Pelvic Inflammatory Disease

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Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. PID occurs when bacteria move from the vagina and cervix upward into the uterus, ovaries or fallopian tubes. The bacteria can lead to an abscess in a fallopian tube or ovary. Long-term problems, like infertility, ectopic pregnancy and chronic pelvic pain, can occur if PID is not treated promptly.

It is common, diagnosed in more than 1 million women each year in the United States.

Gonorrhea and chlamydia are the main cause of PID. When a woman is infected with gonorrhea or chlamydia and does not receive treatment, it can take anywhere from a few days to a few weeks before she develops PID. PID also can be caused by infections that are not sexually transmitted, such as bacterial vaginosis.

PID can occur at any age in women who are sexually active. Those younger than 25 are more likely to develop PID. Other risk factors include:

  • Infection with an STI, most often gonorrhea or chlamydia

  • Multiple sex partners (the more partners, the greater the risk)

  • A sex partner who has sex with others

  • Past PID

Some research suggests that women who douche frequently are at increased risk of PID. Douching is not recommended.

Symptoms

Some women with PID have only mild symptoms or no symptoms at all. Because symptoms can be mild, many cases are not recognized by women or their providers. The most common signs and symptoms of PID are:

  • Abnormal vaginal discharge

  • Pain in the lower abdomen

  • Pain in the upper right abdomen

  • Abnormal menstrual bleeding

  • Fever and chills

  • Painful urination

  • Nausea and vomiting

  • Painful sexual intercourse

Having one of these signs or symptoms does not mean that you have PID. It could be a sign of another serious problem, such as appendicitis or ectopic pregnancy. Contact us if you have any of these symptoms.

Diagnostics

We will ask about your medical history, including your sexual habits, birth control method and symptoms. If you have PID symptoms, you will have a pelvic exam. A sample of fluid from your cervix will be taken and tested for gonorrhea and chlamydia. Blood tests may be done. Other possible tests include ultrasonography, endometrial biopsy and laparoscopy.

Treatments

PID can be treated. However, treatment cannot reverse scarring caused by the infection. The longer the infection goes untreated, the greater the risk for long-term problems, like infertility.

PID is treated first with antibiotics. Antibiotics alone usually can get rid of the infection. We may schedule a follow-up visit two or three days after treatment to check your progress.

Hospitalization may be recommended for women who:

  • do not have a clear diagnosis

  • are pregnant

  • must take antibiotics intravenously

  • are severely ill

  • have nausea and vomiting

  • have a high fever

  • have an abscess in a fallopian tube or ovary

In certain situations, such as when an abscess is found, surgery may be needed.

A woman’s sex partners must be treated. Women with PID may have partners who have gonorrhea or chlamydia. A person can have these STIs even if there are no signs of illness.

Preventions

 To help prevent PID, take the following steps to avoid STI:

  • Use condoms every time you have sex to prevent STIs. Use condoms even if you use other methods of birth control.

  • Have sex only with a partner who does not have an STI and who only has sex with you.

  • Limit your number of sex partners. If you or your partner has had previous partners, your risk of getting an STI is increased.

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