Pelvic Inflammatory Disease

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is a condition where your reproductive organs become inflamed. Your reproductive organs include your ovaries, fallopian tubes, uterus, cervix (lower area of your uterus), and vagina. PID may cause chronic (long-term) abdominal pain and problems with future pregnancies.

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: Your vagina normally has different types of bacteria which do not usually harm your body. If one or more of the normal vaginal bacteria suddenly increase, you may get a vaginal infection. A vaginal infection may then lead to PID.

  • Sexually transmitted infections (STIs): 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 caregiver for more information about STIs.

What increases my risk for PID?

  • Sexual history or behavior: The following may increase your risk for an STI, which may cause PID:

    • You have a new sexual partner within the last 3 months.

    • You have had an STI or PID in the past.

    • You have more than one sexual partner at a time.

    • You started to have sex at a young age.

  • Uterine procedures: Uterine procedures may damage your cervix. Your cervix helps block germs from entering into your reproductive organs. Any of the following procedures may increase your risk for PID:

    • Abortion

    • Hysterosalpingography (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 (having an egg fertilized outside your womb and placed into your uterus)

What are the signs and symptoms of PID?

You may not have any symptoms with PID. If you do have signs or symptoms, you may have any of the following:

  • 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 caregiver will ask you about your health and sexual history. Tell your caregiver if you have other medical conditions or if you have had past surgeries or procedures. Tell your caregiver about any STIs that you or your partner may have. Your caregiver may order a pregnancy test as well as any of the following:

  • Bimanual vaginal exam: Your caregiver will insert 2 gloved fingers into your vagina and place his other hand on your abdomen. Your caregiver will feel for your cervix and ovaries while pressing down lightly on your abdomen. If you feel pain, you may have PID.

  • Biopsy: During a biopsy, your caregiver will take a tissue sample from the lining of your uterus. The sample is then checked for signs of inflammation.

  • Blood and urine tests: You may need blood and urine tests to check for infection. The tests may also show if another condition is causing your symptoms.

  • Culture or smear test: A sample of discharge from your vagina or cervix may be taken for testing. The culture or smear test may help your caregiver learn what germ is causing your PID.

  • Ultrasound: This test uses sound waves to show pictures of your organs and tissues on a monitor. You may have an abdominal, transvaginal, or Doppler ultrasound.

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

How is PID treated?

  • Antibiotics: This medicine helps fight infection caused by bacteria. Your caregiver may have you start this medicine before your test results are back to prevent worsening of your symptoms. Tell your caregiver if you are pregnant or if you have allergies to any antibiotics.

  • Pain medicine: You may be given medicine to take away or decrease your pain.

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

How can I decrease my chances of getting 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 of having another STI in the future.

  • 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.

  • Limit your sexual partners: Avoid having more than one sexual partner at a time to decrease your risk of an STI.

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

What are the risks of PID?

  • You may have an allergic response to the medicine used to treat your PID. Surgery used to diagnose or treat your PID may cause an infection. There is a risk your treatment will not work. Even with treatment, your symptoms may get worse, and you may need to start a different treatment.

  • If you do not treat your PID, your condition may get worse. The infection may spread to your liver or other organs. When this happens, the pain in your lower abdomen may worsen or become chronic (long-term). You may also get a blood infection that causes severe illness. PID may damage your reproductive organs and make it hard for you to get pregnant. PID may increase your risk for an ectopic (outside the uterus) pregnancy or premature delivery of your baby.

Where can I find more information?

  • Centers for Disease Control and Prevention
    1600 Clifton Road
    Atlanta , GA 30333
    Phone: 1- 800 - 232-4636
    Web Address: http://www.cdc.gov
  • The American College of Obstetricians and Gynecologists
    P.O. Box 70620
    Washington , DC 20024-9998
    Phone: 1- 202 - 638-5577
    Phone: 1- 800 - 673-8444
    Web Address: http://www.acog.org

When should I contact my caregiver?

Call your caregiver if:

  • You have nausea or 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.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • 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.

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.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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