Pelvic Inflammatory Disease (PID): Causes, Symptoms, Treatment and Prevention

Pelvic inflammatory disease (PID) is an infection of the uterus, ovaries and other female reproductive organs. It causes scarring in these organs, which can lead to infertility, ectopic pregnancy, pelvic pain, abscesses (collections of pus) and other serious problems. PID is the most common preventable cause of infertility in the United States.

Causes

Many bacteria can cause PID, but it is often caused by a sexually transmitted infection (STI) — most commonly gonorrhea or chlamydia.

Who is at greater risk

You are at greater risk if you:

• are sexually active and younger than 25;
• have more than one sex partner;
• douche — douching can push bacteria up into the reproductive organs, and may also hide the signs of PID;
• have an STI and do not get it treated;
• have had PID or an STI before.

Less often, an intrauterine device (IUD) for birth control can raise the risk — usually only in the first three weeks after it is placed.

Symptoms

PID may cause mild symptoms or none. When there are symptoms, the most common is pain in the lower abdomen. Others include:

• fever;
• foul-smelling vaginal discharge;
• bleeding between periods;
• pain or bleeding during sex;
• painful urination.

See a health care provider if you have any symptoms of PID, or think you or your partner were exposed to an STI. Early treatment is important: waiting increases the risk of infertility.

Diagnosis

There is no single test. A provider may ask about your medical and sexual history, review your symptoms, do a pelvic exam, and order blood, urine and imaging tests.

Treatment

• Antibiotics treat PID. Take all of the medicine, even if symptoms go away, to be sure the infection is cured, and expect a follow-up visit to check it worked.
• Tell recent sex partners so they can be tested and treated, and don't have sex until treatment is finished, or you can reinfect each other.
• If you are pregnant, have an abscess, or your symptoms don't go away, you may need surgery or treatment in hospital.

Treatment cannot undo permanent damage already done to the organs.

Complications if untreated

• scar tissue in the fallopian tubes;
• infertility;
• an abscess in the reproductive organs, which can become a life-threatening infection;
• long-term pelvic or abdominal pain.

Prevention

The surest protection against STIs is not having sex. If you do have sex, you can lower your risk:

• use a condom every time;
• limit your number of partners, and ask partners about their sexual history;
• get tested for chlamydia and gonorrhea every year, and ask your partner to get tested;
• don't douche — it can upset the balance of bacteria in the vagina.

Sources

• "Pelvic Inflammatory Disease," MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/pelvicinflammatorydisease.html
• Rewritten in hubnx's own words.