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Pelvic Inflammatory Disease

Jessica Evert, MD, edited by Benjamin McDonald, MD Updated: Jul 5th 2016

Pelvic Inflammatory Disease (or PID) is a complication of untreated STDs that occurs in women. It is not an STD in of itself.

PID occurs when harmful bacteria (such as those that cause Chlamydia or Gonorrhea) travel up a woman’s reproductive track, affecting her internal reproductive organs. These bacteria attack the delicate reproductive cells found in the uterus, fallopian tubes, and ovaries, leading to tissue damage and permanent scarring. The tissue damage sustained in PID can lead to infertility, even in young, otherwise healthy women.

The symptoms of PID include pelvic pain (pain similar to ‘cramps’ felt before periods), abnormal vaginal discharge (either abnormal color, amount, smell, or consistency), fever, pain during sex, and irregular bleeding. However, it is possible for PID to occur silently (causing no symptoms). Women who experience the symptoms of PID should see their doctor immediately so that proper steps can be taken to minimize the damage to her fertility.

Women are at increased risk for developing PID if they have a history of STD (especially Chlamydia and Gonorrhea), are (or were) a sexually active teenager, douche more than twice per month and/or have multiple sexual partners. PID is unfortunately common. About one million American women get PID each year. Of these about a hundred thousand (10%) become infertile (unable to get pregnant), and seventy thousand (7%) go on to be at increased risk for dangerous ectopic (or tubal) pregnancies. Ectopic pregnancies occur inside the fallopian tubes connecting the uterus to the ovaries, rather than in the uterus itself (where pregnancies are supposed to occur). Ectopic pregnancy can lead to the rupture of the fallopian tube and require emergency surgery. Pregnancy outside the uterus always causes death for the growing fetus and can even lead to the death of the mother.

Doctors looking for signs of PID will generally perform a pelvic examination, and possibly an ultrasound examination as well. A surgical procedure, called a laparoscopy, which involves the insertion of a small tube (containing a camera) through a tiny incision below the belly button, may be required to allow detailed examination of the affected reproductive organs.

PID is treated with multiple courses of antibiotics, and possibly even a stay in the hospital. Antibiotic treatment of sexual partners is also recommended.

Women who have experienced PID may continue to experience pelvic pain for years after their PID episode, even with successful treatment. They also become prone to repeated episodes of PID in the future, with each episode a new assault on their continuing fertility.

The best way to prevent PID in the first place, is to promptly see a doctor at the first sign of any STD. Symptoms such as abnormal vaginal discharge, abnormal pelvic pain, bleeding between periods, pain during sex, or a burning sensation when urinating or inside the vagina should be red flags suggesting a doctor visit is necessary.

Of course, taking steps to prevent STD transmission in the first place, is the very best preventative method of all. Proper use of latex condoms, and limited, safe sexual partners are the very best course. Women should insist upon the use of barrier contraception such as condoms and dental dams for all sexual encounters until they find themselves in a committed and entirely monogamous sexual relationship.

 

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