Pelvic inflammatory disease - Diagnosing pelvic inflammatory disease

There is no single test for diagnosing pelvic inflammatory disease (PID). Your doctor will diagnose PID based on your symptoms and a gynaecological examination.

Your doctor will ask you about your medical and sexual history, before carrying out a pelvic examination to check for any tenderness and abnormal vaginal discharge. You may experience some discomfort during this examination, particularly if you do have PID.

Swabs will usually be taken from the inside of your vagina and cervix, which will be sent to a laboratory to look for signs of a bacterial infection and identify the bacteria responsible.

A positive test for chlamydia or gonorrhoea supports the diagnosis of PID, but most women have negative swabs and this does not rule out the diagnosis.

As PID can be difficult to diagnose, other tests may also be required to look for signs of infection or inflammation, or to rule out other possible causes of your symptoms. These tests may include:

• a urine or blood test
• a pregnancy test
• an ultrasound scan, which is usually carried out using a probe passed through the vagina (transvaginal ultrasound)

In some cases, laparoscopy (keyhole surgery) may be used to diagnose PID. A laparoscopy is a minor operation where two small cuts are made in the abdomen. A thin camera is inserted so that the doctor can look at your internal organs and, if necessary, take tissue samples. This is usually only done in more severe cases where there may be other possible causes of the symptoms, such as appendicitis.

Admission to hospital

You may be urgently admitted to hospital if:

• you are pregnant, especially if there is a chance you may have an ectopic pregnancy
• your symptoms are severe (such as nausea, vomiting and a high fever)
• you have signs of pelvic peritonitis (inflammation of the inside lining of the abdomen)
• an abscess is suspected
• you are unable to take oral antibiotics and need to be given them through a drip (intravenously)
• you may need emergency surgery, for example for appendicitis