Pelvic inflammatory disease: the facts

How is it diagnosed?
The doctor will ask about symptoms, how long they have been present and how severe they are. He or she will also ask some very personal questions about sexual partners, contraception and menstruation. It is important to be honest about these things so that the doctor can reach a diagnosis. Everything will be in complete confidence.

After this, the doctor will examine you. This should include checking the abdomen to localise the pain, looking for fever, abnormal discharge and performing an internal (vaginal) examination. The doctor may use a speculum to examine the cervix, to look for signs of infection of the cervix by gonorrhoea, and take samples for bacteriological investigations.

If the pain is very severe, the patient is generally very unwell, pregnant or in her teens, or there is some doubt about the cause of the symptoms, the doctor may advise hospital admission for a couple of days to have more intensive investigation and treatment. An ultrasound scan or a laparoscopy may enable the doctors to reach a faster diagnosis.

How is PID treated?
It is very important that treatment with antibiotics is commenced as soon as possible so that the least harm will be done to the pelvic organs. At least two antibiotics will be prescribed to cover all bacteria types. It is difficult to identify bacteria from the upper genital tract because they are fragile and do not survive for long outside the body (i.e. on a swab on the way to the laboratory). Several different bacteria may be responsible for the attack, especially if it is a recurring one.

The symptoms may disappear before the course of antibiotics is finished, but it is very important to complete the course (usually at least ten days). A follow-up visit to the doctor should be made after two or three days to ensure the treatment is working, and hear the results of the tests.

Many women with PID will have partners who have no symptoms themselves. Despite this, partners should be treated with antibiotics, because men can often carry these bacteria unknowingly and could cause re-infection.