PCOS: Worksheets

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PCOS iconsPeriod and Symptom Trackers: Keeping track of when your period starts and stops is a good way to see if there is a pattern to your menstrual cycle. It’s also important to write down how many days you have your period and the amount of flow you have. Bring your Period Trackers with you when you see your health care provider so that he or she can evaluate your cycle.

My Monthly Period & Symptom Tracker is an easy way to keep track of your menstrual flow, and it’s also a way to keep track of cramps, and/or PMS and period symptoms (if you have them) each month.

  • Review the sample Monthly Period & Symptom Tracker.
  • Print out copies of My Monthly Period & Symptom Tracker.
  • Make a check mark in the appropriate box (or boxes) for each day of the month. If you don’t have any flow or any symptoms on any given day, leave the box empty. Refer to the Blood Flow Key at the bottom for “Flow” definitions.
  • The numbers at the top are the same as the dates in one month. Some months don’t have 31 days, you may leave some boxes empty.
  • Remember to bring My Monthly Period & Symptom Tracker with you to your medical appointments.

Sample Monthly Period and Symptom Tracker

My Monthly Period and Symptom Tracker

My Yearly Period Tracker: My Yearly Period Tracker is a simple and convenient way to track your period throughout the year.

  • Review the sample Yearly Period Tracker.
  • Print a copy of My Yearly Period Tracker.
  • Refer to the Key at the bottom to learn how to fill in the box with the appropriate letter(s). Place a “T” in the box for the hormone pill taken, and place an “R” for reminder (placebo) pills.
  • Be sure to note if you’ve taken a pill during your period by putting a B/T or B/R in the box.
  • Remember to bring My Yearly Period Tracker with you to your medical appointments.
  • Talk to your health care provider about whether you should use the monthly and/or yearly tracker to track your period.

Sample Yearly Period and Symptom Tracker

My Yearly Period and Symptom Tracker

Medication List:

Why should I keep a list of my medications?

It’s a good idea to keep an up to date list of the current medicines you take (for PCOS and for any other reason). We suggest that you make a photocopy of the My Medication List, fill it out, and bring it with you to your next medical appointment. You’ll then be able to review your medicine with your health care provider.

How do I use “My Medication List”?

Write down each medicine (one per box), the dosage, who prescribed it, when you started taking it, the date you stopped taking it (if applicable) and any side effects that you may have when you take the medicine, such as an upset stomach. You can also write down any questions that you want to ask your health care provider, such as: “Does it matter what time of day I take my medicine?”, or “What if I miss a dose?”

My Medication List

Fitness Planning: Exercise is good for you in many different ways. It can help you maintain a healthy weight and boost your overall energy level. Regular exercise lowers stress and anxiety and helps improve your mood. Exercise can and should be fun. Knowing the health benefits of exercise will help you get started. The worksheets in this section will help you figure out what motivates you (or gets you to exercise), which types of activities you’ll enjoy most, and how to fit them into your life.

Intro to Worksheet 2: Fun Fitness

A good fitness plan should include a balance of stretching, toning, and aerobic activities.

  • The Stretch It section lists stretching exercises that will keep you flexible, help you relax, and help prevent injuries such as pulling a muscle from reaching too far.
  • The Tone It section lists strengthening exercises that will help you build strong muscles and boost your metabolism.
  • The Move It section lists aerobic activities that will help keep your heart healthy and strong.

This worksheet lists exercises from each of the Fun Fitness sections. Check off the ones you want to try, and use the extra lines to fill in related exercises you’d also like to do. You can include exercises you’ve learned from a sports team, in gym class, or from a certified personal trainer. Be sure to choose items from each column for a balanced workout.

Intro to Worksheet 3: My Fitness Plan

Make sure to make time to do the activities that you’ve chosen from Worksheet 2. This will help you plan your fitness schedule so that exercising becomes part of your weekly routine.

Look back at your completed Fun Fitness Worksheet and fill in “My Fitness Plan” worksheet with the activities that you’ve chosen. Think about what activities will work best on which days and what time of day would be best to do them. Remember to balance stretching, toning, and aerobic activities. You don’t have to do all three in one day, but remember to also schedule your week so that you’re not doing only one type of exercise.

After you’ve created your fitness schedule on Worksheet 3, it’s a good idea to mark the days that you plan to exercise on your own personal calendar or planner. Put this worksheet someplace where you’ll see it as a reminder of what’s coming up.

Fitness Worksheets

Meal Assessment: Healthy eating for PCOS includes the following guidelines:

  • Eating small meals and healthy snacks every few hours instead of eating large meals.
  • Including a balance of carbohydrates, protein, and fat at meals and snacks.
  • Choosing high fiber carbohydrates including whole grains (instead of refined grains), fruits, and vegetables.
  • Choosing healthy fats (instead of saturated or trans fats).
  • Limiting sugary drinks, refined grains, processed snack foods, and sugary treats.

You can download, print, and use the Meal Assessment Worksheet located below to help you follow these guidelines. Write down everything you eat on the worksheet, and review it at the end of the day. Look at the boxes that are checked “No”. What could you eat next time to make it a “Yes”? Make a shopping list of foods that will help you stick to your healthy eating plan. If you are eating large portions, try eating smaller portions every few hours and add small healthy snacks for in between meals. The more you practice PCOS-friendly eating, the easier it will become.

Meal Assessment Worksheet