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Pelvic Inflammatory Disease

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is a condition that causes your reproductive organs to become inflamed. Your reproductive organs include your ovaries, fallopian tubes, uterus, cervix (lower area of your uterus), and vagina.

What causes PID?

PID is an infection caused by bacteria or viruses. The infection may start in your vagina and spread upward through your cervix. The infection may then spread to your uterus and into your tubes and ovaries. PID may also spread to other areas of your abdomen. Causes of PID include the following:

  • Vaginal infections develop when the normal vaginal bacteria suddenly increase. A vaginal infection may then lead to PID.

  • Sexually transmitted infections (STIs) are spread by having sex with an infected partner. STIs that commonly cause PID are gonorrhea, chlamydia, and cytomegalovirus (CMV). PID often occurs if an STI is not treated. Ask your healthcare provider for more information about STIs.

What increases my risk for PID?

Uterine procedures may damage your cervix. Your cervix helps block germs from entering into your reproductive organs.

  • A new sexual partner within the last 3 months, or more than 1 partner

  • Past STI or PID

  • Sex at a young age

  • Abortion

  • An x-ray of your uterus and tubes using an injection of dye

  • Intrauterine device (IUD) insertion within the past month

  • Intrauterine insemination (injecting sperm directly into your uterus)

  • In vitro fertilization

What are the signs and symptoms of PID?

  • Fever

  • Nausea or vomiting

  • Pain during sex, especially if your PID is new

  • Lower abdominal or back pain

  • Green or yellow discharge from your vagina that may have an unusual or bad smell

  • Vaginal bleeding or spotting during or after sex or bleeding in between your monthly periods

How is PID diagnosed?

Your healthcare provider will ask about your health and sex history. Tell your healthcare provider if you have other medical conditions or if you have had past surgeries or procedures. Tell your healthcare provider about any STIs that you or your partner may have. You may be given a pregnancy test as well as any of the following:

  • Bimanual vaginal exam is used to examine your cervix and ovaries. Your healthcare provider will insert 2 gloved fingers into your vagina and place the other hand on your abdomen. Your healthcare provider will feel for your cervix and ovaries while pressing down lightly on your abdomen. If you feel pain, you may have PID.

  • A biopsy is used to take a sample of tissue from your uterus to be checked for signs of inflammation.

  • Blood and urine tests may be used to check for infection. The tests may also show if another condition is causing your symptoms.

  • A culture or smear test may help your healthcare provider learn which germ is causing your PID. A sample of discharge from your vagina or cervix may be taken for testing.

  • Ultrasound is used to take pictures of your organs and tissues. You may have an abdominal, transvaginal, or Doppler ultrasound.

  • Laparoscopy is surgery to look directly at your uterus, ovaries, and fallopian tubes. A scope is put into your abdomen through a small incision. You may have one or more incisions in or below your bellybutton. Ask your healthcare provider for more information about this surgery.

How is PID treated?

  • Antibiotics are given to fight a bacterial infection. You will get the antibiotics through an IV for several days.

  • Surgery may be needed to treat problems related to PID. If you have an abscess on your tubes or ovaries, you may need surgery to drain it. Ask your healthcare provider for more information about surgeries or other procedures you may need.

What can I do to manage PID?

  • Finish your treatment. If you do not finish your treatment for PID, your infection may not go away. You may also have an increased risk for another STI in the future.

  • Do not have sex until your healthcare provider says it is okay. You will need to finish treatment before it is safe to have sex.

  • Do not have unprotected sex. Always use a latex condom. Do not have sex while you or your partners are being treated for an STI.

  • Talk to your sex partners. If you have an STI, tell your recent partners. Tell them to see a healthcare provider for testing and treatment. This will help stop the spread of infection to others or back to you.

What are the risks of PID?

PID may cause chronic abdominal pain and problems with future pregnancies. PID may increase your risk for an ectopic (tubal) pregnancy or premature delivery of your baby. PID may damage your reproductive organs. Treatment may not work. Even with treatment, your symptoms may get worse, and you may need to start a different treatment.

When should I seek immediate care?

  • You have chills or a high fever.

  • You have pain in your upper right abdomen.

  • You have pain in your lower abdomen that does not go away with rest or medicine.

  • Your symptoms get worse or do not improve after 3 days of treatment.

When should I contact my healthcare provider?

  • You have nausea or are vomiting.

  • Your skin is red, itchy, or you have a new rash.

  • You think or know you are pregnant.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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