Pelvic inflammatory disease
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Key points
- Pelvic inflammatory disease (PID) is an infection that can affect the womb, fallopian tubes and ovaries.
- Most cases of PID are treated with antibiotics. Rest and painkillers can also ease symptoms.
- Practicing safe sex can help lower your chance of getting PID.
About pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an infection of your upper reproductive organs. These include your womb (uterus), ovaries and fallopian tubes. PID symptoms include:
- pain in your lower tummy
- an unusual vaginal discharge, which can be green or yellow and have an unpleasant or unusual odour
- bleeding between your periods
- bleeding after you have sex.
Pelvic inflammatory disease is most common in people with female reproductive organs aged between 20 and 24. In those aged 30 to 44, it’s more likely to be diagnosed during a hospital admission. It doesn’t always cause symptoms, so some people don’t realise they have it.
Pelvic inflammatory disease is usually treated with antibiotics but sometimes you may need treatment in hospital. If the pelvic infection is serious or you don’t get treatment, you could get long-term pain in your pelvis or fertility problems.
Causes of PID
Pelvic inflammatory disease (PID) is commonly caused by a sexually transmitted infection (STI), but other bacteria that are normally found in the vagina can also contribute. The most common infections that cause it are chlamydia, gonorrhoea and Mgen (Mycoplasma genitalium). When you have these types of infection, bacteria in your vagina or cervix can move up to your womb, fallopian tubes and ovaries. This can cause pelvic inflammatory disease.
You may be more likely to get pelvic inflammatory disease if you have:
- had a STI or pelvic inflammatory disease before
- had sex without using a barrier method of protection, such as condoms
- had a new sexual partner (in the last three months)
- had multiple sexual partners
- had an intrauterine device (IUD, coil) fitted within the last 3 weeks
- recently terminated a pregnancy (had an abortion)
What should I do if I think I've got an STI?
How to get tested for an STI | Watch in 2:15 minutes
In this video Bupa GP, Naveen Puri, explains what you should do if you think you might have an STI.
Hello, my name is Dr. Naveen Puri, I'm one of the GPs at Bupa Health Clinics. Today, I'd like to speak to you about presenting with problems like maybe of a sexual health nature.
We know that people can often feel embarrassed speaking about their sexual health because of fear of judgment, some shame or embarrassment that may accompany whatever their concerns are. But please let me reassure you, as doctors we've heard it all before. Any concern you have, we've probably come across on many occasions, and we're really here to offer you a judgment-free and pain-free service in as far as we possibly can.
It's in your interest to us all about your symptoms so we can help you get better and prevent any onward consequences that might come into play if you don't seek out help for your condition sooner rather than later. We know, for example, that some untreated sexually transmitted infections can lead to problems with fertility, they can lead to pelvic inflammatory disease, or they can lead to severe infections of the testicles. And so rather than you getting worse and your symptoms progressing on to something more serious, let us know sooner rather than later so we can help you.
In terms of accessing sexual health services, there are many ways you can do this. We offer the services within Bupa and you can also access the service within the NHS as well. Some people like to go to a walk-in service where they can turn up and wait for an appointment; others prefer to book an appointment in advance, and that way they know when they're going to be seen and can arrive at the clinic in an appropriate time frame as well.
I'd also say there's nothing to be ashamed or embarrassed about. We have seen and heard all the symptoms before. The kind of things people come to us with range from pain during intercourse, a discharge either from the penis or the vagina, or other symptoms such as abdominal pain, a sore throat, or other things that could occur after an infection is acquired.
So whatever it might be, let us do the detective work for you. Let us know what your symptoms are. Feel free to bring someone with you if you'd like, write your problems down so you can then discuss them with us, or use the language you want to as well. We don't expect you to know the medical terms of things—we can help you with that as well. And hopefully, together, we can get to the bottom of whatever your issue is and provide you with an appropriate course of treatment or indeed cure, if that's available as well.
Symptoms of PID
Pelvic inflammatory disease (PID) symptoms can be very mild or you may not have any symptoms at all.
If you do get PID symptoms, they may include:
- a dull, cramping or aching pain in your lower tummy – this might be on one or both sides or just on the upper right side
- an unusual vaginal discharge – it may be smelly
- bleeding between your periods or after you have sex
- uncomfortable or painful sex
- painful periods
- heavy periods
- a high temperature (over 38°C) (although your temperature may be normal)
- feeling or being sick
These symptoms can be caused by other health conditions, such as endometriosis or cystitis. But if you have them, it’s a good idea to get them checked by your GP or your local sexual health clinic. If you have pelvic inflammatory disease, it’s important to start treatment as soon as possible because treatment will reduce your chance of complications.
Diagnosis of PID
To diagnose pelvic inflammatory disease (PID), your GP will ask about your symptoms and your medical and sexual history. They’ll ask to examine your vagina to check for signs of a pelvic infection.
Your GP may take some samples (swabs) from inside your vagina and cervix to test for bacteria and sexually transmitted infections. This is like having a cervical smear test and it may feel uncomfortable. But it’s important to get tested so you can get the treatment you may need.
You may have some other tests including:
- blood test to check for infection
- urine test for chlamydia (using a sample of pee)
- urine test to rule out a urine infection
- pregnancy test – the tummy pains due to PID are similar to those of an ectopic pregnancy
If your symptoms are very bad, your GP may advise you to go to hospital for more urgent treatment.
