of chronic pain—is just as real and just as important to track. Understanding the connection between your mood, sleep quality, and pain levels can reveal powerful insights that transform how you manage your condition.
Here's your complete guide to using journaling as a tool for tracking the mind-body connection with endometriosis, including what to track, how to structure your journal, and how to use your insights to improve your wellbeing.
Why Track Mood Alongside Pain and Sleep?
The Bidirectional Relationship
Mood, pain, and sleep don't exist in isolation—they're deeply interconnected:
Pain affects mood: Chronic pain increases risk of anxiety and depression. When you're hurting, it's natural to feel frustrated, sad, or irritable.
Mood affects pain perception: Anxiety and depression lower your pain threshold, making the same physical sensation feel more intense. Stress triggers inflammatory responses that worsen endometriosis symptoms.
Sleep impacts both: Poor sleep worsens both pain and mood. When you're exhausted, pain feels worse and emotional resilience plummets.
The cycle compounds: Pain disrupts sleep, poor sleep worsens mood, bad mood increases pain perception, and the cycle continues.
What Tracking Reveals
Journaling mood alongside physical symptoms helps you:
- Identify emotional triggers that worsen physical symptoms
- Recognize when mood changes predict pain flare-ups (or vice versa)
- Understand how your cycle affects your mental health
- Spot patterns you'd miss without written records
- Validate your experience—seeing patterns in writing confirms you're not imagining things
- Communicate more effectively with doctors and therapists
- Track whether treatments improve your overall quality of life, not just pain levels
What to Track: The Essential Elements
1. Mood and Emotional State
Overall mood rating (1-10 scale):
1 = Severely depressed, hopeless
5 = Neutral, neither good nor bad
10 = Excellent, joyful, energized
Specific emotions experienced:
• Anxiety or worry
• Frustration or anger
• Sadness or hopelessness
• Contentment or peace
• Irritability
• Brain fog or difficulty concentrating
• Overwhelm
Emotional triggers:
• Work stress
• Relationship conflicts
• Financial worries
• Health anxiety
• Social situations
• Feeling misunderstood or dismissed
2. Pain Levels and Characteristics
Pain intensity (1-10 scale):
Track at consistent times: morning, afternoon, evening
Pain location:
• Lower abdomen
• Lower back
• Pelvic region
• Legs
• During bowel movements or urination
Pain type:
• Cramping
• Sharp/stabbing
• Dull ache
• Burning
• Pressure
Pain impact:
• Able to work/function normally
• Limited activity
• Bedridden
• Cancelled plans
3. Sleep Quality
Quantitative measures:
• Hours slept
• Time to fall asleep
• Number of wake-ups
• Reason for waking (pain, anxiety, bathroom, unknown)
Qualitative assessment:
• Sleep quality rating (1-10)
• How rested you feel upon waking
• Energy levels throughout the day
• Whether you needed naps
4. Menstrual Cycle Context
Cycle day: Day 1 = first day of period
Phase: Menstrual, follicular, ovulation, luteal
Period status: Flow intensity, spotting
PMS symptoms: Mood swings, irritability, anxiety
5. Self-Care and Coping Strategies
What you did for yourself:
• Heat therapy (when, how long, effectiveness)
• Medication taken
• Exercise or movement
• Meditation or breathing exercises
• Time in nature
• Social connection
• Creative activities
• Rest and downtime
What helped:
Rate effectiveness of each strategy
6. Gratitude and Positive Moments
Even on difficult days, noting small positives helps maintain perspective:
• One thing you're grateful for
• A moment of joy or peace
• Something that made you smile
• A small win or accomplishment
Journal Structure: Three Effective Formats
Format 1: The Quick Daily Check-In (5 Minutes)
Perfect for busy days or when you're in pain and can't write much.
Date: Monday, January 12, 2026
Cycle Day: 15
Mood: 6/10 - Okay, slightly anxious about work deadline
Pain: 3/10 - Mild cramping, manageable
Sleep: 7 hours, quality 7/10 - Slept well, woke once
Energy: 6/10
What helped today: Morning walk, heat therapy before bed last night
Grateful for: Sunny weather, supportive text from friend
Format 2: The Detailed Daily Entry (10-15 Minutes)
For when you have time and want to process more deeply.
Date: Monday, January 12, 2026
Cycle Day: 15 (mid-cycle, around ovulation)
Physical State:
Pain level: 3/10 in the morning, increased to 5/10 by evening
Location: Lower abdomen, mild lower back ache
Type: Dull cramping, occasional sharp twinges
Other symptoms: Slight bloating, mild fatigue
Sleep Last Night:
Bedtime: 10:30 PM, woke at 6:45 AM
Total sleep: ~7 hours
Wake-ups: Once at 3 AM (bathroom), fell back asleep quickly
Quality: 7/10 - Felt reasonably rested
Used hot water bottle: Yes, helped me fall asleep
Emotional State:
Overall mood: 6/10
Emotions: Slightly anxious about work presentation tomorrow, but generally okay. Noticed some irritability in the afternoon—not sure if hormonal or just tired.
