What is PID?

Pelvic inflammatory disease (PID) is a serious infection in the upper genital tract/reproductive organs (uterus, fallopian tubes and ovaries) of a female. PID can be sexually transmitted or naturally occurring. It can lead to infertility in women (unable to have children) or life-threatening complications.

How common is PID?

Sexually active women in their childbearing years are most at risk, and those under 25 are more likely to develop PID than those older than 25. This is because the cervix of teenage girls and young women is not fully matured, increasing their susceptibility to the STDs that are linked to PID. In the United States, PID is the leading cause of infertility in women.

How can I get PID?

Two sexually transmitted diseases (STDs), chlamydia and gonorrhea, are the most common causes of PID. Other bacteria or germs can also cause PID. If you have an infection in the genital tract and do not get treated right away, it can cause PID. The infection spreads from the cervix into the uterus, fallopian tubes and ovaries. It can take anywhere from several days to several months after being infected to develop PID.

What can cause an infection to spread into the upper genital tract?

• Using an IUD (intrauterine device)
  
  
• Bacteria (germs)
  
  
• Douching. Women who douche once or twice a month are more likely to have PID than those who douche less than once a month. Douching may also ease symptoms of an infection, thus delaying effective treatment.

What are the symptoms of PID?

• Dull pain or tenderness in the lower abdomen
  
  
• Nausea and vomiting
  
  
• Bleeding between menstrual periods
  
  
• Increased or changed vaginal discharge
  
  
• Pain during sex
  
  
• Fever and chills

It is possible for a woman to have PID and be asymptomatic (without symptoms), or symptoms too mild to notice, for an unknown period of time.

PID can also be misdiagnosed as appendicitis, ectopic pregnancy, ruptured ovarian cysts or other problems.

How can I find out if I have PID?

The diagnosis of PID can be made when all three of the following symptoms are found during a pelvic exam:

• Lower abdominal tenderness
  
  
• Tenderness of fallopian tubes and ovaries
  
  
• Tenderness of the cervix

All other explanations for these findings must have been ruled out.

What is the treatment and follow up for PID?

Treatment may include antibiotics used to treat gonorrhea, chlamydia, streptococci and other gram-negative bacteria.

Aggressive treatment of PID is recommended for women with HIV who may be more likely to require surgical intervention.

Sex partners of patients who have PID should be examined and treated promptly.

Follow-up:

• Take all medications as directed.
  
  
• Set up a follow-up exam 48 to 72 hours after start of treatment to make sure the medicine is working.
  
  
• Return for another exam after completion of treatment to make sure the infection is completely gone.
  
  
• Tell your partner to get tested and treated.
  
  
• Do not have sex until you and your partner(s) have been treated and cured.

However, antibiotic treatment does not reverse any damage that has already occurred to the reproductive organs.

What can I do to reduce my risk of getting PID?

• Abstain (do not have sex).
  
  
• Latex condoms, when used consistently and correctly, can reduce the risk of transmission of STDs that may cause PID.
  
  
• Mutual monogamy (have sex with only one uninfected partner who is only having sex with you). Multiple sex partners can increase your risk for getting any STD and developing PID.
  
  
• Have regular check-ups if you are sexually active. CDC recommends yearly chlamydia testing of all sexually active women age 25 or younger and of older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners).
  
  
• If you have an STD, do not have sex (oral, vaginal or anal) until all partners have been treated and cured. Treatment and follow-up are important steps in breaking the disease cycle.
  
  
• If you have symptoms of PID or an STD get treated right away.

Why worry about PID?

Untreated PID infections may lead to:

• Infertility. As many as 10 percent of women with PID will not be able to have children as a result of scarring or damage to cells lining the fallopian tubes.
  
  
• Cystitis (inflammation of the urinary bladder)
  
  
• Ectopic (tubal) pregnancy (a pregnancy in the fallopian tube or elsewhere outside the womb)
  
  
• Recurrent episodes of PID
  
  
• Chronic pelvic pain

Hospitalization to treat PID may be recommended if the woman (1) is severely ill, e.g., nausea, vomiting, and high fever); (2) pregnant; (3) does not respond to or cannot take oral medications and needs intravenous antibiotics; (4) or has an abscess in the fallopian tube or ovary. If symptoms continue or if an abscess does not go away, surgery may be needed.

Do I need to talk to my partner about PID?

Yes. Telling a partner can be hard, but keep in mind that most people with an STD don't know they have it. It's important that you talk to your partner as soon as possible so she or he can get treatment. Men are more likely than women to have symptoms of chlamydia or gonorrhea (two STDs that cause PID). It is possible to pass STDs back and forth, so if you get treated and your partner doesn't, you may get infected again.

Should I talk to my health care provider about PID?

Yes. Because STDs which can cause PID often do not have symptoms, you may need to talk to your doctor or nurse about whether or not you should be tested. If you are having unprotected sex or discover that your partner is having unprotected sex with another person, you may want to ask your doctor or nurse about being tested.

Where can I get more information?

Illinois Department of Public Health
HIV/STD Hotline 800-243-2437 (TTY 800-782-0423)

Centers for Disease Control and Prevention (CDC)
CDC-INFO Hotline (24 hours, 7 days a week)
STD information and referrals to STD Clinics
800-CDC-INFO (800-232-4636)
TTY: 888-232-6348
In English, en Español

CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
800-458-5231
888-282-7681 Fax
800-243-7012 TTY
E-mail: info@cdcnpin.org

American Social Health Association (ASHA)
P. O. Box 13827
Research Triangle Park, NC 27709-3827
800-783-9877