Pelvic Inflammatory Disease

What is pelvic inflammatory disease?

From: MedlinePlus, National Library of Medicine

Pelvic inflammatory disease (PID) is an infection of the uterus, ovaries, and other female reproductive organs. PID causes scarring in these organs. This can lead to infertility, ectopic pregnancy, pelvic pain, abscesses (a collection of pus), and other serious problems. PID is the most common preventable cause of infertility in the United States.

What causes pelvic inflammatory disease?

From: MedlinePlus, National Library of Medicine

Many types of bacteria can cause PID, but it's often caused by sexually transmitted infections (STIs). Gonorrhea and chlamydia are the most common causes of PID.

You are at greater risk for PID if you:

• Are sexually active and younger than age 25.
• Have more than one sex partner.
• Douche. Douching can push bacteria into your reproductive organs. It may also hide the signs of PID.
• Have an STI and do not get treated.
• Have had PID or an STI before.

It's not as common, but sometimes using an intrauterine device (IUD) for birth control can increase your risk for PID. However, your risk is usually only during the first three weeks after the IUD is placed inside your uterus.

What are the symptoms of pelvic inflammatory disease?

From: MedlinePlus, National Library of Medicine

If you have PID, you may have mild or no symptoms. If you do have symptoms, the most common symptom is pain in the lower abdomen (belly). Other symptoms can include:

• Fever
• Foul-smelling vaginal discharge
• Bleeding between periods
• Pain or bleeding during sex
• Painful urination (peeing)

See your health care provider if you have any symptoms of PID or if you think you or your partner were exposed to an STI. Early treatment is important. Waiting too long for treatment increases the risk of infertility.

How is pelvic inflammatory disease diagnosed?

From: MedlinePlus, National Library of Medicine

There is no one test for PID. To check for PID, your provider may:

• Ask about your medical and sexual history
• Review your symptoms
• Do a pelvic exam
• Order blood, urine, and imaging tests

What is the treatment for pelvic inflammatory disease?

From: MedlinePlus, National Library of Medicine

Antibiotics are used to treat PID. You must take all the medicine, even if your symptoms go away to make sure the infection is cured. You will likely need to follow up with your provider to make sure the treatment is working.

Tell your recent sex partner(s) so they can get tested and treated. Don't have sex until you finish treatment, otherwise you can reinfect each other.

If you're pregnant, have an abscess, or your symptoms don't go away, you may need to have surgery or be hospitalized for treatment.

Treatment cannot fix any permanent damage already done to your internal organs.

If you don't get treated, complications can occur, such as:

• Scar tissue may develop in your fallopian tubes.
• Infertility.
• An abscess may develop in your reproductive organs. If untreated, this could become a life-threatening infection.
• Long-term pelvic or abdominal (belly) pain.

Can pelvic inflammatory disease be prevented?

From: MedlinePlus, National Library of Medicine

The best way to protect yourself against STIs is not to have sex.

If you do decide to have sex, a few ways you can lower your risk include to:

• Practice safe sex by using a condom every time you have sex, limit your number of sex partners, and ask your partners about their sexual history.
• Get tested for chlamydia and gonorrhea every year and ask your partner to get tested.
• Don't douche since this can upset the balance of bacteria in your vagina.

Which doctor should you see?

The suggested department for discussing Pelvic Inflammatory Disease is Obstetrics and Gynaecology, with a obstetrician-gynaecologist as the relevant type of clinician. Obstetrician-gynaecologist; paediatric services for children as appropriate.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• How do age, pregnancy status and reproductive goals affect the assessment?
• Which changes in bleeding, pain or general health need prompt review?
• What are the benefits and risks of the available options in this situation?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.