Stress level: 6/10
Mental clarity: Good in morning, brain fog by 4 PM
What I Did for Myself:
• 20-minute morning walk - helped mood and energy
• Heat therapy for 30 minutes in evening - reduced pain from 5 to 3
• Meditation app for 10 minutes - helped with anxiety
• Went to bed on time despite wanting to stay up
Connections I Notice:
Pain increased as the day went on, which made me more irritable. When I used heat therapy, both pain and mood improved. Sleep was better than last week—maybe because I've been consistent with bedtime routine?
Gratitude:
Beautiful sunrise on my walk, supportive message from my sister, pain was manageable enough to work normally
Format 3: The Weekly Reflection (20-30 Minutes)
Done at the end of each week to identify patterns.
Week of: January 6-12, 2026
Cycle Days: 9-15
Overall Summary:
Average mood: 6.5/10
Average pain: 4/10
Average sleep quality: 6/10
Best day: Thursday (mood 8, pain 2, slept great)
Worst day: Monday (mood 4, pain 7, poor sleep)
Patterns I Noticed:
• Pain was lowest mid-week when I was less stressed
• Sleep quality directly correlated with next-day mood
• Using heat therapy before bed consistently improved sleep
• Exercise helped mood even when pain was moderate
• Weekend stress about upcoming work week affected Sunday sleep
What Worked Well:
• Consistent bedtime routine
• Morning walks 4 days this week
• Heat therapy every evening
• Saying no to social event when I needed rest
What to Adjust:
• Try meditation earlier in the day, not just when anxious
• Start heat therapy earlier in the evening
• Address work stress—maybe talk to manager about workload
• Go to bed 30 minutes earlier on Sundays
Wins This Week:
• Managed pain without increasing medication
• Maintained exercise despite moderate pain
• Recognized anxiety trigger and used coping strategies
• Prioritized sleep over social media scrolling
How to Use Your Journal Effectively
1. Choose Your Timing
Morning journaling:
Pros: Reflects on previous day while fresh, sets intentions
Cons: May forget evening details
Best for: People who like morning routines
Evening journaling:
Pros: Captures full day, part of wind-down routine
Cons: May be too tired or in pain
Best for: People who use journaling to process the day
Split approach:
Quick morning check-in (mood, pain, sleep quality) + evening reflection (what helped, gratitude)
Best for: People who want comprehensive tracking without large time blocks
2. Be Consistent but Flexible
• Aim for daily entries, but don't beat yourself up for missing days
• On high-pain days, use the quick format
• On good days, you might write more
• Even 2-3 entries per week reveal patterns over time
3. Use Prompts When Stuck
If you're staring at a blank page:
• How does my body feel right now?
• What emotions am I experiencing?
• What's been hardest about today?
• What brought me a moment of peace or joy?
• What do I need right now?
• What am I grateful for, even if it's tiny?
• What pattern am I noticing this week?
4. Review Regularly
Weekly: Look for patterns in the past 7 days
Monthly: Review the full cycle to understand hormonal impacts
Quarterly: Assess whether treatments are improving quality of life over time
Identifying Mind-Body Patterns
After 4-6 weeks of journaling, look for these connections:
Mood-Pain Correlations
• Does high anxiety consistently precede pain flare-ups?
• Does severe pain always tank your mood the next day?
• Are there times when pain is high but mood stays stable? What's different?
• Do certain emotions (anger, sadness) correlate with specific pain types?
Sleep as the Mediator
• Does poor sleep predict both worse pain and worse mood?
• When you sleep well despite pain, is your mood better?
• What sleep quality threshold keeps mood stable?
Cycle-Mood Connection
• Do you experience predictable mood dips at certain cycle phases?
• Is anxiety worse around ovulation or before your period?
• Are there cycle days when you consistently feel better emotionally?
Effective Interventions
• Which self-care strategies improve both mood and pain?
• Does heat therapy help mood as well as physical comfort?
• What activities boost mood even when pain is present?
• Which coping strategies actually work vs which you think should work?
