There's no single test for diagnosing pelvic inflammatory disease (PID). It's diagnosed based on your symptoms and a gynaecological examination. Your doctor will first ask about your medical and sexual history. The next stepa is to carry out a pelvic examination to check for any tenderness and abnormal vaginal discharge.

You may experience some discomfort during this examination, particularly if you do have PID. Swabs are usually taken from the inside of your vagina and cervix. These are sent to a laboratory to look for signs of a bacterial infection and identify the bacteria responsible.

A positive test for chlamydia, gonorrhoea or mycoplasma genitalium supports the diagnosis of PID. But most people have negative swabs and this doesn't rule out the diagnosis. As PID can be difficult to diagnose, other tests may also be required to look for signs of infection or inflammation or rule out other possible causes of your symptoms. These tests may include:

• a urine or blood test
• a pregnancy test
• an ultrasound scan, which is usually carried out using a probe passed into the vagina (transvaginal ultrasound)

In some cases, a laparoscopy (keyhole surgery) may be used to diagnose PID. A laparoscopy is a minor operation where 2 small cuts are made in the abdomen. This is usually only done in more severe cases where there may be other possible causes of the symptoms, such as appendicitis.

Admission to hospital

You may be urgently admitted to hospital if:

• you're pregnant (especially if there's a chance you may have an ectopic pregnancy)
• your symptoms are severe (such as nausea, vomiting and a high fever)
• you have signs of pelvic peritonitis
• an abscess is suspected
• you're unable to take oral antibiotics and need to be given them through a drip (intravenously)
• you may need emergency surgery, such as for appendicitis