Pelvic Inflammatory Disease

What is Pelvic Inflammatory Disease?

Pelvic inflammatory disease (PID) is an infection of one of the parts of the female reproductive system. These can be the uterus, ovaries, fallopian tubes, and cervix. If PID is not treated, it may cause development of scar tissue or development of fluid filled pockets that might be infected. This may cause lower belly pain or hurt the ability to have a baby. The damage might be permanent, if not treated properly.

In PID, in 85% of the cases, infections are caused by sexually transmitted bacteria (bacteria such as Neisseria gonorrhoeae and Chlamydia trachomatis).

What Are the Symptoms of PID?

Early on, the symptoms of PID may not be directly seen. But as the infection gets worse, there may be:

  • Pain in the lower belly and pelvis (lower part of the body, between stomach and thighs)
  • Heavy secretion of fluid (discharge) with bad odour from the vagina
  • Unusually more bleeding in periods
  • In some cases, bleeding may occur in between periods
  • Pain during sex
  • Fever and chills that may return
  • Pain while urinating
  • Feeling of unease or discomfort, with the urge to vomit or vomiting.

What are the causes of PID?

In most cases, the cause of PID is a bacterial infection starting from the vagina or cervix (entrance to the womb) and spreading into the womb, fallopian tubes, and ovaries.

It is sometimes difficult for doctors to pinpoint which bacteria are responsible for PID, as there are multiple bacteria causing it. A combination of antibiotics may be prescribed depending on the nature of the disease.

Sexually transmitted infections (STIs)

Sexually transmitted infections (STIs) such as chlamydia or gonorrhoea are the main cause of PID. These are diseases caused by bacteria of similar names – chlamydia is caused by chlamydia trachomatis. When these bacteria are present only in the cervix – where they are generally present, they can be easily treated with antibiotics. But in case if they are left untreated, there is a risk of bacteria travelling into the female reproductive organs. If a woman has chlamydia and it’s left untreated, it may develop into PID within a year.

Other causes of PID

Sometimes, harmless bacteria present in the vagina may cause infection in other parts of the womb. This may happen if:

  •  A woman already had PID before damage to the cervix. Damage to the cervix could be in cases of childbirth or miscarriage.
  • A woman has undergone a procedure that involves opening the cervix (such as an abortion, inspection of the womb, or insertion of an intrauterine device (IUD)

How Is PID Diagnosed?

On doctor visit, depending upon the symptoms, they conduct a pelvic (an area between the stomach and thighs) examination. Checking of any signs of tenderness in your cervix, uterus, or surrounding organs (ovaries and fallopian tubes) is done.

Doctors may also do the following:

  • Inspect for any signs of fluid in the vagina or cervix that might be troubling
  • Ask about medical and sexual history (if there were prior problems in sex, or any previous history of specific diseases related to the uterus, or any conditions such as hypertension or diabetes)
  • Might check for fever by checking temperature
  • May send for fluid samples to be checked in the laboratory under a microscope and also ask the lab to check cultures for gonorrhea and chlamydia

What are the tests that are conducted?

Doctors might also recommend some tests including:

  • A blood test to confirm if it is an STI
  • An ultrasound for an image of your internal organs

In case of confirmation or high suspicion of PID, the doctor might suggest treatment options.

How Is PID Treated?

Pelvic inflammatory disease (PID) can be easily and effectively treated with antibiotics if it is diagnosed early. Sometimes, if it is left untreated, it may lead to serious complications. In those cases, the doctor may hospitalize the patient.

Treating PID with antibiotics

The doctor may not even wait for the diagnostic test results before starting with antibiotics because administering them quickly is the key to managing PID. The doctor generally gives a combination of different types of medicines to take together. This is because many different types of antibiotics work against the illness for a complete cure. The general time frame for the medicines is 2 weeks. It is highly advised to follow the doctor’s directions and take all of them. The symptoms should improve within 3 days. Even if a patient feels better after these 3 days, they should not stop taking the medicines, because the infection has not completely cleared.

Following-up with doctor:

In some cases, the doctor may advise a follow-up appointment of 3 days post-treatment to check if the antibiotics are working.

If the symptoms do not improve within 3 days of treatment, the doctor may advise a hospital treatment and stay. This may be because of the following reasons:

  • The doctor might ask you to take more tests to figure out why the symptoms are not improving despite the antibiotics.
  • Antibiotics may be given via IV (medicine given through a needle or tube inside the vein directly). If the patient is unable to keep the medicines inside, the doctor will want to give antibiotics directly into the body with intravenous fluids.
  • If a patient has developed a “tubo-ovarian abscess.” It means when there is infected fluid filled in the part of an ovary or fallopian tube and that needs to be drained.
  • If the patient is sick with vomiting or running a high fever. The doctor checks if there are problems or disorders.

What about sharing information about PID diagnosis with partners?

The doctor has diagnosed a patient with PID. The next step is to inform the husband, boyfriend, or any person the woman has had sex with in the past 3 months, about their illness. A PID patient should not have sex while going through the treatment.

Should the partners also be treated for PID?

Any sexual partners the patient has been with in the last 6 months before presence of symptoms should be tested and treated to stop the infection from returning or spreading to others. The partner who is being treated should also not have sex with another partner because it will just spread the infection. PID can also happen in long-term relationships where there is only one partner, and both did not have sex with anyone else. There are high chances of the infection returning if both partners aren’t treated at the same time. Wait for sex until after both partners have completed the course of treatment.

Contact the doctor in the clinic. Complete secrecy can be maintained if preferred.


  1. Jennings LK, Krywko DM. Pelvic Inflammatory Disease. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:
  2. National Health Service. (November 2023). Pelvic Inflammatory Disease.
  3. What Is Pelvic Inflammatory Disease? (November 2023). WebMD.

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