Pelvic inflammatory disease, or PID, is an infection of a woman's reproductive organs.
Treating PID right away is important, because PID can cause scar tissue in the pelvic organs and lead to infertility. It can also cause other problems, such as pelvic pain and tubal (ectopic) pregnancy.
PID is caused by bacteria entering the reproductive organs through the cervix. When the cervix is infected, bacteria from the vagina can more easily get into and infect the uterus and fallopian tubes.
You're more likely to get PID if you:
At first, PID may not cause any symptoms. Or it may cause only mild symptoms, such as bleeding or discharge from the vagina. Some women don't even know they have it. They only find out later, when they can't get pregnant or they have pelvic pain.
As the infection spreads, the most common symptom is pain in the lower belly. The pain has been described as crampy or as a dull and constant ache. It may be worse during sex, during bowel movements, or when you urinate. Some women also have a fever.
Even when PID causes mild or no symptoms, it can still cause serious problems. So you need to see your doctor if you have any unusual symptoms.
Your doctor will ask about your lifestyle and symptoms. He or she will examine you and do tests to see if you have PID. The test results may take some time. For this reason, your doctor will treat you for the disease before the test results are ready. Treating PID early is important to prevent problems later on.
Your doctor may test you for the most common causes of PID and may also do blood tests to look for signs of infection. Your doctor may also order an ultrasound to see if there are other possible causes of your symptoms. An ultrasound may also show if there is damage to the fallopian tubes, uterus, or ovaries from PID.
To treat PID, you will take antibiotics. Take them as directed. If you don't take all of the medicine, the infection may come back.
If your infection was caused by a sexually transmitted infection, your sex partner(s) will also need to be treated so you don't get infected again. Do not have sex until both of you have finished your medicine. And be sure to follow up with your doctor to make sure that the treatment is working.
If you have a very bad case of PID or are also pregnant, you may need to stay in the hospital and get antibiotics through a vein (intravenous). Sometimes surgery is needed to drain a pocket of infection, called an abscess.
Your risk of infertility increases each time you have PID, so it is very important to prevent future infections. Using a condom each time you have sex can reduce your chance of getting a sexually transmitted infection that could lead to PID.
Pelvic inflammatory disease (PID) is caused by bacteria entering the reproductive organs through the cervix. When the cervix is infected, bacteria from the vagina can more easily get into and infect the uterus and fallopian tubes.
Pelvic inflammatory disease (PID) is usually caused by a sexually transmitted infection (STI) that infects the cervix.
When the cervix, which connects the upper vagina to the uterus, is infected with an STI, other bacteria in the vagina can more easily get into and infect the uterus and fallopian tubes.
The most common STIs that cause PID are gonorrhea and chlamydia.
PID caused by chlamydia may have milder symptoms or no symptoms (compared with PID caused by gonorrhea), which can delay diagnosis. PID caused by chlamydia is most common among teenagers and young adult women.
Bacterial vaginosis (BV)
is a drop in the vagina's "good" organisms and an increase in its potentially "bad" organisms.
When this happens and the problem organisms spread into the uterus and fallopian tubes, PID can result. BV is not sexually transmitted.
Inserting an IUD while there is infection in the vagina or the cervix can cause PID. This is especially likely if bacterial vaginosis or an STI is present at the time of insertion.
Symptoms of pelvic inflammatory disease (PID) range from none at all to severe. They often don't appear until infection has spread.
Symptoms tend to be more noticeable during menstrual bleeding and sometimes in the week following.
You may have one or more of these symptoms:
Pelvic inflammatory disease (PID) causes inflammation in the uterus and fallopian tubes. In turn, the inflammation can form scar tissue in the abdominal cavity and the reproductive organs. This doesn't always cause symptoms. But the scar tissue can cause:
PID may also occur inside the belly as:
The longer treatment is delayed, the more likely you are to have permanent damage. And the more often you have repeat infections, the higher your chances of having problems.
You are more likely to get pelvic inflammatory disease (PID) if you:
Some medical procedures can increase your risk of PID by introducing bacteria into the reproductive tract. These include:
In some cases, PID can spread from tuberculosis bacteria that have spread to the pelvic area.
PID is rare in women who aren't sexually active, don't have menstrual periods, are pregnant, or have had their uterus or ovaries removed.
Pelvic inflammatory disease and several other conditions with similar symptoms require prompt treatment.
Call your doctor right away if you have belly pain and any of the following:
Call your doctor soon if you:
Your family doctor, general practitioner, or gynecologist can diagnose and treat pelvic inflammatory disease (PID).
Complications are usually treated by a gynecologist.
Pelvic inflammatory disease (PID) is diagnosed by the combination of your medical history, your symptoms, a physical examination, and lab test results.
