This site uses cookies to store information on your computer. I'm fine with this Cookie information
QUICK EXIT

Pelvic Inflammatory Disease

What is pelvic inflammatory disease?

This is an inflammation affecting the organs in the pelvis. This is usually caused by an infection that spreads from the vagina through the cervix (the entrance to the womb) to the uterus (womb) and then up higher through the fallopian tubes (these tubes carry eggs from the ovaries to the womb) towards the ovaries and then to the inside of the abdomen.

If this inflammation occurs suddenly and is severe it is called 'acute PID'. It can also cause a collection of fluid to develop, usually inside the tubes and close to the ovaries (this is called a tubo-ovarian abscess and is a serious complication that will require hospital treatment).

Sometimes the inflammation is less severe and can persist for a long time - this called chronic PID.

Who gets PID?

Women get PID because this is an inflammatory process affecting female organs inside the pelvis. PID is common and tends to affect younger women (under the age of 45). Those under the age of 25 are most at risk. 

These women are usually sexually active and may have acquired an infection such as gonorrhoea or chlamydia from a sexual partner without realising.

What causes PID?

The most likely cause of PID is untreated Chlamydia or gonorrhoea. These two sexually transmitted infections cause one quarter of cases of PID, and may be passed from a sexual partner without realising as they often do not cause symptoms.

Is PID always sexually transmitted?

No. Sometimes PID is caused by infections that are not sexually transmitted. It can occur after fitting a coil.  Occasionally, PID can develop after a miscarriage or an abortion. Rarely, it can occur after surgery to pelvic and abdominal organs such as the bowel and even after appendicitis.

How will I know if I have PID?

Each person with PID is different, symptoms vary. The following list of symptoms may all be present in some people but others may only have some of them:

  • Smelly or unusual vaginal discharge
  • Pain in the lower abdomen
  • Deep pain inside during sexual intercourse
  • Bleeding during or after sex
  • Bleeding between periods
  • A high temperature

These symptoms in themselves are not uncommon and can be caused by other conditions. PID can be difficult to diagnose because your doctor is also thinking about other possible explanations for each of the symptoms listed above.

If you have lower abdominal pain, this can be due to irritable bowel syndrome (IBS), a urine infection (cystitis), a cyst on the ovary, appendicitis or even inflammatory bowel disease such as ulcerative colitis or Crohn's disease. Pregnancy is a very important cause of abdominal pain especially if the pregnancy is developing in the wrong place such as one of the tubes (ectopic).  Scarring after PID can lead to ectopic pregnancies.

Bleeding between periods can be caused by hormonal contraception such as the pill, an implant, the depo injection or a hormone coil (IUS).

Smelly discharge can be due to a condition called bacterial vaginosis.

How do I get tested for PID?

Your doctor will need to examine you if he or she suspects that you might have PID. Your doctor will recommend that you have a number of swab tests from the vagina and the cervix. You will also be offered, a pregnancy test, A urine test to check for cystitis and blood tests to check for infection.

What treatments are available if I have PID?

If your PID is thought to be mild or moderate (but not severe), you will be offered a course of antibiotic tablets.

What should I tell my partner?

If your PID is thought to have occurred because of a sexually transmitted infection, your partner(s) is advised see phone for a sexual check-up. It’s best to avoid sex with your partner(s) until they have been tested and treated.

When can I have sex again?

You should avoid having sex again with anyone who might have an untreated infection. If this is not possible, then condoms will help reduce the chance of catching infections. If your partner has been tested and treated, you can have sex again when you feel ready.

Are there any long-term problems after PID?

Pelvic inflammation and infection responds very well to antibiotics. Most women make a full recovery without any further problems. If the infection was very severe, or treatment delayed for some reason, then it is possible to get further problems such as:

  • Scarring of the Fallopian tubes which can cause an increased risk of ectopic pregnancy or difficulties in getting pregnant.
  • Long term pain that persists even after treatment

These problems are more likely if you get repeated episodes of pelvic pain. The use of condoms will help reduce the risk of further infection.