Pelvic Inflammatory Disease (PID)

What is PID?

Pelvic inflammatory disease (PID) is an infection in the woman’s reproductive organs. It can affect the uterus, fallopian tubes and/or ovaries. Canadian statistics suggest that one in 10 women will have at least one episode of PID. Seventy-five percent of cases occur in women under 25 years of age.

What causes PID?

A woman can get PID from unprotected sexual intercourse. Most cases of PID occur when the sexually transmitted infections (STIs) chlamydia and gonorrhea are left untreated. The infection spreads from the vagina to the uterus and fallopian tubes. PID can also occur if a woman has an untreated STI or vaginal infection at the time she has an abortion or an IUD (intrauterine device) inserted. Women who have had PID in the past are at higher risk of getting it again.

What are the symptoms?

PID can cause severe pain and other symptoms. However, some women do not have any pain at all and may never know they have an infection until PID has caused damage. The most common symptoms of PID are:

aches or cramping in the lower abdomen
fever and chills
bleeding from the vagina other than period
unusual and/or increased vaginal discharge
pain during or after vaginal intercourse

PID symptoms often start at the end of your period. If you experience any of these symptoms, you should see your doctor as soon as possible. If your symptoms are severe, go to a hospital emergency room.

How is PID diagnosed?

It can be difficult to diagnose PID with certainty. There is no single test used to diagnose the infection. Usually, a diagnosis is made based on a combination of factors: medical history, symptoms, physical exam, and the results of diagnostic tests. If you have symptoms that might be caused by PID, a physical exam including a pelvic exam will be done. Tests will also be done to check for STIs, vaginal infections, and pregnancy. A pelvic ultrasound may also be done to assist with diagnosis.

How is PID treated?

Because early treatment of PID is important, and the consequences of not treating it can be so severe, treatment is usually started right away. PID is treated with 2 weeks of antibiotics. You will be asked to return to the clinic or health provider 2-3 days after treatment for another examination. This is very important. With more severe symptoms, hospital admission for intravenous (IV) antibiotics is often necessary.

What are the complications?

A treatment delay of even a day or two can make the condition much more serious. The later the condition is treated, the higher the risk of damage. Complications that may be caused by PID include:

infertility (increased difficulty becoming pregnant)
ectopic pregnancy (increased risk of pregnancy occurring in a fallopian tube)
chronic pain in the lower abdomen, abscesses and/or scarring
increased risk of getting PID again

How can PID be prevented?

Use condoms every time you have a sexual encounter
Talk to your partner about STIs before having a sexual
relationship
Find out if your partner has or is at risk of having any STIs
Get STI testing done for yourself and your partner(s)
Don’t have vaginal sex after anal sex, or wash carefully in between
Change your tampons and pads frequently during your period
Don’t douche or smoke as these increase your risk of PID
After an abortion, miscarriage, or giving birth, avoid having intercourse until your bleeding has stopped (usually one to six weeks afterwards)
Have regular checkups

What if I have had a PID infection before?

If you have been diagnosed with PID, it could happen again. Some studies suggest that up to 25 percent of cases of PID reoccur. To prevent future PID, take all of the medication prescribed as directed. Ensure that any partner(s) you have had sexual contact with during the 60 days before your symptoms started are examined and treated. Partners can get an infection from the STIs that can cause PID, such as chlamydia and gonorrhea. This is important even if your partner(s) do not have any symptoms. Use a condom until both of you have completed treatment and your health provider has determined that the infection is gone.

Is follow up important?

Once you have been diagnosed with PID, it is very important to follow up with your health provider in 2-3 days. If you do not feel better after taking the prescribed medication for two days, make sure you tell your health provider. It is very important that the PID is cured to prevent further complications.