Diagnosis and tests for pelvic inflammatory disease

PID is diagnosed from symptoms, examination and tests. There is no single test, so doctors treat early when PID is suspected.

Examination

• Pelvic examination: pain on moving the cervix (cervical motion tenderness), tenderness in the womb or ovary areas
• Checking for discharge, fever and belly tenderness

Tests

• Swabs and urine tests from the cervix or vagina for chlamydia, gonorrhoea and Mycoplasma genitalium. A negative test does not rule out PID.
• Vaginal swab to look for bacterial vaginosis and other infection
• Pregnancy test: to rule out ectopic pregnancy
• Blood tests: white cell count, CRP or ESR
• HIV, syphilis and hepatitis B tests, offered with consent
• Pelvic ultrasound: looks for abscess or swollen tubes. It may be normal in early PID.
• CT or MRI in unclear or severe cases
• Laparoscopy: a keyhole look into the pelvis when diagnosis is uncertain or the woman is very unwell

Other conditions doctors rule out

Ectopic pregnancy, appendicitis, ovarian cyst problems, endometriosis, urinary infection and tuberculosis.

Partner testing

Recent sexual partners should be tested and treated, whether or not they have symptoms.

Ayurvedic view

Ayurvedic assessment does not replace swabs and an ultrasound for diagnosis.

See a doctor if you have pelvic pain, particularly with discharge, fever or a missed period.

When to get help

See a doctor promptly for pelvic pain, new discharge, fever or pain during sex. Go to hospital for severe pain with fever, repeated vomiting, fainting, or sharp one-sided pain with a missed period. Early antibiotics protect your fertility.

Remember

Treat early even if tests are pending. Waiting for results can mean damage.