Pelvic Inflammatory Disease

Definition

Pelvic inflammatory disease (PID) is a serious infection of the female reproductive organs. This includes the uterus, ovaries, and fallopian tubes. PID can cause scar tissue to form in the pelvis and fallopian tubes. This damage may result in infertility , a future tubal pregnancy , or chronic pelvic pain.

Female Reproductive System Organs

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Causes

PID may be caused by a variety of bacteria. The most common bacteria that initiate PID are gonorrhea and chlamydia .

Risk Factors

PID is most common in women aged 15-24 years. Other factors that may increase your chance of PID include:

• Current or previous sexually-transmitted disease (STD)
• Multiple sex partners
• Sexual intercourse with a partner who has an STD
• Intercourse without the protection of a condom
• Having an intrauterine device (IUD) recently insterted for birth control

Symptoms

Women with PID do not always have symptoms. If symptoms do occur, they may include:

• Pain in the lower abdomen
• Vaginal discharge with a foul odor
• Fatigue
• Fever
• Nausea or vomiting
• Painful intercourse
• Painful urination
• Vaginal bleeding

Diagnosis

Because symptoms are often subtle or nonexistent, PID can be difficult to diagnose. There are no specific tests for PID.

If PID is suspected, you will be asked about your symptoms, as well as your sexual history, partners, and birth control methods. A physical and pelvic exam will be done. The pelvic exam is key to making the diagnosis. Samples from the vagina or cervix may be taken to help diagnose the problem.

Tests may include:

• Cultures of the cervix to test for STDs
• Blood tests to check pregnancy status, and signs of infection
• Laparoscopy—insertion of a thin, lighted telescopic tube through a small incision in the abdomen to look at the reproductive organs

Imaging tests may be done with ultrasound or MRI scan .

Treatment

The primary treatment for PID is antibiotics. More than 1 antibiotic may be prescribed to treat the problem. Finish the entire dose of each medication, even if your symptoms disappear during treatment.

You may be hospitalized if the diagnosis is uncertain, you do not improve, or your symptoms are severe. In the hospital, antibiotics can be given by IV. In certain situations, surgery may be required to remove infected or damaged tissue.

Prevention

To help reduce your chance of PID:

• Use a latex condom each time you have sexual intercourse.
• Discuss birth control options with your doctor. Ask which methods may decrease your risk of PID.
• Seek immediate treatment for symptoms, such as unusual vaginal discharge or bleeding.
• Limit your number of sexual partners.
• Have regular screening tests for STDs.

If you are diagnosed with PID or another STD:

• Do not have sexual intercourse until after the treatment is complete, symptoms have resolved, and your sexual partner has been treated.
• Notify all sexual partners. They will also need to be treated.