What is Pelvic Inflammatory Disease?
Pelvic Inflammatory Disease (PID) is a serious infection that affects the female reproductive organs, including the uterus, fallopian tubes, and ovaries. It occurs when bacteria from the vagina or cervix travel upwards into the reproductive system, causing inflammation and potentially leading to long-term health complications.
What is Pelvic Inflammatory Disease?
Pelvic Inflammatory Disease (PID) is an infection and inflammation of the upper female reproductive organs. It occurs when harmful bacteria enter the uterus, fallopian tubes, or ovaries, causing irritation, swelling, and potential scarring. The condition can develop suddenly with acute symptoms or progress gradually with mild signs that may be overlooked.
PID is most commonly linked to sexually transmitted infections (STIs), but it can also develop from other bacterial infections.
PID can affect women of any age but is most common in those who are sexually active and under the age of 25. Many women with PID experience noticeable symptoms such as pelvic pain, abnormal vaginal discharge, and fever, while others may have mild or no symptoms at all, making diagnosis challenging. If left untreated, PID can lead to serious consequences, including infertility and chronic pelvic pain.
According to GOV.UK, in the UK, hospital admission rates for PID have remained fairly stable since 2011. In the financial year ending 2024, the admission rate for PID stood at 247.5 per 100,000 cases.
Awareness, early detection, and timely treatment are essential to managing PID effectively. Understanding its causes, symptoms, and prevention methods can help women protect their reproductive health and avoid complications.
This article provides an in-depth look at PID, including when to seek medical attention, common causes, available treatments, potential complications, and strategies for prevention.
However, you should always seek advice from a medical professional if you are worried about PID.
PID Symptoms
PID symptoms vary widely, some women may have only mild discomfort or no symptoms at all. This makes regular sexual health check-ups and early STI testing essential for early detection and treatment.
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Lower abdominal or pelvic pain: Pain is one of the most common symptoms of PID. It may be mild or severe and is often described as a dull or aching discomfort that worsens during sexual activity or urination. Some women experience sharp, stabbing pain that can interfere with daily activities.
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Unusual vaginal discharge: PID often causes abnormal vaginal discharge that may be yellow, green, or foul-smelling. This is due to the presence of infection and inflammation in the reproductive tract.
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Pain during intercourse: Many women with PID experience discomfort or pain during or after sexual intercourse. This symptom occurs due to inflammation and irritation of the reproductive organs, making movement painful.
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Fever and chills: An infection in the reproductive organs can lead to fever, chills, and general flu-like symptoms. A high fever, especially if accompanied by severe pain, should be evaluated by a doctor immediately.
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Painful urination: Some women with PID report pain or a burning sensation when urinating. This symptom can be mistaken for a urinary tract infection (UTI), but in cases of PID, the bacteria may have affected the bladder or surrounding areas.
When to Seek Medical Advice
Seeking medical attention as soon as you experience symptoms suggestive of PID is crucial for preventing complications. Early diagnosis and treatment can help preserve reproductive health and prevent further spread of infection.
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Severe abdominal pain: If you experience intense or persistent lower abdominal pain, especially if it worsens with movement or sexual activity, you should see a doctor immediately. Severe pain may indicate advanced PID or complications such as an abscess.
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High fever: A fever above 38°C (100.4°F) is a sign of a serious infection that requires medical attention. If fever is accompanied by chills and extreme fatigue, it could indicate that the infection is spreading.
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Fainting or dizziness: Lightheadedness or fainting can indicate that the infection has become severe and requires urgent care. These symptoms should never be ignored.
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Vomiting or nausea: Persistent nausea and vomiting could suggest a worsening infection. If you are unable to keep fluids down, dehydration may become a concern, necessitating hospital treatment.
Delaying treatment can increase the risk of long-term health complications. If you experience any of these symptoms, consult a healthcare provider, such as your GP or a sexual health clinic, as soon as possible. Early intervention can help prevent infertility, ectopic pregnancy, and chronic pelvic pain.
However, if you do have multiple partners it is advised that you have frequent STI check ups.
Causes of PID
PID is most commonly caused by bacterial infections that spread from the lower reproductive tract to the upper reproductive organs. The most frequent sources of these infections include:
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Sexually Transmitted Infections (STIs): STIs, particularly chlamydia and gonorrhea, are the leading causes of PID. These infections can sometimes go unnoticed because they do not always present with symptoms. When left untreated, these bacteria travel from the vagina and cervix to the uterus and fallopian tubes, where they trigger an inflammatory response. The longer an STI remains untreated, the higher the likelihood that it will lead to PID. Because STIs are often asymptomatic, regular testing is crucial for early detection and treatment.
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Bacterial Vaginosis (BV): Bacterial vaginosis is a common vaginal infection that occurs when the natural balance of bacteria in the vagina is disrupted. This imbalance creates an environment that makes it easier for harmful bacteria to multiply and spread into the reproductive system. Women with recurrent episodes of BV have a higher risk of developing PID, particularly if they are also exposed to STIs or other infections. Reducing the risk of BV by maintaining good hygiene and avoiding douching can help prevent PID.
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Childbirth or miscarriage: The reproductive system is particularly vulnerable to infection after childbirth, miscarriage, or abortion. During these events, the cervix naturally dilates, creating an opening for bacteria to enter the uterus. If proper medical care is not followed, an untreated infection can spread into the fallopian tubes and ovaries, leading to PID. Women who experience prolonged or heavy bleeding, foul-smelling discharge, or fever after childbirth or a miscarriage should seek immediate medical attention to rule out infection.
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Intrauterine Device (IUD) insertion: While rare, the insertion of an intrauterine device (IUD) for contraception can introduce bacteria into the uterus, leading to infection and increasing the risk of PID. The risk is highest within the first few weeks of insertion. To minimise this risk, many healthcare providers recommend screening for STIs before inserting an IUD. If a woman develops symptoms of an infection shortly after IUD placement, it is important to seek medical advice to determine if treatment is needed.
Understanding these risk factors can help women take precautions to prevent PID. Using protection during sex, attending regular STI screenings, and maintaining good hygiene can reduce the risk of infection.
To learn more about condoms, head on over to our Condoms Guide.
Treatment for PID
The main goal of PID treatment is to eliminate the infection and prevent long-term complications. Treatment usually involves:
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Antibiotic Therapy: Doctors prescribe a combination of antibiotics to target the bacteria responsible for PID. It is crucial to complete the entire course of medication, even if symptoms improve, to ensure the infection is fully eradicated.
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Partner Notification and Treatment: If an STI caused PID, sexual partners should be tested and treated to prevent reinfection. Abstaining from sexual activity until treatment is complete is also recommended.
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Hospitalisation: In severe cases, hospitalisation may be necessary for intravenous antibiotics and close monitoring. Surgery may be required if an abscess forms or if the infection does not respond to antibiotics.
Prompt and complete treatment is essential to prevent complications such as infertility and chronic pelvic pain.
