How is pelvic inflammatory disease (PID) diagnosed?

Dr. Jeanne Morrison, PhD
Family Practitioner
Doctors may suspect pelvic inflammatory disease (PID) based on a woman's symptoms, and then may perform tests to confirm diagnosis. First, doctors will usually perform a pelvic exam, which may involve using swabs to take samples of fluid from your vagina and cervix. These samples can be analyzed to check for bacteria or other factors that may indicate PID. Other tests, including blood tests and pregnancy tests, may also be done. In some cases, doctors may perform an ultrasound to look for abnormalities in the pelvic area. Sometimes, biopsy of the uterus or laparoscopy (inserting a thin tube in your abdomen to look at your reproductive organs) may be done to confirm the diagnosis.
Pelvic inflammatory disease (PID) is characterized by inflammation and scarring, primarily of the fallopian tubes, that leads to infertility or tubal pregnancies, but it is difficult to diagnose. PID is comprised of various inflammatory disorders of the upper genital tract, including endometritis and tubo-ovarian abscess.

Its signs and symptoms vary widely, and many females have only subtle symptoms. Other females experience severe pelvic pain, especially during intercourse. Diagnosis is most frequently based on clinical presentations, such as lower abdominal pain and physical findings like tenderness on palpation of the pelvic organs during a pelvic exam. These findings can be supplemented with laboratory detection of chlamydia and/or gonorrhea from genital specimens. In some cases, diagnosis requires an ultrasound, and less often, laparoscopy, during which a scope is surgically inserted near or through the belly button to examine the pelvic area.

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