If your GP isn’t sure if you have PID, they may refer you to a specialist. for more tests. The tests that a specialist might do include:
- a transvaginal ultrasound scan, which creates a picture of the inside of your pelvis
- a laparoscopy, which is a keyhole procedure to look at your fallopian tubes, ovaries and womb
- more blood tests
- an MRI or CT scan
Treatment of PID
How can I treat pelvic inflammatory disease at home?
If you have pelvic inflammatory disease (PID), you’ll need to see a GP for treatment with antibiotics.
If your symptoms are bad, get plenty of rest until you feel better. If you’re in pain, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine. If you have any questions, ask a pharmacist for advice.
What antibiotics treat pelvic inflammatory disease?
Pelvic inflammatory disease (PID) treatment is with antibiotics, usually two or more different types. Your doctor will probably advise you to start taking antibiotics straightaway, rather than wait for test results. This is because the long-term effects of pelvic inflammatory disease can be serious, so it's best to start PID treatment as soon as possible.
Your GP might prescribe antibiotic tablets, such as doxycycline or metronidazole, which you’ll usually need to take for 14 days. It’s important to finish the whole course of antibiotics, even if you feel better, to make sure the infection clears up.
Make sure you (and your partner if you have one) finish the antibiotics before you have sex again (including oral sex). Or use a barrier method of protection, such as a condom.
If you don’t get better or your symptoms get worse after you’ve been taking antibiotics for two to three days, speak to your GP. You may need to go to hospital to have antibiotics through a drip.
If you have an intrauterine device (IUD) and antibiotics haven’t started to help after three days, your GP may suggest you have the IUD taken out.
If you’re pregnant, you’ll need to go to the hospital for antibiotics through a drip.
Surgery
If you have a severe infection or if antibiotics through a drip don’t work, you may need to have a keyhole surgery procedure. This is to drain infection from your fallopian tubes and wash out any infected fluid within your pelvis. Sometimes the infection can be drained using a needle with ultrasound scan to guide them to the right spot.
Treating sexual partners
If you have pelvic inflammatory disease, your GP will test you for sexually transmitted infections (STIs), such as chlamydia and gonorrhoea. They’ll also ask you to tell any sexual partner (any you’ve had in the last six months) that you have pelvic inflammatory disease. Your past and present partners need to get tested and treated for these infections too. Staff at a sexual health clinic can contact your past partners for you.
Complications of PID
If pelvic inflammatory disease (PID) isn’t treated or isn’t treated quickly, it can cause complications. These include the following.
- An abscess (a collection of pus) can form in your ovary or fallopian tube.
- Ectopic pregnancy. A fertilised egg can implant outside your womb, usually in one of your fallopian tubes.
- Infertility. If PID damages your fallopian tubes, you may find it harder to get pregnant. PID is more likely to affect your fertility if it’s very bad or you’ve had it a number of times.
- Long-term pain in your pelvis (chronic pelvic pain). This may be related to inflammation, scarring and adhesions from PID.
Why is an ectopic pregnancy more likely if I have PID?
If you get pelvic inflammatory disease (PID), it can make an ectopic pregnancy more likely because of damage to your fallopian tubes from PID. This can make them narrower or block them completely. A fertilised egg can get stuck inside the tube and begin to grow and develop there. If you could be pregnant and have bleeding from your vagina or pain in your tummy, get medical help straightaway.
Prevention of PID
To prevent pelvic inflammatory disease (PID), you need to avoid getting a sexually transmitted infection (STI). Use safe sex contraception such as condoms.
- If your sexual partner is diagnosed with an STI or pelvic inflammatory disease, get tested too. And treated, if necessary.
- Don’t have sex with your partner until you’ve both finished your treatment for pelvic inflammatory disease or any STI.
- Regularly get tested for common STIs such as chlamydia.
- If you take antibiotics for pelvic inflammatory disease, make sure you finish the full course.
Who can pass on PID?
Pelvic inflammatory disease is commonly caused by a sexually transmitted infection (STI). Anyone with an STI can pass on the infection. So, it’s important to use condoms to prevent passing on STIs. Some people get symptoms of STIs, but many don’t. So, if you think you could have caught an STI, get tested.
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Pelvic inflammatory disease (PID) is almost always triggered or caused by a sexually transmitted infection (STI). It’s often an infection with chlamydia or gonorrhoea although other infections can also cause PID. The bacteria can move up from your vagina or cervix to your womb, fallopian tubes and ovaries, and cause PID.
For more information, see our section on causes of pelvic inflammatory disease.
You might not know you have pelvic inflammatory disease (PID) because symptoms can be very mild, or you might not have any symptoms. PID symptoms include pain in your tummy and an unusual vaginal discharge, which may smell. You may also feel pain when you have sex.
For more information, see our section on symptoms of pelvic inflammatory disease.
Pelvic inflammatory disease (PID) is treated with antibiotics, which will usually clear the infection up within 14 days. If you have a severe infection or antibiotics don’t work, you may need surgery. However, if PID isn’t treated or isn’t treated quickly, it can cause complications such as an abscess or chronic pelvic pain.
For more information, see our section on complications of pelvic inflammatory disease.
Antibiotics
Common vaginal infections
Female infertility
Getting pregnant (conceiving) often takes a while.
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