Pelvic Inflammatory Disease

The term pelvic inflammatory disease refers to an infection of the uterus (womb), fallopian tubes (tubes that carry eggs from the ovaries to the uterus) and other reproductive organs.  PID is a common and serious complication of some sexually transmitted diseases or infections, especially chlamydia and gonorrhea.  While the infection itself can be cured, PID can cause serious damage to a woman’s reproductive organs that is permanent.
PID happens when bacteria move up from a woman’s vagina past the cervix (the opening to the uterus) and into her reproductive organs.  Many kinds of bacteria can cause PID, but usually PID is linked with chlamydia and gonorrhea.
Because PID is associated with two very common STDs, the same things that put a woman at risk for STDs can put her at risk for PID.  Sexually active women under age 25 are more likely than older women to develop PID. The more sex partners a woman has, the greater the risk of getting an STD and developing PID.  Douching also puts women at risk for PID because douching can disturb the normal and healthy vaginal organisms in harmful ways and can push the bacteria into the upper reproductive organs.
Symptoms can vary depending on what’s causing the infection. If chlamydia is the cause, it is possible a woman would have no symptoms even when serious damage is being caused inside.  If a woman does experience symptoms of PID, they would typically include lower belly pain or unexplained bleeding from the vagina.  Other signs might be fever, unusual vaginal discharge that may or may not smell bad, pain or discomfort with sex and/or urination, and pain in the upper right stomach area.
A healthcare provider will do a pelvic exam (a vaginal exam) to look for cervical and vaginal discharge. They will also look for lumps around the ovaries and fallopian tubes and see if there is any tenderness or pain in the pelvis. They will also run some lab tests on vaginal fluid to check for bacterial infections, including STDs, and may run a pregnancy test. There is no lab test for PID, itself, only lab tests to find out if there are too much harmful bacteria that might be causing PID.
PID infection can be cured with prescription antibiotics; however, antibiotics will not fix the damage that has been done to a woman’s reproductive organs. If a woman is having symptoms of PID, it is very important that she see a healthcare provider immediately to prevent further or more severe damage to her body.  Hospitalization may be needed depending on how severe the infection is.
PID is usually treated using two different types of antibiotics together. These antibiotics are given either orally, by injection, or both. It is important to finish taking all medicine, even if symptoms go away. The healthcare provider may ask the woman to return to their office within three days of starting the medicine to make sure it’s working.
It is very important that a woman’s sex partners be checked and treated for STDs too, even if that partner doesn’t have any symptoms. A woman with PID and her partner must not have sex until both have been completely treated – otherwise the infection will return.
PID is very serious and needs to be treated by a healthcare provider right away.  PID can cause permanent damage to reproductive organs, including permanent scar tissue that can develop and block normal movement of eggs to the uterus.  This can cause:
  • Ectopic pregnancy, a condition where a fertilized egg begins to grow in the fallopian tube which can lead to a life threatening rupture of tissues. Fertilized eggs normally should grow in the womb, not the fallopian tubes;
  • Infertility; if the fallopian tubes are partly blocked or damaged;
  • Constant pelvic pain. 

Having PID once, puts a woman more at risk for getting it again because her reproductive organs are already damaged.  The more times a woman gets PID, the greater the likelihood that she will become infertile, have an ectopic pregnancy, or suffer from long-term pelvic pain.

Once diagnosed with PID by a healthcare provider there are some very important steps to take to make sure you and any sex partners get and stay healthy.  Your healthcare provider may want you to do more, but at a minimum, you should do the following:
  • Take ALL prescribed medication from your healthcare provider;
  •  If you have a current sex partner(s), they will need to get tested or treated for any STDs they may have;
  • Do not have sex for 7-10 days after you AND your current partner(s) have been treated for the PID/STDs to allow time for the medicine to fully kill the germs;
  • Make and go to any follow up appointments your healthcare provider says you need;
  • Get a yearly Pap smear and ask the provider to test you for STDs.  (You don’t automatically get tested for STDs when you get your Pap.)

 

The best way to prevent PID is to prevent sexually transmitted diseases by not having sex, using a latex or polyurethane condom correctly every time you have sex, and limiting your number of sex partners.  You can also prevent PID by getting tested regularly for STDs and getting early treatment if you have one. 
If you think you might have PID, make an appointment with your doctor or gynecologist immediately. If you are not comfortable seeing your usual doctor or don't have one, you can see someone else—check out the clinic finder. If you are in severe pain, go to your nearest emergency room.  It is very important to be honest with your healthcare provider about your sexual history theycan provide you with the best care possible.