PID or endo?

[Goldencat]

Hi everyone,

I needed some advice as I haven't been totally happy with the care I've received from my GP and wanted to know what other people have experienced with their care pathway. Apologies for the length of the message but thought should put my history in.

I was first referred to gynae 18+ months ago with bleeding after sex with ++pain. Had an USS a year ago which was normal and was referred for laparoscopy + hysteroscopy following a colposcopy. Didn't have this due to personal reasons at the time. During this time I was also treated with antibiotics following a suspected cervix/womb/pelvic infection (had horrible constant pain in lower abdomen and this resolved with the metronidazole). Since October the pain has become an everyday thing and not just after sex. seems to be at its worst the week before my period but is pretty erratic in that i might have one day of feeling good and the next day I have a bad burning heavy sensation. It' most painful most when lying down. I know the symptoms of PID and endo are supposed to be very similar. I have pain in abdomen and vagina, burning and heaviness in womb, nausea and vomiting. I I'm awaiting a laparoscopy however due to the winter crisis I still don't have a date and have been told it won't be for a few months (which is horrible to hear when you're in constant pain and stressed from missimg work!). My boyfriend is concerned that the GP aren't doing enough to exclude the possibility it's PID - I've never had a swab / examination by my GP but they say unless I have abnormal discharge they wouldn't do one. Is this correct? Ive seen various GPs in the last few months and they all say conflicting things which hasn't helped my confidence in them. My bf came to my last appt and the gp conceded it prob would be good to repeat my ultrasound given how bad my symptoms have got since I last had one (Dec 2016). What I wanted to know is should anything else be done to exclude for PID? Should I have a swab test? I'm only concerned because of the length of time I have to wait for the laparoscopy and how long it's already been. I'm scared if it does turn out to be PID my fertility could be seriously affected for having left it so long with no treatment.

Apologies for the super long message but any comments/ advice would be appreciated please. If anyone has PID and had experience in the issue I'd really appreciate your feedback too xxx

[Penelopeel]

1. You could have PID. It is a clinical diagnosis and the doctor needs to take a history and examine you and treat you that day , before swabs results come back. You can have it even if the swabs are negative. It can just be caused by your normal bacteria climbing into your tubes. I have pasted in some info on PID FROM THE family planning NSW WEBSITE . D( fpnsw.org.au) why don’t you find a sexual

Health clinic and go there. They will know much more than a usual family Gp who is doing high blood pressure and diabetes as well. Those clinics are specialised and will know all about PID. Do you have those in the UK? They must exist! Google! Butantibiotics would fix the pain so why not try some!!!

How can I test for PID?

PID is diagnosed clinically, after a doctor or nurse has taken a history about your symptoms and performed a vaginal examination. Swabs will be taken during this examination to look for possible infections. Treatment should be commenced immediately, without waiting for test results, as PID is a clinical diagnosis and prompt treatment is required to prevent possible serious complications.

How is PID treated?

PID is treated with a combination of different antibiotics for at least 14 days. A rapid improvement in symptoms after starting antibiotic treatment supports the diagnosis of PID. It is important not to have sex for at least a week after commencing treatment or until your symptoms have resolved. Follow up is important, and even if the tests for infection are negative, you can still have PID and it is essential to complete the full course of medication. Current sexual partners should also be treated and screened for STIs.

PID can be caused by sexually transmissible infections (STIs), most commonly chlamydia and gonorrhoea. It can also be caused by other infections, such as Mycoplasma genitalium, and overgrowth of normal vaginal bacteria. It occurs when bacteria move from the cervix (the neck of the womb) into the uterus and the fallopian tubes. The cause is not identified in up to 70% of cases.1

How do people get infected?

PID that is caused by an STI is spread by having unprotected sex with an infected person. These STIs can be silent and infected partners can have no symptoms. Normal vaginal bacteria can also cause PID especially in young sexually active women. PID can also more rarely occur after having a procedure performed, such as an IUD (intrauterine device) insertion or an abortion, as the procedure can introduce bacteria from the vagina and cervix into the

[Goldencat]

Thanks for both of your posts. I spoke to my uncle who's a gp and specialised in gynae and he said the same thing that I should of had an internal examination, swabs and antibiotics - had none of these in the 3 months I've been to see them in everyday pain. So went back this afternoon and said basically "my uncles a gynae de and says this" and voila suddenly they do all three. I don't know why they didn't do it as a first point of call. I feel like they've really fobbed me off these past few months. Fingers crossed the antibiotics will help. Xx