Symptoms of PID
- Lower abdominal or pelvic pain — often bilateral
- Pain during sex (deep dyspareunia)
- Unusual vaginal discharge — may be coloured or smell unusual
- Abnormal bleeding — between periods or after sex
- Fever and feeling unwell
- Pain on urination
See a Doctor TodayPID can develop rapidly and cause permanent fertility damage within 72 hours of onset. If you have pelvic pain with abnormal discharge or fever, attend a sexual health clinic or A&E today. Do not wait for a routine GP appointment.
Tests for PID
| Test | Purpose |
|---|---|
| Endocervical swabs (chlamydia, gonorrhoea) | Confirm causative organism — guides antibiotic choice |
| High vaginal swab | Bacterial vaginosis, anaerobes |
| Urine NAAT test | STI testing — alternative if speculum refused |
| FBC + CRP | Confirm infection severity; elevated WBC + CRP |
| Pregnancy test (urgent) | Ectopic pregnancy must be excluded — looks similar to PID |
| Pelvic ultrasound | Exclude tubo-ovarian abscess (complication of PID) |
Same-Day TreatmentYou don't need a confirmed diagnosis to start treatment — PID is a clinical diagnosis. Antibiotic treatment is started immediately when PID is suspected, before swab results return. Delay increases fertility risk.
Antibiotic Treatment
| Regimen | Outpatient (oral) | Inpatient (IV — for severe PID) |
|---|---|---|
| First-line | Ceftriaxone 500mg IM single dose + doxycycline 100mg BD × 14 days + metronidazole 400mg BD × 14 days | IV cefoxitin + doxycycline, then oral completion |
| If gonorrhoea confirmed | Adjust based on sensitivity — discuss with GUM clinic | — |
Can PID come back?
Yes — recurrence is common, especially with ongoing STI risk. Each episode causes increasing fallopian tube scarring. Consistent condom use, partner treatment, and early STI testing reduce recurrence risk.
Can PID affect fertility?
Yes — one episode of PID causes tubal damage leading to infertility in ~12%, ectopic pregnancy risk in 10%, and chronic pelvic pain in 20%. Early, complete treatment is critical.
Does my partner need treatment?
Yes — always. Both partners should be tested for STIs and treated simultaneously, even if the partner has no symptoms. Without partner treatment, re-infection is almost certain.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.