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inflammatory disease, or PID, is an infection of a woman's reproductive organs.
Treating PID right away is important,
because PID can cause scar tissue in the pelvic organs and lead to
infertility. It can also cause other problems, such
pelvic pain and
tubal (ectopic) pregnancy.
PID is caused by bacteria
entering the reproductive organs through the cervix. When the cervix is
infected, bacteria from the vagina can more easily get into and infect the
uterus and fallopian tubes.
You're more likely to get PID if
At first, PID may not cause
any symptoms. Or it may cause only mild symptoms, such as bleeding or discharge
from the vagina. Some women don't even know they have it. They only find out
later, when they can't get pregnant or they have
As the infection spreads,
the most common symptom is pain in the lower belly. The pain has been described
as crampy or as a dull and constant ache. It may be worse during sex, during bowel
movements, or when you urinate. Some women also have a fever.
Even when PID causes mild
or no symptoms, it can still cause serious problems. So you need to see your doctor if you have any
Your doctor will ask about your lifestyle and
symptoms. He or she will examine you and do tests to see if you have PID. The
test results may take some time. For this reason, your doctor will treat you
for the disease before the test results are ready. Treating PID early is
important to prevent problems later on.
Your doctor may test you
for the most common causes of PID and may also do 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.
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. And be
sure to follow up with your doctor to make sure that the treatment is
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, called an
Your risk of infertility
increases each time you have PID, so it is very important to prevent future
infections. Using a condom each time you have sex can reduce your chance of
getting a sexually transmitted infection that could lead to PID.
Learning about pelvic inflammatory disease:
Pelvic inflammatory disease (PID) is
usually caused by a
sexually transmitted infection (STI) that infects the
When the cervix, which connects the upper vagina to the uterus, is infected with an STI, other bacteria
in the vagina can more easily get into and infect the uterus and fallopian tubes.
The most common STIs that cause PID are gonorrhea and chlamydia.
PID caused by chlamydia may have milder symptoms or no
symptoms (compared with PID caused by gonorrhea), which can delay
diagnosis. PID caused by chlamydia is most
common among teenagers and young adult women.
Bacterial vaginosis (BV) is a drop in the
vagina's "good" organisms and an increase in its potentially "bad" organisms.
When this happens and the problem organisms spread into the uterus and
fallopian tubes, PID can result. BV is not sexually transmitted.
IUD while there is infection in the
vagina or the
cervix can cause PID. This is especially likely if bacterial vaginosis or an STI is present at the time of insertion.
pelvic inflammatory disease (PID) range from none at
all to severe. They often don't appear until infection has
Symptoms tend to be more
menstrual bleeding and sometimes in the week
You may have one or more of these symptoms:
Pelvic inflammatory disease (PID) causes inflammation in the uterus and fallopian tubes. In turn, the
inflammation can form scar tissue in
the abdominal cavity and the reproductive organs. This doesn't always cause
symptoms. But the scar tissue can cause:
PID may also occur inside the belly as:
The longer treatment is delayed, the more likely you
are to have permanent damage. And the more often you have repeat infections, the higher your chances of having problems.
You are more likely to get
pelvic inflammatory disease (PID) if you:
Some medical procedures can increase your risk of
PID by introducing bacteria into the reproductive tract. These include:
PID is rare in women who aren't sexually active, don't
have menstrual periods, are pregnant, or have had their uterus or ovaries
Pelvic inflammatory disease and several
other conditions with similar symptoms require prompt
Call your doctor right away if you have belly
pain and any of the following:
Call your doctor soon
The following health
professionals can diagnose and treat pelvic inflammatory disease:
Complications are usually treated by a
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Pelvic inflammatory disease (PID) is diagnosed by the combination of your medical history, your symptoms,
a physical exam, and lab test results.
Your doctor may ask you a number of questions, such as what your symptoms are, what method of birth control you use, and whether you or your partner engage in high-risk sexual behaviors.
Your exam for PID will include a
You will also be tested for
Yearly chlamydia testing for young,
sexually active women is thought to reduce the number of cases of
PID. This screening is recommended by experts.
Antibiotics are the main treatment for pelvic inflammatory disease (PID). And it's important to treat PID right away, even if you have only one or two symptoms. This is because waiting
several days to treat you could raise your risks of fallopian tube damage and
You may be given medicine even before lab results have come back,
based on your medical history and a physical exam.
PID are cured with antibiotics. But sometimes surgery is needed to drain an abscess or cut scar tissue.
Your doctor will
recommend hospitalization if you are pregnant, are very ill, are vomiting, may
need surgery for a
tubo-ovarian abscess or
ectopic pregnancy, or
aren't able to treat yourself at home.
