In a pelvic exam, your physician inserts two gloved fingers inside your vagina. While simultaneously pressing down on your abdomen, he or she can examine your uterus, ovaries and other organs.
There is no one test that can accurately diagnose pelvic inflammatory disease. Instead, your doctor will rely on a combination of findings from:
- Your medical history. Your doctor will likely ask about your sexual habits, history of sexually transmitted infections and method of birth control.
- Signs and symptoms. Tell your doctor about any symptoms you're experiencing, even if they're mild.
- A pelvic exam. During the exam, your doctor will check your pelvic region for tenderness and swelling. Your doctor may also use cotton swabs to take fluid samples from your vagina and cervix. The samples will be tested at a lab for signs of infection and organisms such as gonorrhea and chlamydia.
- Blood and urine tests. These tests may be used to test for pregnancy, HIV or other sexually transmitted infections, or to measure white blood cell counts or other markers of infection or inflammation.
- Ultrasound. This test uses sound waves to create images of your reproductive organs.
If the diagnosis is still unclear, your doctor may recommend additional tests, such as:
- Laparoscopy. During this procedure, your doctor inserts a thin, lighted instrument through a small incision in your abdomen to view your pelvic organs.
- Endometrial biopsy. During this procedure, your doctor inserts a thin tube into the uterus to remove a small sample of endometrial tissue. The tissue is tested for signs of infection and inflammation.
Prompt treatment with medicine can get rid of the infection that causes pelvic inflammatory disease. But there's no way to reverse any scarring or damage to the reproductive tract that PID might have caused. Treatment for PID most often includes:
- Antibiotics. Your doctor will prescribe a combination of antibiotics to start immediately. After receiving your lab test results, your doctor might adjust your prescription to better match what's causing the infection. You'll likely follow up with your doctor after three days to make sure the treatment is working. Be sure to take all of your medication, even if you start to feel better after a few days.
- Treatment for your partner. To prevent reinfection with an STI, your sexual partner or partners should be examined and treated. Infected partners might not have any noticeable symptoms.
- Temporary abstinence. Avoid sexual intercourse until treatment is completed and symptoms have resolved.
If you're pregnant, seriously ill, have a suspected abscess or haven't responded to oral medications, you might need hospitalization. You might receive intravenous antibiotics, followed by antibiotics you take by mouth.
Surgery is rarely needed. However, if an abscess ruptures or threatens to rupture, your doctor might drain it. You might also need surgery if you don't respond to antibiotic treatment or have a questionable diagnosis, such as when one or more of the signs or symptoms of PID are absent.
Coping and support
Pelvic inflammatory disease can bring up difficult or stressful feelings. You may be dealing with the diagnosis of a sexually transmitted infection, possible infertility or chronic pain. To help you cope with the ups and downs of your diagnosis, consider these strategies:
- Get treatment. PID is most often caused by a sexually transmitted infection. Finding out that you have an STI can be traumatic for you or your partner. Nevertheless, you and your partner should both seek immediate treatment to lessen the severity of PID and to prevent reinfection.
- Be prepared. If you've experienced more than one episode of pelvic inflammatory disease, you're at greater risk of infertility. If you've been trying to get pregnant without success, make an appointment with your doctor for an infertility evaluation. Ask your doctor to explain the steps for infertility testing and treatment. Understanding the process may help reduce your anxiety.
- Seek support. Although sexual health, infertility and chronic pain can be deeply personal issues, reach out to your partner, close family members or friends, or a professional for support. Many online support groups allow you to maintain your anonymity while you discuss your concerns.
Preparing for your appointment
If you have signs or symptoms of pelvic inflammatory disease, make an appointment to see your doctor.
Here's some information on what you can do to get ready and what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance.
- Write down any symptoms you're experiencing, including any that might seem unrelated to the reason you scheduled the appointment.
- Make a list of all medications, vitamins or supplements that you're taking.
- Write down questions to ask your doctor.
Some basic questions to ask include:
- What kinds of tests do I need?
- Is this a sexually transmitted infection?
- Should my partner be tested or treated?
- Do I need to stop having sex during treatment? How long should I wait?
- How can I prevent future episodes of pelvic inflammatory disease?
- Will this affect my ability to become pregnant?
- Is there a generic alternative to the medicine you're prescribing me?
- Can I be treated at home? Or will I need to go to a hospital?
- Do you have any printed materials that I can take with me? What websites do you recommend?
- Do I need to come back for a follow-up visit?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- Do you have a new sexual partner or multiple partners?
- Do you always use condoms?
- When did you first begin experiencing symptoms?
- What are your symptoms?
- Are you experiencing any pelvic pain?
- How severe are your symptoms?