Pelvic Inflammatory Disease

Condition Basics

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is an infection of your uterus, fallopian tubes, or ovaries. If it's not treated right away, PID can cause scars in the fallopian tubes. This can make it harder to get pregnant. It can also cause other long-term problems, like pelvic pain or tubal (ectopic) pregnancy.

What causes it?

PID is caused by bacteria. When the cervix is infected, bacteria from the vagina can more easily get into and infect the uterus and fallopian tubes. The most common causes of PID are gonorrhea and chlamydia, which are sexually transmitted infections (STIs). It may also be caused by other types of bacteria.

What are the symptoms?

The most common symptom is pain in the lower belly. It's often described as cramping or a dull and constant ache. It may get worse during vaginal sex, during bowel movements, or when you urinate. PID may also cause vaginal bleeding after sex, abnormal vaginal discharge, irregular menstrual bleeding, or a fever.

How is it diagnosed?

Your doctor will ask about your symptoms and do a physical exam. You may have tests for common causes of PID. Your blood and vaginal discharge may be tested to look for signs of infection. You may also have an ultrasound to look for other possible causes of your symptoms.

How is pelvic inflammatory disease treated?

Your doctor will prescribe antibiotic pills to treat PID. Any sex partners will also need to be treated. If PID is severe, if you're pregnant, or if you don't get better by taking antibiotics at home, you may need to be treated in the hospital.

Prevention

Your risk of chronic pelvic pain and infertility increases each time you have PID, so it's important to prevent future infections.

• Use a condom each time you have sex. This can reduce your risk of getting a sexually transmitted infection that might lead to PID.
• Avoid douching. Douching may increase your risk for pelvic infections.

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Symptoms

The most common symptom of PID is pain in the lower belly. The pain is often described as cramping or a dull and constant ache. It may be worse during vaginal sex, during bowel movements, or when you urinate.

You could also have:

• A fever.
• Abnormal vaginal discharge. You may have more discharge than usual or discharge that is yellow, brown, or green.
• Vaginal bleeding after sex.
• Irregular menstrual bleeding.

You may notice symptoms more during your period or the week after your period.

When to Call

Call your doctor now if you have belly pain and any of the following:

• A positive home pregnancy test
• Fever
• Pain or difficulty urinating

Call your doctor soon if you:

• Have a dull pain, unusual cramping, or a feeling of pressure in your lower belly.
• Have pain during sex, especially in the belly.
• Have abnormal vaginal bleeding, bleeding between menstrual periods, or bleeding after sex.
• Have a vaginal discharge that is yellow, green, or brown or smells bad.
• Need to urinate often or have pain, burning, or itching with urination for longer than 24 hours.
• Think you may have been exposed to a sexually transmitted infection, or you have a sex partner who has symptoms, such as discharge, genital sores, or pain in the genital area.

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Exams and Tests

Your doctor will ask about your symptoms and do a physical exam, including a pelvic exam. You may have tests for the most common causes of PID, including chlamydia and gonorrhea. Your blood and vaginal discharge may be tested to look for signs of infection.

Your doctor may order an ultrasound to look for other possible causes of your symptoms. An ultrasound may also show if there is damage to the fallopian tubes, uterus, or ovaries from PID.

The test results may take some time, so your doctor will treat you before the test results are ready. Treating PID early is important to prevent problems later on.

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Treatment Overview

Your doctor will prescribe antibiotic pills to treat PID. Take them as directed. If you don't take all of the medicine, the infection may come back. See your doctor for follow-up to make sure that the treatment is working.

Your sex partner or partners will also need to be treated to avoid spreading the infection. It's important to avoid sex until you and any sex partners have finished the medicine.

If PID is severe, if you're pregnant, or if you don't get better by taking antibiotics at home, you may need to be treated in the hospital and get antibiotics through a vein (intravenous). In rare cases, surgery is needed to drain a pocket of infection, or abscess.

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Self-Care

Take antibiotics as directed. Rest until your symptoms have improved. If you're not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine. Any sex partners need to be treated to avoid spreading the infection. Don't have sex until you and your sex partner or partners have completed treatment.

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