Pelvic Inflammatory Disease

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What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs, including the uterine lining, ovaries, and fallopian tubes. It may produce severe symptoms, including pain and reproductive dysfunction.

Pelvic inflammatory disease is a common disease that affects nearly one million women each year. It appears most frequently in women who are younger than 20 years old. About one in every eight women in this age range develops PID (Source: NIH).

PID is commonly caused by bacteria from a sexually transmitted disease, such as Chlamydia or gonorrhea. The bacteria spread through the vagina after sexual contact with an infected person and then move up into the uterus, fallopian tubes, or ovaries, eventually infecting the reproductive system. Non-sexual contact does not spread the disease. Less commonly, the bacteria that cause pelvic inflammatory disease can enter the body when an intrauterine device is implanted or during a procedure related to an abortion, a miscarriage, or an endometrial biopsy.

Women with pelvic inflammatory disease may not experience any symptoms, or symptoms may be mild. Typically, the disease is detected when complications arise, such as severe symptoms, infertility, or ectopic pregnancy (life-threatening pregnancy growing outside the uterus). The most common symptoms of pelvic inflammatory disease include abdominal pain, vaginal discharge, and fever. More severe symptoms may include painful sexual intercourse, painful urination, fatigue, and nausea with or without vomiting. Antibiotic therapy is the treatment for PID and can prevent serious complications.

Left untreated, pelvic inflammatory disease can lead to potentially life-threatening complications. Severe infection can occur, resulting in shock, coma, and even death. Seek immediate medical care (call 911) if you have symptoms of severe infection, such as confusion, lethargy, loss of consciousness, high fever (higher than 101 degrees Fahrenheit), rapid heart rate, weak pulse, difficulty breathing, or reduced urine production.

What are the symptoms of pelvic inflammatory disease?

You may not experience any symptoms with pelvic inflammatory disease (PID); however, because the disease causes inflammation of the reproductive organs, a number of symptoms may occur. The symptoms can vary in intensity among individuals.

Common symptoms of pelvic inflammatory disease

Common symptoms that may occur with PID include:

Other symptoms of pelvic inflammatory disease

Other symptoms that may occur with PID include:

Serious symptoms that might indicate a life-threatening condition

In some cases, infection resulting from pelvic inflammatory disease is so severe that a life-threatening situation may develop within hours. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Fast heart rate (tachycardia)

  • High fever (higher than 101 degrees Fahrenheit)

  • Greatly reduced or no urine output

  • Rapid breathing rate (tachypnea)

  • Weak pulse

What causes pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is infection of the female reproductive organs. The disease is most commonly caused by bacteria from a sexually transmitted disease, such as Chlamydia or gonorrhea, which spread through the vagina after sexual contact with an infected person. These bacteria then spread to the uterus, fallopian tubes, or ovaries, eventually infecting the reproductive system. Less commonly, the bacteria that cause PID can enter the body when an intrauterine device is implanted or during a procedure related to an abortion, childbirth, a miscarriage, or an endometrial biopsy.

What are the risk factors for pelvic inflammatory disease?

A number of factors increase the risk of developing pelvic inflammatory disease (PID). Not all people with risk factors will develop the disease. Risk factors include:

  • Age less than 25 years

  • Intrauterine device

  • Multiple sex partners

  • Previous history of pelvic inflammatory disease or sexually transmitted disease

  • Regular vaginal douching

  • Sexual intercourse with a male infected with Chlamydia or gonorrhea

  • Unprotected sexual intercourse

Reducing your risk of pelvic inflammatory disease

You can reduce your risk of developing pelvic inflammatory disease by:

  • Abstaining from sexual intercourse

  • Engaging in a monogamous relationship with a partner who has been screened for sexually transmitted infections

  • Practicing safe sex

  • Using a condom consistently and correctly

  • Submitting to a yearly Chlamydia screening if you are sexually active, change sex partners, or are pregnant

How is pelvic inflammatory disease treated?

Treatment for pelvic inflammatory disease (PID) begins with seeking medical care from your health care provider.

  • If you are experiencing symptoms and think you might have been exposed to a sexually transmitted disease, such as Chlamydia or gonorrhea, or if you think you have PID, contact your health care provider. PID is usually treated with antibiotic therapy. Because the disease may be caused by several different bacteria, two different antibiotics are normally prescribed. With proper antibiotic therapy, PID can be successfully eliminated. Left untreated, however, PID can produce serious complications.

  • Your health care provider will prescribe antibiotics to reduce the duration of the infection and lessen the severity of your symptoms.

Antibiotics for pelvic inflammatory disease

Antibiotics used to treat pelvic inflammatory disease include:

  • Azithromycin (Zithromax)
  • Ceftriaxone (Rocephin)
  • Cefuroxime (Ceftin)
  • Erythromycin (E-Mycin, E.E.S., Ery-Tab)
  • Metronidazole (Flagyl)
  • Tetracycline (Brodspec, Emtet-500, Ala-Tet)

What are the potential complications of pelvic inflammatory disease?

Severe pelvic inflammatory disease has the potential to cause serious damage to female reproductive organs. Fortunately, such damage can be prevented by prompt treatment with antibiotics. Left untreated, pelvic inflammatory disease can cause serious complications including:

  • Adverse effects of treatment

  • Chronic pain

  • Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)

  • Infertility

  • Recurrent infections

  • Scarring within reproductive organs

  • Spread of infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 30
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Pelvic inflammatory disease (PID) - CDC fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/pid/stdfact-pid.htm
  2. Pelvic inflammatory disease (PID). Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000888.htm
  3. Pelvic Inflammatory Disease (PID). Merck Manual. https://www.healthgrades.com/conditions/pelvic-inflammatory-disease