Pelvic inflammatory disease (PID)

Overview

PID happens when bacteria travel up from the vagina or cervix into the womb, fallopian tubes, and ovaries. Chlamydia and gonorrhea are the most common causes.

Symptoms can be mild, so PID is often missed. Even mild PID can scar the tubes and lead to infertility, ectopic pregnancy, and long-term pelvic pain. Early treatment lowers the risk.

Symptoms

Symptoms can be mild or missing.

• Pelvic or lower belly pain
• Unusual vaginal discharge, often with a bad odor
• Pain during sex

Less common

• Fever
• Bleeding between periods or after sex
• Burning when urinating
• Nausea or vomiting

How it usually goes

• Days to weeks after an STI: Infection can spread upward.
• Within 3 days of treatment: You should start to feel better.
• 14 days: Treatment is finished.

Look up a symptom: Bleeding after sex or between periods · Burning when urinating · Fever · Pain during sex · Pelvic or lower belly pain · Unusual vaginal discharge

When to get medical care

Causes

PID is usually caused by bacteria from untreated STIs, like chlamydia and gonorrhea, moving up into the womb and tubes. Other bacteria, including those linked to bacterial vaginosis, can also play a role.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Having chlamydia or gonorrhea
• Being sexually active and under 25
• More than one partner
• Having had PID before

Possible complications

• Infertility: Scarred tubes can block eggs
• Ectopic pregnancy: A pregnancy outside the womb; an emergency
• Chlamydia: A common cause

Diagnosis

There's no single test for PID. A healthcare professional uses your symptoms, an exam, and tests.

Questions you may be asked

• Where your pain is and when it started
• Unusual discharge, bleeding, or pain during sex
• Fever, nausea, or vomiting
• Recent partners and STIs
• Whether you could be pregnant

The exam

A pelvic exam to check for tenderness in the cervix, womb, and ovaries.

Tests

Tests may include:

• STI tests: For chlamydia and gonorrhea.
• Pregnancy test: To rule out ectopic pregnancy.
• Ultrasound: To look for an abscess or other causes of pain.

Treatment

PID is treated with antibiotics as soon as it's suspected. Most women take pills at home.

Self-care

• Take all of your antibiotics, even if you feel better
• Follow up within 3 days to make sure you're improving
• Don't have sex until you and your partners finish treatment
• Make sure your partners are tested and treated
• Rest and use pain relievers as directed

Medicines

Antibiotics need a prescription.

Treatment won't undo damage that has already happened, so treat it early.

You may need IV antibiotics in the hospital if you're very sick, pregnant, have an abscess, or aren't better after 3 days of pills.

How it compares

Prevention

Preventing STIs prevents most PID:

• Use condoms correctly every time
• Get tested for chlamydia and gonorrhea regularly; ask how often
• Get STIs treated right away, and make sure partners are treated
• Don't douche

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a gynecologist (OB-GYN).

Children, pregnancy, and older adults

• Teens and young women: PID is most common in young women, and it can affect future pregnancies.
• Pregnancy: Get care right away for pelvic pain or discharge in pregnancy.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

PID can be cured with antibiotics. Quick treatment lowers the chance of infertility and long-term pain. It can come back if you get another STI.

Getting ready for your visit

Bring notes about your symptoms.

What to bring

• When the pain started
• Recent partners and STI tests
• Your last period and birth control
• Any allergies

Questions to ask

• Do I need to be in the hospital?
• How will this affect getting pregnant?
• How do my partners get treated?
• How can I avoid PID again?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Pelvic inflammatory disease (PID)