Pelvic Inflammatory Disease (PID): Symptoms, Causes and Treatment

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It most often occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries.

The signs and symptoms of pelvic inflammatory disease can be subtle or mild. Some women don’t experience any signs or symptoms. As a result, you might not realize you have it until you have trouble getting pregnant or you develop chronic pelvic pain.

Symptoms

The signs and symptoms of pelvic inflammatory disease might be mild and difficult to recognize. Some women don’t have any signs or symptoms. When signs and symptoms of PID are present, they most often include:

  • Pain — ranging from mild to severe — in your lower abdomen and pelvis
  • Abnormal or heavy vaginal discharge that may have an unpleasant odor
  • Abnormal uterine bleeding, especially during or after intercourse, or between menstrual cycles
  • Pain during intercourse
  • Fever, sometimes with chills
  • Painful, frequent or difficult urination

RELATED: Common Causes of Delay in Conception

Causes

Many types of bacteria can cause PID, but gonorrhea or chlamydia infections are the most common. These bacteria are usually acquired during unprotected sex.

Less commonly, bacteria can enter your reproductive tract anytime the normal barrier created by the cervix is disturbed. This can happen during menstruation and after childbirth, miscarriage or abortion. Rarely, bacteria can also enter the reproductive tract during the insertion of an intrauterine device (IUD) — a form of long-term birth control — or any medical procedure that involves inserting instruments into the uterus.

PID

Risk factors

A number of factors might increase your risk of pelvic inflammatory disease, including:

  • Being a sexually active woman younger than 25 years old
  • Having multiple sexual partners
  • Being in a sexual relationship with a person who has more than one sex partner
  • Having sex without a condom
  • Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and might mask symptoms
  • Having a history of pelvic inflammatory disease or a sexually transmitted infection

There is a small increased risk of PID after the insertion of an intrauterine device (IUD). This risk is generally confined to the first three weeks after insertion.

Tests for pelvic inflammatory disease

Diagnosing PID

Your doctor may be able to diagnose PID after hearing your symptoms. In most cases, your doctor will run tests to confirm the diagnosis.

Tests may include:

  • pelvic exam to check your pelvic organs
  • cervical culture to check your cervix for infections
  • urine test to check your urine for signs of blood, cancer, and other diseases

After collecting samples, your doctor sends these samples to a laboratory.

Assessing damage

If your doctor determines that you have pelvic inflammatory disease, they may run more tests and check your pelvic area for damage. PID can cause scarring on your fallopian tubes and permanent damage to your reproductive organs.

Additional tests include:

  • Pelvic ultrasound. This is an imaging test that uses sound waves to create pictures of your internal organs.
  • Endometrial biopsy. In this outpatient procedure a doctor removes and examines a small sample from the lining of your uterus.
  • Laparoscopy. A laparoscopy is an outpatient procedure where a doctor inserts a flexible instrument through an incision in your abdomen and takes pictures of your pelvic organs.

Treatment for pelvic inflammatory disease

Your doctor will likely have you take antibiotics to treat PID. Because your doctor may not know the type of bacteria that caused your infection, they might give you two different types of antibiotics to treat a variety of bacteria.

Within a few days of starting treatment, your symptoms may improve or go away. However, you should finish your medication, even if you’re feeling better. Stopping your medication early may cause the infection to return.

If you’re sick or pregnant, can’t swallow pills, or have an abscess (pocket of pus caused by the infection) in your pelvis, your doctor may send you to the hospital for treatment.

Pelvic inflammatory disease may require surgery. This is rare and only necessary if an abscess in your pelvis ruptures or your doctor suspects that an abscess will rupture. It can also be necessary if the infection doesn’t respond to treatment.

The bacteria that cause PID can spread through sexual contact. If you’re sexually active, your partner should also get treated for PID. Men may be silent carriers of bacteria that cause pelvic inflammatory disease.

Your infection can recur if your partner doesn’t receive treatment. You may be asked to abstain from sexual intercourse until the infection has been resolved.

Ways to prevent pelvic inflammatory disease

You can lower your risk of PID by:

  • practicing safe sex
  • getting tested for sexually transmitted infections
  • avoiding douches
  • wiping from front to back after using the bathroom to stop bacteria from entering your vagina

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