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Pelvic inflammatory disease (PID)

Key points

  • Pelvic inflammatory disease (PID) affects the female reproductive system.
  • It's usually caused by a sexually transmitted infection (STI).
  • The symptoms are usually mild but it's important to get treatment early as PID can lead to serious complications.
  • You can help prevent STIs that cause PID by limiting the number of sexual partners you have and using a condom.

Featured FAQ

Why is an ectopic pregnancy more likely if I have had PID?

Ectopic pregnancy is more likely if you have had PID because it can lead to a blockage in your fallopian tubes. This means the egg can’t pass through to your womb as it would usually after it has been fertilised.

Read all our FAQs on pelvic inflammatory disease

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 lead to infertility.

About PID

PID is a common health problem. In England and Wales, it's the reason for one in 60 visits to a GP by women under the age of 45.

PID is usually caused by an infection (normally an STI) that starts in your vagina and cervix (neck of your womb) and spreads to your womb (uterus), ovaries and fallopian tubes (the tubes that go from your ovaries to your womb).

PID can become a chronic condition and pain in your pelvic area can continue for some time. A chronic illness is one that lasts a long time. When describing an illness, the term 'chronic' refers to how long a person has it, not to how serious a condition is.

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

Illustration showing the position of the womb and structures of the female pelvis

Symptoms of PID

Most women with PID have mild symptoms but sometimes they can be severe. Symptoms may include:

  • abnormal vaginal discharge that may smell unpleasant
  • irregular periods, bleeding between periods or periods that are heavier than usual
  • pain in the lower part of your abdomen (tummy), which may spread to your legs
  • uncomfortable or painful sex
  • a high temperature (over 38°C)
  • feeling sick or vomiting

These symptoms aren't always caused by PID but if you have them, see your GP or local sexual health clinic. It's very important to seek help early to reduce your risk of developing complications. However, because PID may have symptoms that can be confused with those of other conditions, it can sometimes take a while to diagnose.

Complications of PID

It’s possible for PID to lead on to a number of complications, including the following.

  • PID can cause infertility. The risk of you becoming infertile after having PID is related to the number of times you get the condition and how severe it is.
  • If you do go on to get pregnant, you’re more likely to have an ectopic pregnancy than a woman who has never had PID. An ectopic pregnancy is when a fertilised egg implants outside your womb, most often in one of the fallopian tubes. It's not possible for pregnancy to continue outside the womb. Sometimes an ectopic pregnancy can cause the fallopian tube to rupture (burst) leading to life-threatening bleeding. See our frequently asked questions for more information.
  • You may develop chronic pelvic pain after having PID.

Causes of PID

PID is most commonly caused by an STI, usually chlamydia or gonorrhoea. You can catch an STI by having sex with an infected partner – your partner may not know that he or she has an infection. Young women who have a new sexual partner, numerous sexual partners or unprotected sex are more at risk of STIs. Although women in same sex relationships are at a lower risk of STIs, it's still possible for these conditions to be passed on through oral sex or by sharing sex toys.

It’s possible for infections other than STIs to cause PID. Bacteria that are usually found in your vagina and on your cervix can sometimes get into your womb and spread to your fallopian tubes, ovaries and surrounding tissues. Although the bacteria are harmless to your vagina, they can cause an infection in other parts of your body.

You're also more at risk of developing PID:

  • in the first six weeks after having an intrauterine device (IUD) or coil inserted
  • after having an operation to terminate a pregnancy
  • after a miscarriage
  • if you douche (rinse out) your vagina

Diagnosis of PID

Your GP will ask about your symptoms and your medical and sexual history. He or she will also examine you.

Your GP may take some samples (swabs) from inside your vagina and cervix to test for bacteria. He or she will insert a speculum into your vagina to hold it open, similar to when you have a smear test, and then use a cotton wool swab to take one or more samples. The swabs will be sent to a laboratory to be tested for chlamydia and gonorrhoea as well as other bacteria. You may also be offered routine tests for other STIs – for example a blood test can show if you have certain infections.

If there is a possibility you could be pregnant, 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 may also test a sample of your urine to check for a urinary tract infection.

If you have ongoing pain, irregular or heavy bleeding and your GP isn’t sure if you have PID, he or she may refer you to a specialist for further tests including:

  • a pelvic ultrasound or transvaginal ultrasound scan, which uses sound waves to produce an image of the inside of your body
  • a biopsy, which involves taking a small sample of tissue from the lining of your womb – this is then sent to a laboratory for testing
  • a laparoscopy, which is a keyhole procedure used to examine your fallopian tubes, ovaries and womb

Treatment of PID

Medicines

If your GP thinks that you have PID, he or she will prescribe a combination of 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 a two-week course of antibiotics to treat the infection. Always ask your GP for advice and read the patient information leaflet that comes with your medicine. It’s important to finish your treatment before you have sex again. If you have an IUD fitted, your GP may recommend that you have it removed if your symptoms don’t improve with antibiotic treatment.

If it’s found that your PID was caused by an STI, it’s essential that your partner is also tested and treated.

Your GP will probably ask you to come back a few days later to check that your symptoms are getting better and to talk through your test results. He or she may then want to see you four to six weeks later to see if your treatment has been successful.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

If your symptoms are severe or you're pregnant, you may be admitted to hospital for further treatment. You’re likely to be given antibiotics through a drip for the first 24 hours, followed by tablets. See our frequently asked questions for more information.

Surgery

The bacteria that cause PID can leave scar tissue and cause abscesses (collections of infected fluid) in your fallopian tubes. Occasionally you may need surgery to drain an abscess in or around your fallopian tubes or ovaries. You may also be offered keyhole surgery to remove fibrous scar tissue (adhesions) that can develop after PID.

Sexual partners

If you have a regular sexual partner, it’s important for him or her to make an appointment to see a GP or at a sexual health clinic for tests and treatment. Wait until you have both completed your treatment before you have sex so that there is no risk of you infecting each other again.

The doctor or nurse that you see may ask for details of your sexual history over the past six months or more. This will be in confidence. Staff at the sexual health clinic can contact your past partners for you.

Prevention of PID

The best ways to reduce your risk of STIs that often cause PID are to use condoms and limit the number of sexual partners you have. It’s important to remember that although condoms will reduce your risk of getting an STI, they can't completely prevent all infections.

 

Reviewed by Polly Kerr, Bupa Health Information Team, October 2013.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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