Pelvic inflammatory disease or PID is a serious infection of the fallopian tubes and uterus. This infection, which may result in blockage or scarring of the tubes, is the most common preventable cause of infertility in women. It is estimated that over one million women in the U.S. are affected each year, and the rates are increasing. Besides causing infertility, PID can lead to ectopic or tubal pregnancy, or produce chronic pelvic pain.
Symptoms of PID range from mild to severe. Some have no symptoms at all, while others have mild lower abdominal discomfort or pain with intercourse. Stronger pain, high fever, vomiting, and extreme exhaustion are associated with a more advanced infection. You may also notice abnormal bleeding, spotting, or vaginal discharge. You may experience fever, chills, sweats, severe abdominal pain, and an elevated white blood cell count. You should seek help immediately if these symptoms occur.
You are at risk for PID if you:
Anyone can get PID. If you suspect you have PID, it is important to be examined promptly.
PID is a sexually transmitted disease (STD) most commonly caused by chlamydia or gonorrhea bacteria, although an overgrowth of the bacteria that comprise the normal vaginal flora (i.e., bacteria that are always found in the vagina and are normally not a problem) can also cause PID.
Transmission of the bacteria that cause PID is theoretically possible between women who have sex with women, although it has not been studied. Because the risk of transmission of gonorrhea and chlamydia is thought to be lower among women who have sex with women, it is thought that lesbians and bisexual women may be at lower risk of PID.
If you have lower pelvic pain, or if your practitioner finds that your cervix is tender when moved and/or that your uterus or the Fallopian tubes and ovaries are tender, you probably have PID and should be treated. Tests for chlamydia and gonorrhea should be done, but are only positive in 50% of cases.
It is important to treat for the most common causes of PID: chlamydia, gonorrhea, and other vaginal bacteria. This broad coverage requires two and often three antibiotics. We often recommend an injection of an antibiotic and a two-week course of one or two other antibiotics. It is essential to take all of the antibiotics prescribed to you, or the infection may return. Anti-inflammatory drugs such as ibuprofen are often prescribed to decrease pain and inflammation. If an IUD is in place, it may need to be removed.
Physical rest for one to three days or until pain has significantly improved is an integral part of therapy. A return to normal physical activity too early after starting treatment may cause reappearance of symptoms.
Pelvic rest is very important. Therefore, do not have intercourse for at least two weeks, or until an exam demonstrates healing. Careful follow-up with your medical provider is very important to ensure resolution of this infection and to minimize the potential serious consequences of this disease.
If symptoms do not improve after this combination of antibiotics, anti-inflammatory medication, and rest, you may require hospitalization.
Since PID is almost always as sign of an underlying STD, it is essential that all sexual partners be promptly evaluated and treated, whether or not they have symptoms. Once diagnosed, do not have sex with your partner until both of you have completed your treatment.
Hall Health's article on how to tell your partner you have an STD.
Contact Hall Health to schedule an appointment.
Call Hall Health's consulting nurse for problems and questions.
CDC factsheet on PID
American Social Health Association (ASHA) Frequently Asked Questions about PID
Public Health-Seattle & King County information about STDs for bisexual women and lesbians