Using Insights to Improve Your Life
Predict and Prepare
If journaling reveals you're always anxious and in pain on cycle days 26-28:
• Clear your schedule those days when possible
• Start heat therapy and stress management preventatively on day 25
• Prepare easy meals in advance
• Arrange support from partner or friends
• Practice extra self-compassion
Optimize Your Toolkit
If heat therapy consistently improves both pain and mood:
• Invest in a premium hot water bottle with sheepskin cover for maximum comfort
• Build it into your daily routine, not just crisis management
• Use it preventatively before pain peaks
If exercise helps mood even when pain is moderate:
• Prioritize gentle movement on difficult days
• Adjust expectations (walk instead of yoga, 10 minutes instead of 30)
• Recognize movement as medicine for mental health
Communicate with Healthcare Providers
Bring your journal to appointments to discuss:
• How endometriosis affects your mental health
• Whether you need support for anxiety or depression
• How treatments impact quality of life, not just pain numbers
• Patterns that concern you
Practice Self-Compassion
Journaling often reveals how hard you are on yourself. When you see patterns of self-criticism, practice reframing:
Instead of: "I'm so weak, I can't even handle this pain"
Try: "I'm managing a chronic condition while still showing up for my life. That takes strength."
Instead of: "I ruined the day by being irritable"
Try: "I was in pain and exhausted. My irritability was a symptom, not a character flaw."
Sample Journal Entry: Putting It All Together
Date: Tuesday, January 13, 2026
Cycle Day: 2 (second day of period)
Physical:
Pain: 8/10 this morning, 6/10 by evening
Location: Severe lower abdomen cramping, radiating to lower back
Flow: Heavy
Other: Nausea, fatigue, headache
Sleep:
Last night: 5 hours, quality 3/10
Woke 4 times due to cramping pain
Exhausted all day, took 90-minute nap at 2 PM
Used hot water bottle all night—helped me fall back asleep after wake-ups
Mood & Mental State:
Overall: 3/10 - Really struggling today
Emotions: Frustrated, sad, overwhelmed, anxious about missing work
Crying this morning—combination of pain, exhaustion, and feeling like my body is betraying me
Brain fog severe—couldn't concentrate on anything
Felt isolated and alone with this
What I Did:
• Called in sick to work (felt guilty but necessary)
• Heat therapy on and off all day—only thing that helped
• Ibuprofen 400mg every 6 hours
• Stayed in bed most of the day
• Texted my sister who has endo—she reminded me I'm not alone
• Watched comfort TV instead of trying to be productive
• Ordered takeout instead of cooking
What Helped:
• Heat therapy: 8/10 effectiveness for both pain and comfort
• Sister's support: Made me feel less alone
• Giving myself permission to rest: Reduced guilt and anxiety
• Nap: Helped a little with exhaustion
Reflections:
This is always my worst day of the cycle. I need to remember that next month and not schedule anything important on day 2. The combination of severe pain and no sleep makes my mental health plummet—it's not just "being negative," it's a physiological response to pain and exhaustion.
Heat therapy was the only thing that provided both physical relief and emotional comfort. The weight and warmth of the hot water bottle felt like a hug when I needed it most.
Tiny Gratitude:
My sheepskin hot water bottle—it was my constant companion today. My sister's understanding. My body is doing its best even when it feels like it's failing me.
Tomorrow's Intention:
Be gentle with myself. Pain should be better tomorrow. One day at a time.
When Journaling Reveals Concerning Patterns
Seek professional help if your journal shows:
- Persistent low mood (below 4/10) for 2+ weeks
- Thoughts of self-harm or hopelessness
- Anxiety that interferes with daily functioning
- Increasing isolation or withdrawal from activities you used to enjoy
- Mood swings that feel unmanageable
- Reliance on unhealthy coping mechanisms (excessive alcohol, etc.)
Endometriosis increases risk of anxiety and depression. There's no shame in needing support—therapy, medication, or both can be life-changing.
Journal Supplies: What You Need
Minimal Approach
• Any notebook
• A pen
• Consistency
Enhanced Experience
• Journal you love (makes you want to write)
• Comfortable pen that doesn't hurt your hand
• Colored pens or highlighters to mark patterns
• Stickers or washi tape if that brings you joy
• Quiet, comfortable space
• Hot water bottle for comfort while writing
Digital Option
• Note-taking app (Notion, Day One, Evernote)
• Password protection for privacy
• Easy to search for patterns
• Can include photos or voice notes
The Bottom Line
Journaling mood alongside pain and sleep transforms abstract suffering into concrete data. It validates your experience, reveals patterns you'd otherwise miss, and empowers you to make informed decisions about your care.
You don't need to write pages every day. Even brief entries—mood number, pain level, sleep quality, one thing that helped—provide valuable insights over time.
The act of writing itself can be therapeutic. It creates space to process difficult emotions, celebrate small wins, and practice self-compassion. On your hardest days, your journal becomes a witness to your strength.
Living with endometriosis means managing both physical and emotional pain. Tracking both honors the full reality of your experience and gives you tools to improve your quality of life in meaningful ways.
Your pain is real. Your emotions are valid. And understanding the connection between your mind and body puts you back in control of both.
