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Pelvic Inflammatory Disease

Last Updated October 2020 | This article was created by familydoctor.org editorial staff and reviewed by Daron Gersch, MD, FAAFP

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. This includes the uterus, fallopian tubes, and ovaries. Left untreated, PID can damage a woman’s reproductive organs. It can cause trouble getting pregnant, problems during pregnancy, and long-term pelvic pain.

Symptoms of pelvic inflammatory disease

Pelvic inflammatory disease causes different symptoms in different women. These may include:

  • A dull pain and tenderness in the lower abdomen
  • Vaginal discharge that is yellow or green and may have an unpleasant smell
  • Irregular menstrual periods, such as extra-long periods, spotting, or cramps throughout the month
  • Chills, fever, nausea, diarrhea, and vomiting
  • Pain during sex
  • Low back pain
  • Painful urination

Some women who have PID don’t experience symptoms and don’t know they have the disease. This is why it is important to have routine checkups and testing.

If you have the above symptoms, or if you think you have been exposed to an STI, call your doctor. The sooner you see your doctor, the better. Waiting can allow the infection to spread and cause more pain and damage.

What causes pelvic inflammatory disease?

Pelvic inflammatory disease is caused by different types of bacteria. Many times, it’s caused by bacteria from a sexually transmitted infection (STI). The two most common STIs that cause PID are chlamydia and gonorrhea. But PID can be caused by normal bacteria found in the vagina, too. You can get PID if the bacteria move from your vagina into your reproductive organs.

There are several ways women can get PID. The most common way is by having sex with a person who has an STI. These diseases are carried in the semen and other body fluids of infected people. During sexual contact, the germs spread to the woman’s cervix. The germs can also infect the glands at the opening of the vagina, the urethra (passageway for urine), or the anus.

Sometimes PID can occur after the cervix is treated due to an abnormal Pap smear or after the insertion of an intrauterine device (IUD). However, that’s uncommon. Rarely, PID can occur as a result of giving birth or having a miscarriage, abortion, or procedure to take a sample from the inside of the womb for laboratory testing.

Additionally, the same things that put you at risk for STIs also put you at risk for PID. Your risk for PID is higher if you:

  • Have had an STI
  • Have had PID before
  • Are a sexually active woman younger than 25 years of age
  • Have had multiple sexual partners
  • Have unsafe sexual habits
  • Douche (this can flush the bacteria up into your genital tract)

How is pelvic inflammatory disease diagnosed?

There is no single test for PID. Your doctor will diagnose the condition based on your medical history, your symptoms, and a pelvic exam. This exam can help him or her tell if any of your reproductive organs are tender. Your doctor may swab the area for a sample and have the sample tested for STIs. He or she may test for a urinary tract infection or other conditions that can cause pelvic pain. He or she might also do imaging tests, such as ultrasound. This uses sound waves to create pictures of your organs. It can help your doctor look for signs of PID.

Can pelvic inflammatory disease be prevented or avoided?

Many cases of pelvic inflammatory disease can be prevented in the same way that STIs are prevented. The only way to avoid an STI is to not have vaginal, oral, or anal sex.

If you’re sexually active, you can lower your risk of getting an STI by:

  • Using condoms.Even though the condom will not prevent 100% of STIs, it will greatly reduce your chances of getting infected. Remember, only a condom can provide some protection against STIs. Other forms of birth control don’t provide this protection.
  • Getting tested.Make sure you and your partner are tested for STIs before you have sex. Tell each other the results.
  • Limiting sexual partners.Your risk of getting an STI increases with the number of sexual partners you have.
  • Remaining monogamous.This means having sex with only one partner.
  • Not abusing alcohol or drugs.Drinking too much or using drugs can lead to risky behavior. It can increase your risk of being exposed to STIs.
  • Not douching. Douching removes normal bacteria from your vagina that help to fight infections. It also helps bacteria travel up to other areas of the reproductive tract where they can cause infection.

Pelvic inflammatory disease treatment

Pelvic inflammatory disease can be treated, especially if it’s diagnosed early. It can usually be cured with antibiotics. It’s very important that you take all of your medicine exactly as your doctor tells you to, even if your symptoms go away. If you don’t take all the medicine, your symptoms may get worse. A few days after you start taking the medicine, your doctor may want to see you again for a checkup.

The sooner your PID is treated, the better. The longer PID is left untreated, the more damage it can cause, and the more likely there will be complications.

Hospitalization may be recommended if you’re very sick with PID. It may also be needed if you’re pregnant, are under the age of 18, or have HIV.

Should my partner be treated if I have PID?

If you’re treated for pelvic inflammatory disease, especially if it’s caused by an STI, your partner must also be treated. Unless your partner is treated, you may be infected again. Making good choices about sexual contact is important. If you think you might have PID, talk to your family doctor right away.

Living with pelvic inflammatory disease

Early and complete treatment can help prevent complications of pelvic inflammatory disease. However, if PID isn’t treated, it can cause permanent damage to your internal organs. Scar tissue can form in the fallopian tubes and around the abdomen. This tissue can prevent pregnancy. It can also cause the pregnancy to form outside the uterus. This is called a tubal or ectopic pregnancy. Scarring can cause pain that lasts for months or even years. Occasionally, the effects of PID can be so severe that surgery is required to remove pus, get rid of scar tissue, or remove damaged organs.

PID is more likely to come back if you’re exposed to STIs again. Each time you have PID, it causes more damage and a greater possibility of complications.

Questions for your doctor

  • What is the likely cause of my pelvic inflammatory disease?
  • Do I need any tests?
  • What do my test results mean?
  • What treatment option do you recommend?
  • Does my sexual partner need to be treated too?
  • Is it safe for me to have sex now, or do I need to wait until after treatment?
  • Is it safe for me to try to get pregnant before I finish treatment?
  • Will I have trouble getting pregnant?
  • Do I have scar tissue or other damage to my organs?
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