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Pelvic inflammatory Disease (PID): Symptoms, Signs and Treatment

By: Author Dr Akatakpo Dunn, MBBS, PG Dip Ultrasound, Prof Dip O&G (RCPI) Medical Director & Lead Obstetrician/Ultrasonologist, Verah Clinic & Maternity

Posted on Last updated:

PID or pelvic inflammatory disease is an ascending infection that affects the uterus, ovaries, fallopian tubes and abdomen in women. It affects many women in their child bearing age each year.

Gonorrhea and chlamydia are common causes of PID (recent studies suggest around half of women diagnosed with acute PID test positive for either). Women that show no symptoms of gonorrhea and chlamydia infection may also develop PID. Also, Bacterial vaginosis (BV) is associated with PID, and other bacteria can also be involved.

PID occurs only in women. This is because men do not have uterus, ovaries or fallopian tubes. The infection ascends from the vagina through the cervix to the uterus and then through the fallopian tubes to the abdomen.

In severe cases, pus can collect around the tubes and ovaries (tubo-ovarian abscess) and cause severe lower abdomen pain.

Common PID symptoms include low abdomen pain, abnormal vaginal discharge, high body temperature or fever and body weakness. However, PID can often be prevented since it is usually a complication of sexually transmitted infection. Use of condoms, abstinence can prevent infections that cause pelvic inflammatory disease.

In addition, treatment and cure of PID is dependent on the severity of the infection. Treatment will not reverse any damage done by the infection. Mild to moderate PID will require medications while severe forms may require surgery.

What is PID (pelvic inflammatory disease) and what causes it?

PID is an acronym that stands for pelvic inflammatory disease. It is caused by sexually transmitted infection and can only affect women. The commonest organism that cause PID are gonorrhea and chlamydia. They both account for some PID in women.

However, other organisms can cause pelvic inflammatory disease. BV (bacterial vaginosis) is associated with PID.

It is important for women to know gonorrhea and chlamydia symptoms early. Early detection and treatment of these std symptoms will prevent PID

Common gonorrhea symptoms in women

Women with chlamydia infection will also have similar symptoms. It is therefore important to see your doctor if you notice any abnormal discharge or symptom of the disease.

What are PID signs and symptoms in women?

Not all women that develop pelvic inflammatory disease will show symptoms. Also, symptoms experienced in women will depend on the severity of the infection.

If you have PID, you may have any of these symptoms

  • Lower abdomen pain

  • Pain during intercourse

  • Fever

  • Purulent vaginal discharge

  • Heavy vaginal bleeding or menorrhagia

  • Bleeding between periods

  • Mass in the abdomen that is painful. This is due to pus collection in the abdomen

  • Severe body infection (sepsis) that may affect other parts of the body

  • Infertility (difficulty getting pregnant later)

If you experience any of these PID symptoms then see your doctor. Fortunately, early diagnosis and treatment will prevent complications of the disease.

How is PID diagnosed in women?

Presence of the above PID symptoms will assist to make diagnosis. Some of the questions you will be asked by your doctor include

  • If you had unprotected sexual intercourse in the past?

  • Number of sexual partners?

  • Any abdominal pain, vomiting, change in your normal white vaginal discharge?

Other symptoms will also be asked by your doctor. Your doctor will also do some test. these include

  • Complete blood count. This is important to check your white blood cell count. An increased white blood cell count may support infection, but it is not specific.

  • Pregnancy test. Pregnancy test is necessary to rule out pregnancy, ectopic pregnancy miscarriage or threatened miscarriage.

  • C-Reactive protein or Erythrocyte sedimentation rate (ESR). This is raised in women with PID.

  • Pelvic ultrasound

  • CT Scan

  • MRI

  • Specific test for the infection is also done. These may include gram staining and culture (and swab/urine tests for STIs).

  • Laparoscopy can be used in unclear cases, but it is not routinely needed to diagnose PID.

What is Pelvic inflammatory disease treatment?

Following PID testing and diagnosis, treatment is commenced. Most women start to feel better within 2–3 days of therapy. Also, treatment depends on the severity of your infection. Your doctor may decide to admit you if severe or you may be treated as an out-patient.

Women with Intrauterine contraceptive device (IUCD) would be counselled on the risk. The IUCD does not need to be removed immediately in most cases, but you should be reassessed in 48–72 hours.

Some of the drugs combination used are

Will i get admitted?

This depends on the severity of the infection. Women with severe form of PID will require admission. Other reason for possible admission in the hospital are

  • Severe infection

  • Presence of abscess (collection of pus)

  • Severe pain that requires strong relief medications

  • Pregnancy

In severe PID, treatment will be extended to 14 days. In addition, women that cannot take orally will be given parenteral medications.

Will treatment involve surgery?

Yes. However, this is only for very few patients that medical treatment fail. Also, women with collection of pus may need drainage or surgery.

How is PID treated in pregnancy?

PID in pregnancy is uncommon, but if it is suspected you should be seen urgently and treated in hospital with IV antibiotics.

What are the complications of PID?

The inflammation of the uterus, fallopian tubes can cause discharge of pus into the abdomen. This will result to scarring and abscess formation.
PID can affect fallopian tubes in women resulting in difficulty getting pregnant. It is a common cause of infertility in women
Due to damage to the fallopian tube, the baby may be implanted outside the uterus. This is ectopic pregnancy.
Chronic pelvic pain
Preterm delivery risk if PID happens in pregnancy

How to prevent Pelvic inflammatory disease

Understanding PID symptoms and early visit to your doctor will prevent complications in women. However, not all women will show symptoms of infection or PID. Regular testing in therefore important in sexually active women at risk.

Some of the ways to prevent PID in women are

  • Avoid sexual intercourse. Abstinence is the easiest and effective way to prevent to prevent PID

  • Consistent use of condoms

  • Advice your partner to get tested and treated if he shows STD symptoms or not

  • Reinfection by your partner is possible. This will increase your risk to damage tubes and tubal pregnancy.

  • If you have an IUCD and develop PID, see your doctor early (don’t remove it yourself).

  • Stop Vaginal Douching

What other disease condition can mimic PID symptoms?

Frequently Asked Questions

You asked about PID and we answered.

How do you get pelvic inflammatory disease?

You get pelvic inflammatory disease by ascending infection of the uterus, fallopian tubes. It results from poorly treated or untreated sexually transmitted infections (STIs) including gonorrhea and chlamydia infections.

Is PID treatable?

Yes. There is both medical and surgical treatment. Most women feel better after treatment for 2–3 days. However, surgical treatment is required for severe PID.

What is the meaning of PID?

PID simply means Pelvic inflammatory disease.

PID in men? is it possible?

PID does not occur in men. This is because they do not have uterus and fallopian tubes. However, men will experience prostatitis and urethral stricture due to gonorrhea or chlamydia infections.

What is the pelvic bacterial infection that causes PID?

The bacteria infection that cause PID are gonorrhea and chlamydia, but they do not cause all PID in women. BV can also be involved.

How is pelvic inflammatory disease treated naturally?

There is no proven natural cure for PID. Home remedies like yogurt and garlic should not replace antibiotics.

Now its your turn to tell us your PID symptoms. Do you experience pain or abnormal discharge. Share your experiences and questions.