Condition Basics

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is an infection of your uterus, fallopian tubes, or ovaries. If it's not treated right away, PID can cause scars in the fallopian tubes. This can make it harder to get pregnant. It can also cause other long-term problems, like pelvic pain or tubal (ectopic) pregnancy.

What causes it?

PID is caused by bacteria. When the cervix is infected, bacteria from the vagina can more easily get into and infect the uterus and fallopian tubes. The most common causes of PID are gonorrhea and chlamydia, which are sexually transmitted infections (STIs). It may also be caused by other types of bacteria.

What are the symptoms?

The most common symptom of PID is pain in the lower belly. It's often described as cramping or a dull and constant ache. It may get worse during bowel movements, during sex, or when you urinate. You may also have a fever, more vaginal discharge than usual, or irregular menstrual bleeding.

How is it diagnosed?

To diagnose PID, your doctor will ask about your symptoms and do a physical exam. You may have tests for common causes of PID and blood tests to check for signs of infection. Your doctor may also order an ultrasound to look for other possible causes of your symptoms.

How is pelvic inflammatory disease treated?

To treat PID, you will take antibiotics. If your infection was caused by a sexually transmitted infection, your sex partner(s) will also need to be treated. If PID is severe or you're pregnant, you may need to be treated in the hospital.

Prevention

Your risk of infertility increases each time you have PID, so it's important to prevent future infections. Use a condom each time you have sex. This can reduce your chance of getting a sexually transmitted infection that could lead to PID. Also avoid douching, which increases your risk for pelvic infections.

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Symptoms

The most common symptom of PID is pain in the lower belly. The pain is often described as cramping or a dull and constant ache. It may be worse during sex, during bowel movements, or when you urinate.

You could also have:

• Fever.
• More discharge from the vagina than usual, or discharge that is yellow, brown, or green.
• Irregular menstrual bleeding.

You may notice symptoms more during menstrual bleeding or the week after your period.

When to Call

Call your doctor now if you have belly pain and any of the following:

• A positive home pregnancy test
• Fever of 38.3°C (101°F) or higher
• Pain or difficulty urinating

Call your doctor soon if you:

• Have a dull pain, unusual cramping, or a feeling of pressure in your lower belly.
• Have pain during sex, especially in the belly.
• Have abnormal vaginal bleeding, bleeding between menstrual periods, or bleeding after sex or douching.
• Have a vaginal discharge that is yellow or green or smells bad.
• Need to urinate often or have pain, burning, or itching with urination for longer than 24 hours.
• Think you may have been exposed to a sexually transmitted infection, or you have a sex partner who has symptoms, such as discharge, genital sores, or pain in the genital area.

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Exams and Tests

To diagnose PID, your doctor will ask about your lifestyle and symptoms. He or she will do a physical exam, including a pelvic exam. Your doctor may test you for the most common causes of PID, including chlamydia and gonorrhea. You may also have 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.

The test results may take some time, so your doctor will treat you before the test results are ready. Treating PID early is important to prevent problems later on.

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Treatment Overview

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.
• See your doctor for follow-up 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, or abscess.

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Self-Care

Rest as much as possible until your symptoms start to get better (usually a few days). Take a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, for pain. And don't have sex until your treatment is completed. Otherwise, there's a risk that the infection will come back.

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