 during a pelvic exam:
Lower abdominal tenderness
Tenderness of fallopian tubes and ovaries
Tenderness of the cervix
All other explanations for these findings must have been ruled out, so your healthcare provider may also order tests to identify the organism which led to the infection (such as chlamydia or gonorrhea) or to distinguish between PID and other problems with similar symptoms.
A pelvic ultrasound is a helpful procedure for diagnosing PID. An ultrasound can view the pelvic area to see whether the fallopian tubes are enlarged or whether an abscess (pus-filled area) is present.
In some cases, a laparoscopy may be necessary to confirm the diagnosis. A laparoscopy is a surgical procedure in which a thin, flexible tube with a lighted end (laparoscope) is inserted through a small incision in the lower abdomen. This procedure enables the doctor to view the internal pelvic organs and to take specimens for laboratory studies, if needed.
How is it treated?
Broad-spectrum antibiotics are the recommended treatment, as they can cover the likely pathogens.
Treatment may include antimicrobial agents to treat gonorrhea, chlamydia, streptococci and other gram-negative bacteria.
Ofloxacin (oh-flox-ah-sin) tablets (FLOXIN) can be used alone to treat PID.
Aggressive treatment of PID is recommended for women with HIV, who may be more likely to require surgical intervention.
Sex partners of patients who have PID should be examined and treated if they have had recent sexual contact to avoid re-infection.
Take all medications as directed.
You may need a follow-up exam 48 to 72 hours after start of treatment to make sure the medicine is working.
Return for another exam after completion of treatment to make sure the infection is completely gone.
Tell your partner to get tested and treated.
Remember: Do not have sex until you and your partner(s) have been treated and cured.
Hospitalization to treat PID may be recommended if the woman:
is severely ill (nausea, vomiting, and high fever);
does not respond to or cannot take oral medication and needs intravenous antibiotics;
has an abscess (infected area with pus) in the fallopian tube or ovary.
If symptoms continue or if an abscess does not go away, surgery may be needed. Complications of PID, such as chronic pelvic pain and scarring are difficult to treat, but sometimes they improve with surgery.
What does it mean for my health?
Untreated PID infections may lead to:
Infertility. Because of PID, each year more than 100,000 women will not be able to have children as a result of scarring or damage to cells lining the fallopian tubes.
Use latex condoms for vaginal, oral and anal sex from the very beginning of sexual contact until there is no longer skin contact.
Mutual monogamy (have sex with only one uninfected partner). Multiple sex partners can increase your risk for getting any STI and developing PID.
Have regular check-ups if you are sexually active.
If you have an STI, do not have sex (oral, vaginal or anal) until all partners have been treated and cured. Treatment and follow-up are important steps in breaking the disease cycle.
Water-based spermicides (foams, jellies, creams, or suppositories) can be used along with latex condoms for additional protection during vaginal intercourse. Use of spermicide is not recommended nor found to be effective for oral or anal intercourse.
Since PID can be transmitted even if the penis or tongue does not completely enter the vagina, mouth or rectum, using latex condoms from the beginning of sexual contact until there is no longer skin contact is recommended.
How do I tell my partner?
Telling a partner can be hard, but keep in mind that most people with an STI don't know they have it. It's important that you talk to your partner as soon as possible so she or he can get treatment. Men are more likely than women to have symptoms of chlamydia or gonorrhea (two STIs that cause PID). It is possible to pass PID back and forth, so if you get treated and your partner doesn't, you may get infected again.