Pelvic Inflammatory Disease (PID)

What is pelvic inflammatory disease (PID)?

PID is an infection of the internal reproductive organs in women, involving the uterus, fallopian tubes, ovaries, and surrounding pelvic tissues. These tissues become inflamed, irritated, and swollen. The most common causes of PID are chlamydia and gonorrhea, although other types of bacteria also play a role. PID is one of the leading causes of infertility in women.

How does someone get PID?

PID is caused by sexually transmitted infections (STIs) that have been left untreated, most commonly chlamydia and gonorrhea. Other types of bacteria also play a role.

What are the risk factors for PID?

The primary risk factor for PID is infection with an STI—in particular, chlamydia and gonorrhea. Risk factors for these STIs include:

Engaging in unsafe sex
Having sex with more than one partner
Having sex with someone who has multiple sex partners

How can you protect yourself from getting PID?
Infection with PID can be prevented by avoiding risky sexual behaviors.
To reduce your risk:
Use latex or polyurethane condoms during sex
Limit the number of your sex partners

If you have symptoms suggestive of an STI or think you may have been exposed to one, you should seek medical attention immediately.

If you have recently been treated or are being treated for an STI, you must make sure your sex partner(s) also receives treatment in order to prevent getting infected again. Sex partners should receive treatment even if they do not have any symptoms.

What are some symptoms of PID?

The primary symptom of PID is lower abdominal or pelvic pain. In mild cases, there may be only slight cramping. In severe cases, the pain may constant and very intense. Physical activity, especially sexual intercourse, may greatly increase the pain. Other symptoms of PID include:

Abnormal vaginal discharge
Abnormal and/or heavy vaginal bleeding
Bleeding between periods
Fever/chills
Nausea/vomiting

Women with PID may have no symptoms or the symptoms may not be those usually seen with episodes of PID.

Can infection with PID lead to other health problems?

The complications following PID can be very serious and can lead to death. They include:

Tubo-ovarian or pelvic abscess: Local collection of pus in the ovaries and fallopian tubes or the pelvis can occur in severe cases of PID. These require hospitalization and intravenous antibiotic treatment, and may require surgery.
Infertility: After PID, scar tissue can form around the pelvic organs. This scar tissue can cause blockage and distortion of the fallopian tubes so that the egg cannot get through the tube and into the uterus. After one episode of PID, a woman has an estimated 15% chance of infertility. After two episodes, the risk of infertility increases to approximately 35%, and after three, the risk is nearly 75%.
Chronic pelvic pain: Besides causing infertility, the scar tissue associated with PID may lead to pelvic pain or discomfort because of the distortion of the pelvic organs. Surgery may be required in severe cases.
Ectopic pregnancy: An ectopic pregnancy is a pregnancy that occurs outside the uterus, most commonly in the fallopian tubes. Because PID can cause partial blocking or distortion of the fallopian tubes, the chances of an ectopic pregnancy are increased. Ectopic pregnancy is a very serious condition and must be treated surgically and immediately.

What is the impact of PID on pregnancy?

A woman with a history of PID may have difficulty getting pregnant. Prior PID can also place women at increased risk for ectopic pregnancy (a pregnancy that occurs outside the uterus, most commonly in the fallopian tubes). It can lead to serious complications. Once detected, it must be treated immediately with surgery.

Women who are pregnant and suspected of having PID, should be hospitalized and treated with intravenous antibiotics to reduce the risk of serious illness, loss of pregnancy, or premature delivery.

PID is usually diagnosed using several criteria, including symptoms, signs, and results of a pelvic exam and lab tests.

These include:

Abdominal tenderness
Tenderness of the cervix, ovaries, and fallopian tubes during the pelvic exam
Fever
Abnormal cervical or vaginal discharge
Lab tests of cervical discharge that show the presence of chlamydia or gonorrhea

Is there a treatment or cure for PID?

PID can be treated and cured with a combination of antibiotics. Sometimes, hospitalization and intravenous antibiotics are necessary. If infection spreads beyond the reproductive tract and deeper into the abdomen, or if an abscess forms, surgery may be necessary. In order to reduce the inflammation and scarring, anti-inflammatory drugs like steroids may be prescribed. If left untreated, the complications of PID may be very serious and may need immediate medical attention.

Signs of improvement must be carefully monitored within 3 days of beginning treatment. If symptoms do not improve, hospitalization is usually required. Follow-up examination and testing is recommended after completion of treatment.

It is important to make sure your sex partner(s) also receives treatment in order to prevent getting infected again. Avoid having sex while being treated to reduce the chances of getting the infection again or transmitting it to someone else.

Here are some other pages that might help you:

Condoms Guide
         Types of Condoms
         How To Use Condoms
         Myths About Condoms
         Female Condoms
Lubricant Resource Guide
         Lubricant Guide
Sexual Health Guide
         Sexual Health
         Chlamydia
         Gonorrhea
         HIV Infection / AIDS
         Hepatitis B
         Hepatitis C
         Herpes
         Human Papillomavirus (Genital Warts)
         Pelvic Inflammatory Disease (PID)
         Syphilis
         Trichomoniasis