Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. The reproductive system includes the uterus, fallopian tubes, ovaries, and nearby tissues in the lower belly (pelvis). The infection starts at the cervix, which is the opening of the uterus into the vagina. The infection then moves up through the whole reproductive system. If the infection is not treated, it could spread to other parts of your body. It might cause long-term pelvic pain and scarring that could make it hard for you to get pregnant. Prompt and complete treatment is very important to try to keep your ability to have children.
PID is most common among younger women who have sex, especially with multiple partners. It rarely happens after menopause.
What is the cause?
Having sex with someone who is infected with gonorrhea or chlamydia is the most common cause. Other types of bacteria normally found in the vagina and on the cervix can cause also cause PID.
You may have an increased risk of PID:
After a miscarriage, termination of pregnancy (also called abortion), or childbirth
Rarely, with use of an IUD for birth control, especially within the first 20 days after the IUD is put inside your uterus
After pelvic surgery
If you have a new sex partner or more than 1 sex partner
If your only sex partner has more than 1 sex partner
If you frequently douche (clean out the vagina with water or other fluids)
What are the symptoms?
Sometimes there are no symptoms. When you do have symptoms, they may include:
Pain in the lower belly
Heavy vaginal discharge
Irregular or heavy menstrual periods
Pain during sex
Pain or burning when you urinate or have a bowel movement
Chills or high fever, nausea, or vomiting
How is it diagnosed?
Your healthcare provider will ask about your symptoms, sexual activity, and medical history. Your provider will examine you, including a pelvic exam. Tests may include:
Tests of samples of blood, vaginal discharge, and urine
An ultrasound, which uses sound waves to show pictures of the organs in your pelvis
Pregnancy test (abdominal pain and vaginal bleeding can be symptoms of a pregnancy that is outside the uterus)
Laparoscopy, which uses a small lighted tube put into the belly through a small cut to look at the organs and tissues inside your belly and pelvis. Your provider may remove a sample of tissue (biopsy) for tests.
If your healthcare provider thinks you have PID, he or she may talk to you about testing for HIV (the virus that causes AIDS) and other sexually transmitted diseases or infections (also called STDs or STIs). If your provider thinks your infection was caused by an STD, your partner(s) must be examined and treated.
What is the treatment?
Some PID infections can be treated with antibiotic shots or pills.
A more serious infection needs several days of IV antibiotics. This may be done in the hospital or emergency room, at your healthcare provider’s office, or sometimes at home with visits from a nurse. After several days of IV antibiotics, you will need to take antibiotics by mouth.
Your provider may prescribe pain medicine.
You will usually start to feel better 2 to 3 days after starting treatment. Make sure you finish all of the medicine as prescribed.
If you have pus in your pelvis (an abscess), you may need surgery to remove or drain it. If you have an IUD, your healthcare provider will probably remove it.
How can I take care of myself?
Follow your healthcare provider’s instructions and take all of your medicine as prescribed.
Rest and take acetaminophen, ibuprofen, aspirin, or other medicines recommended or prescribed by your provider for pain relief and fever. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you donâ€™t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
It may help to put a hot water bottle or heating pad on your stomach. Cover the hot water bottle with a towel or set the heating pad on low so you donâ€™t burn your skin.
Make sure you tell your sexual partner(s) about your infection. They need to be treated. Do not have sex until your provider tells you itâ€™s OK.
Ask your healthcare provider:
How and when you will hear your test results
How long it will take to recover
What activities you should avoid and when you can return to normal activities
When it is safe to start having sex again
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
How can I help prevent pelvic inflammatory disease?
You can lower your risk of getting PID if you:
Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.
Have just 1 sexual partner who is not having sex with anyone else.
Donâ€™t have sex when you have an infection.
Keep your genital area clean. Do not douche unless your healthcare provider says you should.
If you have had sex and are worried that you may have been infected, see your healthcare provider even if you donâ€™t have any symptoms.
If you are sexually active ask your healthcare provider if you and your partner(s) should be tested once a year for chlamydia and gonorrhea even if you donâ€™t have symptoms. You can be infected and not know it. A urine test can be done to test for these diseases. Prompt treatment of these infections can keep them from turning into PID.
If you have been raped or sexually assaulted, you may need to be treated to prevent sexually transmitted infections. You should have an exam within a few hours of the assault (and before showering or bathing) even if you donâ€™t want to press charges. You can also ask about being protected from pregnancy when you have the exam.
Developed by RelayHealth.
Pediatric Advisor 2015.1 published by RelayHealth. Last modified: 2014-12-18 Last reviewed: 2014-11-18
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Pelvic Inflammatory Disease: Teen Version: References
Haggerty CL, Ness RB. Diagnosis and treatment of pelvic inflammatory disease. Womens Health (Lond Engl). 2008 Jul;4(4):383-97.
Livengood, Charles, et al. (2014). Clinical features and diagnosis of pelvic inflammatory disease. UpToDate. Retrieved 12/17/2014 from http://www.UpToDate.com.
Livengood, Charles, et al. (2014). Pathogenesis of and risk factors for pelvic inflammatory disease. Retrieved 12/17/2104 from http://www.UptoDate.com.
Ness RB, Soper DE, Holley RL, Peipert J, Randall H, Sweet RL, et al. Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: results from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) Randomized Trial. Am J Obstet Gynecol 2002;186:929â€“37.
Pediatric and Adolescent Gynecology, 5th Edition. S.J. Emans, Marc R. Laufer, Donald P. Goldstein. Chapter 12. Sexually Transmitted Diseases: Gonorrhea, Chlamydia Trachomatis, Pelvic Inflammatory Disease, and Syphilis. 2004.