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STIs: Pelvic Inflammatory Disease (PID)

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is a general term describing an infection and inflammation that occurs in a woman’s uterus, fallopian tubes, ovaries, and/or uterine wall. PID is a common and serious complication of some STIs, including Chlamydia and gonorrhea. PID can cause anatomical changes of the woman’s reproductive system that could increase the risk of an ectopic (tubal) pregnancy.

How does a woman get pelvic inflammatory disease?

PID occurs when bacteria move to the upper reproductive system from the woman's vagina or cervix. Many different organisms can cause PID, but many cases are associated with gonorrhea and Chlamydia even though test may be negative for both.

Sexually active women are at risk for getting PID. Sexually active women under the age of 25 are more likely to develop PID than sexually active women over age 25. According to the CDC, this is because the cervix of young women is not fully matured, which increases the susceptibility to STIs that are linked to PID. Women with multiple sex partners are also at an increased risk for developing PID because of the potential to be exposed to more infectious organisms.

Douching can change the balance of bacteria in the vagina and push bacteria into the cervix and increase the risk of PID. Douching is discouraged.

The insertion and use of an IUD for contraception can increase the risk of developing PID.

How common is pelvic inflammatory disease?

The CDC estimates that more than one million women experience an episode of PID each year. Women between ages 15 and 25 have the highest incidence of PID in the U.S.

What are the symptoms of pelvic inflammatory disease?

Some women do not experience any symptoms with PID. When women experience symptoms, they may include:

• Lower abdominal or pelvic pain
• Unusual vaginal discharge (sometimes with a foul odor)
• Painful intercourse
• Painful urination
• Irregular menstrual bleeding (between periods) or unusually long or painful periods
• Pain in the upper right abdomen (rare)
• Low back pain
• Flu-like symptoms (headache, fever, body weakness or discomfort, nausea, vomiting)

How is pelvic inflammatory disease diagnosed?

There is no single test that can identify PID. Your healthcare provider will diagnose PID on the basis of your medical history, your symptoms, a physical exam, and lab test results. Lab tests might include gonorrhea and Chlamydia testing (these bacteria are common causes of PID, but not always identified with testing).

An ultrasound can determine if the fallopian tubes are enlarged or if an abscess is present. In some cases, a laparoscopy may be done to allow your healthcare provider to view your internal pelvic organs and take specimens for lab analysis. A laparoscopy is a surgical procedure in which a thin, flexible tube with a lighted end is inserted through a small incision in the lower abdomen while the patient is asleep.

How is pelvic inflammatory disease treated?

PID is frequently treated with a combination of antibiotics because the causal organism can be difficult to determine. Timely treatment with antibiotics can help to prevent severe damage to the reproductive organs which can cause chronic pain, increased risk of ectopic pregnancy, and infertility.

Does my partner need to be treated?

Yes. You should tell your partner right away if you are diagnosed with PID. Even if he or she has no symptoms, your partner may be infected with the organism(s) that has led to your PID and will need to be tested and treated.