If you have an
IUD and you get PID, you may not need to have the IUD removed, depending on how severe the infection is.2
If your PID was caused by a sexually transmitted infection (STI), anyone with whom you have
had sex in the last 60 days should be checked and treated.
Having sex too soon after treatment could cause your infection to come back, so it's important to wait. The amount of time you must wait depends on what type of treatment you have. For more information about when it's safe to resume sex, see Home Treatment. Talk to your doctor to be sure.
Follow-up visits to your doctor are important for
making sure that treatment is working and to prevent
complications, such as chronic pelvic pain and infertility.
Your doctor will
want to check you 2 to 3 days after you've started treatment, then 7 to 10 days
later. You will also have a checkup 4 to 6 weeks after treatment has ended, to
check your recovery.
After you've had PID, you will need to have any
further pelvic symptoms checked promptly. Your doctor will want to examine you
for signs of another infection, possible pelvic organ damage (adhesions), and
other possible causes of your symptoms.
You can prevent
pelvic inflammatory disease (PID) by using condoms.
This helps protect you from
sexually transmitted infections that cause PID. To learn more, see the topic Safer Sex.
which increases your risk for vaginal and pelvic infections.
Use the following home
treatment measures to support your recovery.
It's very important that you don't have sexual relations until your treatment is completed. Otherwise, there is a risk that the infection will come back.
The time frame for having sex again depends on what type of medicine you received.
Pelvic inflammatory disease (PID) is usually treated with a broad-spectrum antibiotic, which kills more than one type of bacteria.
How long you need to take antibiotics depends on your infection
and the type of antibiotic used. Although you may feel better before you have taken all of your pills, don't stop taking them. If you stop too soon, your infection may return.
Treatment usually takes 14 days. But the number of days you continue to take antibiotics depends on your infection and the type of antibiotic medicine. You may also be able to use a nonsteroidal anti-inflammatory drug (NSAID) to relieve PID pain or discomfort.
It sometimes takes more than one course of medicine to
cure PID. Sometimes bacteria can become resistant to an antibiotic. This means
that the antibiotic is no longer effective against the bacteria. In this case, you'll need to try another type of antibiotic.
Surgery isn't usually done to treat
pelvic inflammatory disease (PID) unless it is needed
Surgery—usually laparoscopy— is sometimes used when a diagnosis is still unclear
after other tests are done or when antibiotic treatment is not working.
Procedures that may be used to diagnose and treat the
complications of PID include:
American Congress of Obstetricians and Gynecologists
(ACOG) is a nonprofit organization of professionals who provide health care for
women, including teens. The ACOG Resource Center publishes manuals and patient
education materials. The Web publications section of the site has patient
education pamphlets on many women's health topics, including reproductive
health, breast-feeding, violence, and quitting smoking.
The mission of the American Social Health Association is
to improve the health of individuals, families, and communities, with a focus
on sexual health and preventing sexually transmitted diseases.
The National Center for HIV/AIDS, Viral Hepatitis, STD,
and TB Prevention is a branch of the Centers for Disease Control and Prevention
(CDC). Its website provides information and updates on sexually transmitted
diseases (STDs), human immunodeficiency virus (HIV), and tuberculosis (TB). You
can also find fact sheets on these health topics.
The National Institute of Allergy and Infectious
Diseases conducts research and provides consumer information on infectious and
The hotline is available Monday through Friday, 8 a.m. to 11 p.m.,
Eastern standard time. It provides education, research, and public policy
information on sexually transmitted diseases (STDs), including minor and major
STD infections. Referrals, information on prevention, and free pamphlets are
Centers for Disease Control and Prevention (2010). Pelvic inflammatory disease section of Sexually transmitted diseases treatment guidelines, 2010. MMWR, 59(RR-12): 63–67. Also available online: http://www.cdc.gov/std/treatment/2010/default.htm.
American Academy of Pediatrics (2009). Pelvic
inflammatory disease. In LK Pickering et al., eds., Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed., pp.
499–504. Elk Grove Village, IL: American Academy of Pediatrics.
American College of Obstetricians and Gynecologists
(2004, reaffirmed 2010). Chronic pelvic pain. ACOG Practice Bulletin No. 51.
Obstetrics and Gynecology, 103(3): 589–605.
Other Works Consulted
Ross J (2007). PID, search date May 2007. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
Soper DE (2010). Infections of the female pelvis. In Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases, 7th ed., vol. 1, pp. 1511–1519. Philadelphia: Churchill Livingstone Elsevier.
August 7, 2012
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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