Pelvic inflammatory diseases have either mild or no symptoms at all hence often go undiagnosed until very severe.However, when any irregularities in menstruation, vaginal discharge with an unpleasant odor, bleeding during intercourse, or any similar symptoms are noticed, one should visit a doctor and have an examination done to rule out any infection and its effects on the pelvic region.

Your gynecologist will begin with an examination of the pelvis, vaginal discharge, and recommend some tests, most important of which is the PAP smear. In the case of recurrent infections, the discharge will be collected with swabs to culture and identify the organism causing the infection. The doctor may collect samples on cotton swabs from the vagina and cervix.

Furthermore, the doctor may recommend some more detailed tests for better diagnosis and treatment.

Blood tests — These tests will try to look for any infections by assessing your white blood cell count. Abnormalities in the cell count may point towards an infection, suggesting inflammation. Milder infections usually do not show up on blood tests, in case of severe infection a white blood cell count is done to assess the degree of infection.

Some of the pelvic inflammatory diseases(PID) such as gonorrhea, chlamydia, herpes, HPV are sexually transmitted. These can be detected through blood tests. PID is often associated with a urine infection and urinary symptoms, requiring a urine test to be done.

Ultrasound — This test employs the use of sound waves to generate images of the reproductive organs. PID in severe forms can cause swelling of the fallopian tubes and formation of the collection of pus called an abscess, these are diagnosed with ultrasonography. Milder PID does not show any signs in ultrasonography.

Laparoscopy — Laparoscopy also called keyhole surgery uses a thin telescope to see and treat the problem in the pelvis. Usually, this is used as last recourse either due to damaged tubes there is difficulty in conceiving or if there is an abscess not responding to antibiotics.

Endometrial biopsy — In this procedure, the doctor will collect, from the lining of the uterus, a sample tissue for analysis and examination. This is done for cases of Tuberculosis affecting the pelvis.

Treatment for pelvic inflammatory diseases
After having performed the tests, if a case of pelvic inflammatory disease comes to light, the doctor will immediately put you on a course of antibiotics to be taken orally. If the infection is serious, the doctor may recommend hospitalization. On hospitalization, antibiotics will be injected intravenously.

Recent sexual partners, if any, will also have to undergo tests and treatment depending on the test results. The doctor will ask you to avoid sexual intercourse until the treatment isn’t complete as it has a high risk of spreading with sexual contact.

Is surgery required to treat a pelvic inflammatory disease?
Very rare cases of pelvic inflammatory disease require surgery. If there is a rupture or a threat of rupturing, the doctor may operate and drain the abscess. One may also need surgery if the infection does not subside with antibiotics.

Pelvic inflammatory diseases, if diagnosed in time, are usually treatable with the help of oral and intravenous antibiotics.

Special thanks to Dr. Anshumala Shukla-Kulkarni (MD, FCPS, DGO) for the expert advice.

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