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Pelvic inflammatory disease

Published by Bupa's health information team, July 2009.

This factsheet is for women who have pelvic inflammatory disease (PID), or who would like information about it.

Pelvic inflammatory disease (PID) is an infection of the female 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.

About pelvic inflammatory disease (PID)
Symptoms of PID
Complications of PID
Causes of PID
Diagnosis of PID
Treatment of PID
Prevention of PID
Questions and answers
Related topics
Further information
Sources

About pelvic inflammatory disease (PID)

PID is common - in England and Wales, PID is the reason for one in 60 visits to a GP by women under 45.

PID can result if an infection spreads from your vagina and cervix (neck of your womb) to your womb (uterus), ovaries and fallopian tubes (the tubes that go from your ovaries to your womb).

A chlamydia infection can cause pelvic inflammatory disease (PID) - between one and three in every 10 women with untreated chlamydia will get PID.

PID can become a chronic (long-term) condition with acute flare-ups characterised by fever and abdominal pain. The terms acute and chronic refer to time, not how serious a condition is.

PID can affect your quality of life and maybe also your ability to have children.

Illustration showing the structures of the female pelvis
Female pelvis

Symptoms of PID

Most women with PID have no symptoms. If you do, they may include:

an abnormal vaginal discharge
irregular periods, or having heavier periods than usual
pain in the lower part of your abdomen (tummy), which may spread to your legs
uncomfortable or painful sex
pain when urinating
a fever
feeling sick or vomiting

These symptoms may be caused by problems other than PID. Visit your GP for advice.

Complications of PID

There are a number of possible complications of PID. These include the following.

PID can cause infertility - around one in 10 women with a history of PID are infertile. The risk of you becoming infertile after having PID is related to the number of times you get the disease and how severe it is.
For those women with PID who do go on to get pregnant, up to one in 20 will have an ectopic pregnancy. Ectopic pregnancy is when pregnancy occurs outside the womb, for example in one of the fallopian tubes.
There may also be complications with childbirth if you have had PID, such as having a pre-term baby or passing on the infection to your baby.
Chronic pelvic pain can develop following PID.

Causes of PID

PID is most commonly caused by an STI, usually chlamydia or gonorrhoea, but it can be caused by other infections. Rarely you can get PID without having an STI as bacteria that are usually found in the vagina and on the cervix can sometimes cause the condition.

You can catch an STI by having sex with an infected partner who may not know he or she has 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. Although women in same sex relationships are less at risk of STIs, it's still possible for these conditions to be passed on through oral sex or by sharing sex toys.

You're also more likely to develop PID:

in the first three weeks after having an intra-uterine device (IUD or coil) inserted
after having an operation, such as a termination of a pregnancy
if you have sex during your period
after giving birth
if you inherit genetic factors that can make it more likely
after douching (rinsing out the vagina), although the evidence isn't certain

Diagnosis of PID

If you think you may have PID, visit your GP or local sexual health clinic. It's very important to seek help early to reduce your chances of developing complications.

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your GP may 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 will be sent to a laboratory to be tested for chlamydia and gonorrhoea. You will also be offered routine tests for other STIs.

Your GP may recommend that you have a pregnancy test because the symptoms of PID can be very similar to those of ectopic pregnancy. He or she will also test a sample of your urine to check for a urinary tract infection.

Your GP may refer you to a specialist for further tests, such as a laparoscopy, a procedure used to examine the fallopian tubes, ovaries and womb.

Treatment of PID

Medicines

If your GP suspects that you have PID, he or she will prescribe antibiotics for you to start taking straight away, 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 GP will usually prescribe antibiotics for at least two weeks to treat the infection. It's essential that you take your antibiotics exactly as directed, or they may not treat the infection completely. Your GP may 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 (IUD or coil) in place, your GP may recommend that you have it removed if your condition doesn't improve with antibiotic treatment.

You will usually be asked to go back to your GP surgery or sexual health clinic a few days later to see if your symptoms are getting better and to talk through your test results.

Hospital treatment

You may be admitted to hospital for further tests and treatment. This may happen if:

it's not possible to rule out other conditions, such as appendicitis or ectopic pregnancy
your symptoms are very severe
you can't keep down any medicine because of vomiting
you're pregnant
your symptoms aren't getting any better after three days of antibiotic treatment

Sexual partners

If you have a regular sexual partner, he or she will also need to make an appointment for tests and treatment.

You will be asked for details of your sexual history during the past six months or more. This will be in complete confidence. If you visit a sexual health clinic, staff there can contact your past partners for you.

Prevention of PID

The 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.