What Is Pelvic Inflammatory Disease?

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs (cervix, uterus, Fallopian tubes, and ovaries). It is typically caused by a sexually transmitted infection (STI); in fact, 90% of PID cases are caused by chlamydia or gonorrhea. If left untreated, PID can lead to fertility issues, chronic pelvic pain, ectopic pregnancies, or tubo-ovarian abscesses.

Symptoms

Symptoms of PID vary widely from person to person, ranging from no symptoms to symptoms of intense pain and bleeding. Other symptoms include, but are not limited to, the following:

• Pain, ranging from mild to severe, in the lower abdomen and pelvis
• Abnormal vaginal discharge, which may have an unpleasant odor
• Abnormal uterine bleeding (e.g., after intercourse or breakthrough bleeding between periods)
• Fever that may produce chills
• Pain during intercourse
• Increased bleeding during menstruation
• Painful, frequent urination or difficulty urinating

Severe symptoms include:

• Sharp pains in the abdomen
• Vomiting
• Fainting
• Fever higher than 101ºF

Severe symptoms require immediate medical attention. These are signs that the infection may have spread and could be life-threatening.

Causes

PID develops from bacteria that spread through the reproductive system. The majority of PID cases are caused by an STI. However, PID can also be caused from other types of bacteria that enter the reproductive tract when the cervix is vulnerable (e.g., during menstruation or after childbirth, abortion, or miscarriage), during implantation of an intrauterine device (IUD), or during a medical procedure that requires the insertion of instruments into the uterus.

Risk factors

Factors that increase the risk of developing pelvic inflammatory disease include the following:

• Previous PID
• Frequent douching
• Unprotected sex (specifically, sex without a condom or dental dam)
• Improper condom use
• History of STI(s)
• Multiple sexual partners
• Sexual encounter or relationship with an individual who has had more than one sexual partner
• Sexual intercourse before the age of 25
• Recent implantation of an intrauterine device (IUD)

Prompt treatment of PID is imperative, even if symptoms are not severe. Treatment can minimize the risk of potential complications and long-term effects of PID, such as infertility and chronic pelvic pain.