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Pelvic inflammatory diseasePublished by Bupa's health information team, August 2007. This factsheet is for women who have pelvic inflammatory disease (PID), and for anyone who would like information about it. Pelvic inflammatory disease (PID) is an infection of a woman's reproductive organs, usually caused by a sexually transmitted infection (STI). Although PID can often be treated quickly and effectively, if left untreated it can cause infertility.
What is pelvic inflammatory disease?The condition happens when an infection spreads from the vagina and cervix (neck of the womb) to the womb (uterus), ovaries and fallopian tubes (the tubes that go from the ovaries to the womb). It can flare up suddenly, causing fever, pain and vomiting. This is called acute PID. An acute illness is typically over quite quickly. The term acute refers to time, not how serious a condition is. Alternatively, it can be a chronic condition. A chronic illness is one that lasts a long time, sometimes for the rest of the affected person's life. The term chronic refers to time, not how serious a condition is. Some women with PID have no symptoms. Having PID can affect your quality of life and may affect your ability to have children.
SymptomsSymptoms of PID include:
These symptoms may be caused by problems other than PID. You should visit your GP for advice. Long-term effects of PIDPID can cause abscesses, scarring and damage to your reproductive organs. This can cause pelvic pain, infertility and ectopic pregnancies. Ectopic pregnancy is where a fetus starts to develop outside the womb (usually in a fallopian tube). The fetus won't survive and needs to be removed. The sooner PID is treated, the better. Around three in 10 women with PID develop chronic pelvic pain. Around one in 10 women who have had PID can no longer have children as a result of damage to their fallopian tubes. For those women with PID who do go on to get pregnant, up to one in 20 will have an ectopic pregnancy. There may also be complications with childbirth, such as having a pre-term baby or passing on the infection to the baby. CausesPID is most commonly caused by an STI, usually chlamydia or gonorrhoea, but it can be caused by other infections. You can catch an STI by having sex with an infected partner, who may not know they have an infection. Young women who have a new sexual partner, have had numerous sexual partners or have had unprotected sex are more at risk of STIs. Not every woman infected with chlamydia or gonorrhoea goes on to develop PID. And, some women that do have PID test negative for chlamydia and gonorrhoea because some other bacteria may have caused their infection. Childbirth, termination of a pregnancy, insertion of an intra-uterine device (IUS or coil) and sexual intercourse during your period may all increase the risk of bacterial infection spreading from your vagina or cervix to your womb, ovaries and fallopian tubes. It's difficult to know how common PID is because some women with the condition have no symptoms at all. Also, some women have very mild symptoms and don't go to see their doctor about them. However, PID is very common. In England and Wales it's thought to account for one in 60 visits to the GP by women under the age of 45. DiagnosisIf your GP suspects you have PID, he or she may refer your to a genito-urinary medicine (GUM) clinic for further tests and treatment. If this is something you would rather not discuss with your GP, you can go straight to a GUM clinic instead where, if you wish, you can be treated anonymously. To find your local GUM clinic, go to NHS Condom essential wear. Your doctor will ask whether you have had any pain during sex or any bleeding afterwards, about your periods, and whether you use any form of contraception. Your doctor will then take specimens from inside your vagina and cervix, using a cotton wool swab. This is a simple procedure that involves inserting a speculum into the vagina to hold it open, similar to a smear test. The swabs are sent to a laboratory to be tested for chlamydia and gonorrhoea. You will also be offered routine tests for other STIs. Your doctor may also recommend that you do a pregnancy test because the symptoms of PID can be very similar to those of ectopic pregnancy. Your doctor will also test your urine sample to check for a urinary tract infection. TreatmentMedicinesIf your doctor suspects that you have PID, he or she will prescribe antibiotics for you to start taking straightaway, even though the test results probably won't be ready for a few days. This is because the long-term effects of PID can be serious, so it's best to start treatment as soon as possible. Your doctor will usually prescribe antibiotics to treat the infection for at least two weeks. It's essential that you take your antibiotics exactly as directed by your doctor, or they may not treat the infection completely. Your doctor can also recommend some painkillers if you need them. You will be advised not to have sex until you have finished your treatment. If you have an intra-uterine device (IUS or coil) in place and your symptoms are severe, your doctor may recommend that you have it removed. You will usually be asked to go back to the GUM clinic or GP surgery a few days later to see if your symptoms are getting better and to talk through your test results. Hospital treatmentSome women need to be admitted to hospital for further tests and treatment. This may be the case if:
What about my partner?If you have a regular sexual partner, he or she will also need to make an appointment at the GUM clinic, or with his or her GP, for chlamydia and gonorrhoea testing and treatment. The GUM clinic will also ask you for details of your sexual history during the past six months or more. This will be in complete confidence, and you can give the information anonymously if you wish. PreventionThe best way to reduce the risk of STIs that usually cause PID is to use a barrier method of contraception. Condoms offer protection for both women and men against most STIs, but they can't completely prevent all infections. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: August 2007. Expected review date: August 2009.
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