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The Facts About Pelvic Inflammatory Disease

Although it can be asymptomatic at first, PID can have serious complications if left untreated.

A woman holds her abdomen in pain.

Pelvic inflammatory disease (PID) is an infection that affects the female reproductive organs. It's not an uncommon infection. Based on data from the National Health and Nutrition Examination Survey carried out in 2013 to 2014, the Centers for Disease Control and Prevention (CDC) reported 4.4 percent of sexually experienced women of reproductive age in the United States have or have previously suffered from PID. That's about 2.5 million individuals.

What is PID?

Pelvic inflammatory disease occurs when a bacterial infection makes its way through the lower reproductive tract the upper reproductive tract. The presence of infectious microorganisms can disturb and change the composition of the bacterial flora of the female reproductive organs. PID can affect the vagina, cervix, uterus, fallopian tubes and ovaries.

Some cases are asymptomatic, while others range from mild to severe. But if left untreated, pelvic inflammatory disease can cause infertility and permanent damage to the female reproductive tract.

What are the symptoms of PID?

Pelvic inflammatory disease symptoms can range from mild to severe. In some cases, the disease is asymptomatic altogether or may be hard to recognize as the symptoms often mirror other, less serious conditions.

Common PID symptoms include:

  • Abnormal vaginal bleeding, especially between menstrual cycles or during or after sex
  • Fever
  • Large amounts of strong-smelling vaginal discharge
  • Lower abdomen or pelvic pain
  • Painful and frequent/difficult urination
  • Painful intercourse

If you experience any of these symptoms, consult with your doctor right away.

Causes of PID

There are a variety of microorganisms that can cause pelvic inflammatory disease. Untreated sexually transmitted infections (STIs) such as chlamydia and gonorrhea are to blame for anywhere from one-third to half of all PID cases.

However, pelvic inflammatory disease can be caused by conditions such as bacterial vaginosis and other non-sexually transmitted infections.

How do I get PID?

Most often, you get pelvic inflammatory disease after contracting gonorrhea or chlamydia through unprotected sex. However, there are other ways you can develop PID.

In some instances, certain bacteria enter the reproductive tract after menstruation, childbirth, miscarriage or abortion may disturb the bacterial flora of the reproductive tract, leading to infection. This is partly because, after each of these events, the barrier typically put in place by the cervix is vulnerable.

A rare cause of PID is the insertion of an intrauterine device (IUD) or other medical procedures during which instruments are inserted into the uterus.

How is PID diagnosed?

Symptoms of pelvic inflammatory disease often mimic those of conditions such as bacterial vaginosis or other STIs. For this reason, PID can be mistaken for another less serious condition or misdiagnosed altogether.

At present, there's no single test that can definitively diagnose pelvic inflammatory disease. However, the condition can be diagnosed by a gynecologist or your primary care provider following the completion and analysis of a combination of your medical history, symptoms, cervical swabs, blood and urine tests, a pelvic exam, and an ultrasound.

Although not as common, a laparoscopic surgery may be performed to check for PID as the procedure allows your doctor to examine the inside of the pelvis with a camera.

Treatment for PID

Pelvic inflammatory disease can be treated and cured with broad-spectrum antibiotics that fight the most likely pathogens.

That being said, antibiotic treatment is unable to reverse any scarring or other damage that infection has done to the reproductive tract. This means that while the active infection can be cured, the consequences of the disease can be long-lasting, particularly if the condition was untreated for a long period of time.

Treatment may be more extensive and include hospitalization in the event of serious complications such as the rupture of an abscess.

What happens if I don’t get treated?

Early detection and treatment are critical to avoiding complications of pelvic inflammatory disease. Unfortunately, though, since the disease can go easily undetected—and therefore untreated—for an extended period of time, an estimated 1 in 4 women develop a PID complication, according to Contemporary OB-GYN.

Untreated PID can cause complications, which include ectopic pregnancy, infertility, long-lasting pelvic pain, as well as abscesses in the reproductive tract that can cause pain and fever and may turn life-threatening if ruptured.

Can women who have sex with women get PID?

Women who have sex with women can get pelvic inflammatory disease and other STIs as a result of having unprotected sex.

Be sure to practice safe sex and discuss your previous sexual history with your partner before having sex. It's a good idea for both you and your partner to get tested for PID and other STIs before having sex.


The potential complications of PID are the result of the inflammation and damage caused by the infection in the reproductive tract. This can look like scar tissue of abscesses (pockets of infected fluid).

Complications of pelvic inflammatory disease can include:

  • Chronic pelvic pain. The scarring left by PID can lead to long-lasting pelvic pain, particularly during intercourse and ovulation. This pain can last just a few months or multiple years.
  • Ectopic pregnancy. When scar tissue develops in the fallopian tubes as a result of PID, the fertilized egg can be prevented from traveling through the tube to implant into the uterus. This can cause the fertilized egg to implant in the fallopian tube instead, which can lead to extreme bleeding and be life-threatening.
  • Infertility. The damage done to the reproductive tract as a result of PID can result in infertility. Delayed treatment for PID or multiple infections of PID increases the risk of infertility.
  • Tubo-ovarian abscess. Pockets of pus, or abscesses, can form in the fallopian tubes or ovaries as a result of untreated PID. This can lead to fever and may become life-threatening.

The long-term outlook for PID

If detected and treated early, the long-term outlook for pelvic inflammatory disease can be bright and complication-free. However, untreated PID can lead to long-lasting pelvic pain and infertility issues. Those who suffer PID complications should talk to their doctor about treatments available to mitigate symptoms.

Preventing pelvic inflammatory disease is the best way to avoid the risk of serious complications.

Here are some measures you can take to prevent PID:

  • Don't douche
  • Ensure you and your sexual partners are regularly tested for STIs
  • Have safe sex


What are the six symptoms of PID?

Some of the most common symptoms of pelvic inflammatory disease include lower abdomen pain, pelvic pain, heavy and foul-smelling vaginal discharge, fever, abnormal bleeding and pain during sex.

What is the main cause of PID?

Typically, you get pelvic inflammatory disease after contracting gonorrhea or chlamydia through unprotected sex. However, in some cases, certain bacteria that enter the reproductive tract after menstruation, childbirth, miscarriage or abortion may disturb the bacterial flora of the reproductive tract, leading to infection. PID occurs when this infection-causing bacteria travels from the lower female reproductive tract to the upper female reproductive tract.

What happens if you have PID?

You may or may not experience any symptoms. However, internally, the infection can cause long-lasting damage to your reproductive organs. When detected early, pelvic inflammatory disease can effectively be treated by broad-spectrum antibiotics.