What is Pelvic inflammatory disease?

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Pelvic Inflammatory Disease (PID): Causes, Symptoms & Treatment

Pelvic Inflammatory Disease (PID): Causes, Symptoms & Treatment

Pelvic inflammatory disease (PID) is an infection of a woman’s upper reproductive organs—the uterus, fallopian tubes and ovaries. Prompt diagnosis and treatment are vital to preventing long‑term problems.

What Is PID?

PID occurs when bacteria ascend from the vagina or cervix into the upper genital tract. It can affect:

  • The uterus (womb)
  • The fallopian tubes
  • The ovaries

This ascending infection causes inflammation and possible scarring if untreated :contentReference[oaicite:2]{index=2}.

Common Causes of PID

  • Neisseria gonorrhoeae (gonorrhoea)
  • Chlamydia trachomatis (chlamydia)
  • Mycoplasma genitalium and bacteria linked to bacterial vaginosis :contentReference[oaicite:3]{index=3}
  • Other bacteria (e.g., E. coli, Streptococcus spp.) :contentReference[oaicite:4]{index=4}

Who Is at Risk?

PID is most commonly seen in sexually active women under 25. Risk factors include:

  • Multiple sexual partners or a partner with STIs
  • Unprotected sex
  • Douching or altering vaginal flora :contentReference[oaicite:5]{index=5}
  • Recent STI or PID history
  • IUD insertion within the past 3 weeks :contentReference[oaicite:6]{index=6}

Signs & Symptoms

PID may be asymptomatic or cause a range of symptoms:

  • Lower abdominal or pelvic pain (mild to severe)
  • Unusual vaginal discharge with possible odour
  • Fever, chills, nausea, vomiting
  • Pain during intercourse or urination
  • Irregular bleeding :contentReference[oaicite:7]{index=7}

Complications of Untreated PID

  • Tubo‑ovarian abscess: a pus-filled infection requiring urgent care :contentReference[oaicite:8]{index=8}
  • Infertility: caused by tubal scarring—risk increases several‑fold :contentReference[oaicite:9]{index=9}
  • Ectopic pregnancy: scarred tubes raise risk significantly :contentReference[oaicite:10]{index=10}
  • Chronic pelvic pain: can last months to years :contentReference[oaicite:11]{index=11}
  • Fitz‑Hugh–Curtis syndrome: liver capsule inflammation and shoulder pain :contentReference[oaicite:12]{index=12}

How PID Is Diagnosed

Diagnosis is clinical and supported by tests:

  • Bimanual pelvic exam: tenderness on uterus, cervix or ovaries :contentReference[oaicite:13]{index=13}
  • Swabs and NAAT for chlamydia, gonorrhoea and M. genitalium :contentReference[oaicite:14]{index=14}
  • Blood tests: CRP, white cell count
  • Transvaginal ultrasound: identifies abscesses or fluid-filled tubes :contentReference[oaicite:15]{index=15}
  • Laparoscopy: used when diagnosis is uncertain or complications suspected :contentReference[oaicite:16]{index=16}

Treatment of PID

Treatment should begin immediately—don’t wait for lab results :contentReference[oaicite:17]{index=17}.

  • Outpatient antibiotics: ceftriaxone injection + 14 days doxycycline ± metronidazole :contentReference[oaicite:18]{index=18}
  • Hospitalisation if severe, pregnant, vomiting, high fever, abscess present
  • Partner treatment to prevent reinfection
  • Follow‑up: ensure symptoms resolve within 72 hours, repeat testing for STIs

Preventing PID

  • Use condoms and practise safe sex
  • Regular STI screening for sexually active women under 25 or at risk :contentReference[oaicite:19]{index=19}
  • Avoid douching
  • Treat sexual partners promptly
  • Wait until cervix has fully healed (~3 weeks) after miscarriage, childbirth or IUD insertion

Living with PID

Early detection and correct treatment significantly improves outcomes. However, scarring may be permanent. If pain or fertility issues persist, consult a gynaecologist or fertility specialist for further care.

Final Thoughts

Pelvic inflammatory disease is common among young women but preventable and treatable. Vigilance for symptoms, safe sexual behaviour, and timely medical care are key to protecting reproductive health.

FAQs

How long does PID treatment take?

Symptoms often improve within 48–72 hours; oral antibiotic courses last 14 days. Follow‑up tests are essential.

Can PID be cured completely?

Yes, but scarring may lead to lasting effects like pain or fertility issues. Early treatment lessens risks.

Is PID contagious?

PID itself isn't directly contagious—it results from infections like chlamydia or gonorrhoea, which can be passed during sex.

Should sexual partners be treated?

Yes—treating partners prevents reinfection and helps stop the spread of STIs.

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