Your doctor may ask you a number of questions, such as what your symptoms are, what method of birth control you use, and whether you or your partner engage in high-risk sexual behaviours.
Your examination for PID will include a pelvic examination.
You will also be tested for gonorrhea, chlamydia, and bacterial vaginosis.
Yearly chlamydia testing for young, sexually active women is thought to reduce the number of cases of PID. This screening is recommended by experts.
Antibiotics are the main treatment for pelvic inflammatory disease (PID). And it's important to treat PID right away, even if you have only one or two symptoms. This is because waiting several days to treat you could raise your risks of fallopian tube damage and infertility.footnote 1
You may be given medicine even before lab results have come back, based on your medical history and a physical examination.
Most cases of PID are cured with antibiotics. But sometimes surgery is needed to drain an abscess or cut scar tissue.
Your doctor will recommend hospitalization if you are pregnant, are very ill, are vomiting, may need surgery for a tubo-ovarian abscess or ectopic pregnancy, or aren't able to treat yourself at home.
If you have an IUD and you get PID, you may not need to have the IUD removed, depending on how severe the infection is.footnote 1
If your PID was caused by a sexually transmitted infection (STI), anyone with whom you have had sex in the last 60 days should be checked and treated.
Having sex too soon after treatment could cause your infection to come back, so it's important to wait. The amount of time you must wait depends on what type of treatment you have. Talk to your doctor to be sure.
Follow-up visits to your doctor are important for making sure that treatment is working and to prevent complications, such as chronic pelvic pain and infertility.
Your doctor will want to check you 2 to 3 days after you've started treatment to see if you are improving or if you need a different antibiotic.
After you've had PID, you will need to have any further pelvic symptoms checked promptly. Your doctor will want to examine you for signs of another infection, possible pelvic organ damage (adhesions), and other possible causes of your symptoms.
You can prevent pelvic inflammatory disease (PID) by using condoms. This helps protect you from sexually transmitted infections that cause PID. To learn more, see the topic Safer Sex.
Avoid douching, which increases your risk for vaginal and pelvic infections.
Use the following home treatment measures to support your recovery.
It's very important that you don't have sexual relations until your treatment is completed. Otherwise, there is a risk that the infection will come back. Talk to your doctor about when it is safe for you to start having sex again.
Pelvic inflammatory disease (PID) is usually treated with a broad-spectrum antibiotic, which kills more than one type of bacteria.
How long you need to take antibiotics depends on your infection and the type of antibiotic used. Although you may feel better before you have taken all of your pills, don't stop taking them. If you stop too soon, your infection may return.
Treatment usually takes 14 days. But the number of days you continue to take antibiotics depends on your infection and the type of antibiotic medicine. You may also be able to use a non-steroidal anti-inflammatory drug (NSAID) to relieve PID pain or discomfort.
It sometimes takes more than one course of medicine to cure PID. Sometimes bacteria can become resistant to an antibiotic. This means that the antibiotic is no longer effective against the bacteria. In this case, you'll need to try another type of antibiotic.
Surgery isn't usually done to treat pelvic inflammatory disease (PID) unless it is needed to:
Surgery—usually laparoscopy— is sometimes used when a diagnosis is still unclear after other tests are done or when antibiotic treatment is not working.
Procedures that may be used to diagnose and treat the complications of PID include:
Centers for Disease Control and Prevention (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR, 64(RR-03): 1–137. http://www.cdc.gov/std/tg2015. Accessed July 2, 2015. [Erratum in MMWR, 64(33): 924. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a9.htm?s_cid=mm6433a9_w. Accessed January 25, 2016.]
American College of Obstetricians and Gynecologists (2004, reaffirmed 2010). Chronic pelvic pain. ACOG Practice Bulletin No. 51. Obstetrics and Gynecology, 103(3): 589–605.
Other Works Consulted
Wiesenfeld H, Paavonen J (2010). Pelvic inflammatory disease. In SA Morse et al., eds., Atlas of Sexually Transmitted Diseases and AIDS, 4th ed., pp. 94–110. Philadelphia: Saunders.
ByHealthwise StaffPrimary Medical ReviewerKathleen Romito, MD - Family MedicineThomas M. Bailey, MD, CCFP - Family MedicineAdam Husney, MD - Family MedicineMartin J. Gabica, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineSarah A. Marshall, MD - Family MedicineKevin C. Kiley, MD - Obstetrics and Gynecology
Current as ofMay 15, 2018
Current as of: May 15, 2018
Kathleen Romito, MD - Family Medicine
& Thomas M. Bailey, MD, CCFP - Family Medicine & Adam Husney, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Sarah A. Marshall, MD - Family Medicine & Kevin C. Kiley, MD - Obstetrics and Gynecology
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