Pelvic Inflammatory Disease: Symptoms, Causes, and Prevention

    Updated 03 February 2023 |
    Published 12 February 2020
    Fact Checked
    Reviewed by Olga Adereyko, MD, Primary Care Physician, General Practitioner, Medical Consultant
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    An infection of the female reproductive system, pelvic inflammatory disease (PID), requires proper treatment and monitoring. Here, Flo gives information on it.

    What is PID?

    Pelvic inflammatory disease targets your reproductive organs and is usually triggered by another type of infection in the body or a sexually transmitted disease (STD). This includes untreated cases of gonorrhea and chlamydia. The bacteria responsible for the STD spreads from your vagina to your uterus, ovaries, or fallopian tubes. It’s a serious medical condition, and one in eight women with a history of pelvic inflammatory disease has difficulty conceiving.

    In some instances, PID doesn’t present any signs or symptoms (or only mild ones), which makes it harder to seek treatment in a timely manner. It could remain undiagnosed until you notice chronic pain in your pelvis or have trouble getting pregnant. That’s why it’s important to take active steps to prevent it from occurring.

    Pelvic inflammatory disease symptoms

    Symptoms of pelvic inflammatory disease include:

    Severe pelvic inflammatory disease can cause fever, chills, bowel discomfort, and extreme pelvic or lower abdominal pain, especially during a pelvic examination.

    Causes of pelvic inflammatory disease

    Certain kinds of bacteria are listed as pelvic inflammatory disease causes ‒ chlamydia and gonorrhea being the most common. These strains of bacteria tend to be acquired through unprotected sexual contact.

    Less frequently, PID-causing bacteria enter your reproductive tract when your normal cervical barrier is disturbed. This might be the result of pregnancy termination, miscarriage, or childbirth.

    Contributing factors and complications of PID

    A wide variety of factors might make you more susceptible to developing pelvic inflammatory disease. 

    • You’re a sexually active woman, who’s 25 years of age or younger. 
    • You have multiple sexual partners.
    • You engage in unprotected sex.
    • Your sexual partner has multiple partners.
    • You douche regularly (upsetting the balance of good and harmful bacteria in your vagina and masking the symptoms of pelvic inflammatory disease).
    • You have a history of pelvic inflammatory disease or STDs.

    According to experts, use of an intrauterine device (IUD) doesn’t raise your likelihood of getting PID, especially after the first three weeks following insertion.

    Note that, if left untreated, pelvic inflammatory disease might leave behind scar tissue in the affected organs. You might even develop abscesses (an accumulation of infected fluid) in your fallopian tubes capable of damaging reproductive organs. Other complications of pelvic inflammatory disease include:

    • Ectopic pregnancy

    Pelvic inflammatory disease is one of the main causes of ectopic (or tubal) pregnancy. Due to the presence of scar tissue, the fertilized egg cannot travel through the fallopian tube and implant in your uterus. Furthermore, excessive bleeding from an ectopic pregnancy may become life-threatening and require emergency medical attention.

    Each flare-up of pelvic inflammatory disease compromises your reproductive organs and increases your chances of infertility. This likelihood also goes up dramatically when pelvic inflammatory disease treatment is delayed.

    • Chronic pelvic pain

    Chronic pain felt in your pelvic region, which lingers for months or years, is another indicator of pelvic inflammatory disease. Scar formation in your fallopian tubes, uterus, or other reproductive organs produce pain during intercourse and ovulation.

    • Tubo-ovarian abscess

    If you develop an untreated abscess in your fallopian tubes or ovaries due to pelvic inflammatory disease, it could trigger a life-threatening infection.

    Diagnosis and pelvic inflammatory disease treatment

    Doctors can diagnose pelvic inflammatory disease based on symptoms, a pelvic examination, analysis of vaginal discharge, cervical cultures, and urine tests.

    During a pelvic exam, your physician will check for any signs of PID. They may take vaginal and cervical swabs, which are sent to a laboratory to pinpoint the organism causing your reproductive tract infection.

    They might also recommend other tests either to confirm your diagnosis or to determine the extent of the infection, such as:

    • Urine and blood tests

    These measure your white blood cell (WBC) count, which, if elevated, often indicates infection or inflammation. Testing for HIV and STIs associated with pelvic inflammatory disease is common as well.

    • Ultrasound

    Images of your reproductive organs are created with the use of sound waves.

    • Laparoscopy

    In this procedure, your doctor inserts a lighted, thin instrument via a tiny incision in your abdomen to view your pelvic organs.

    In order to treat pelvic inflammatory disease, your doctor may recommend the following:

    • Starting an antibiotic combination immediately. Once the results of your labs come back, they may adjust the prescription to better fight the specific organism behind the infection.
    • Continue following all prescriptions, even if your symptoms improve. Pelvic inflammatory disease treatment involving antibiotics could prevent serious complications, but it cannot undo any damage.
    • Take steps to avoid reinfection with an STI. Ask your partner to get tested and seek medical treatment if necessary. Remember, not everyone shows noticeable signs and symptoms when they’re infected.
    • Practicing temporary abstinence until you complete your course of treatment and tests show that you and your partner(s) are in the clear.

    The majority of patients with pelvic inflammatory disease need only outpatient treatment. If you’re pregnant, seriously ill, or do not respond to oral medications, you might require hospitalization. There, you may receive intravenous (IV) antibiotics, followed by oral antibiotics. Lastly, the rupturing of an abscess, or a potential rupture, may warrant surgical drainage.

    Prevention of pelvic inflammatory disease

    Lower your chances of developing pelvic inflammatory disease by doing the following:

    • Practice safe sex: Always use condoms for intercourse, and inquire about the sexual history of every potential partner.
    • Do your research: Discuss with your doctor the types of contraception methods you’re considering since not all of them prevent pelvic inflammatory disease. If you take oral contraceptives, for example, it’s critical to use a condom to protect against STIs.
    • Get tested regularly: This is especially important if you think you might be more susceptible to contracting an STI.
    • Be responsible: If you’ve been diagnosed with an STI or pelvic inflammatory disease, ask your partner to get tested and treated if necessary.
    • Stop douching: As mentioned, this destroys the balance of bacteria in your vagina and should be avoided.

    When to see a doctor

    Seek medical attention right away if you observe:

    • Severe pain in the lower abdomen
    • Vomiting, nausea, and an inability to keep any food down
    • Fever higher than 101 degrees Fahrenheit or 38.3 degrees Celsius
    • Foul-smelling vaginal discharge


    PID affects your reproductive organs and can produce very mild (or possibly no) symptoms. However, if you’re experiencing pelvic inflammatory disease symptoms, consult your doctor as soon as possible. 

    Alternatively, painful urination, strong-smelling vaginal discharge, or bleeding between menses could point to an STI. If this is the case, stop having sexual intercourse and seek medical help immediately to prevent its progression into PID. 

    Delaying pelvic inflammatory disease treatment or having recurring episodes makes you more vulnerable to major, long-term health complications.

    History of updates

    Current version (03 February 2023)

    Reviewed by Olga Adereyko, MD, Primary Care Physician, General Practitioner, Medical Consultant

    Published (12 February 2020)

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