Your Guide to Pelvic Inflammatory Disease, PID

Pelvic inflammatory disease, commonly called PID, is an infection of the female reproductive organs. PID is one of the most serious complications of a sexually transmitted disease in women. PID can cause irreversible damage to the uterus, ovaries, fallopian tubes, or other parts of the female reproductive system, and is the primary preventable cause of infertility in women.

How Common Is Pelvic Inflammatory Disease?

Each year, more than 1 million women in the U.S. experience an episode of PID. As a result of PID, more than 100,000 women become infertile each year. In addition, a large proportion of the 100,000 ectopic (tubal) pregnancies that occur each year can be linked to PID. The rate of infection is highest among teenagers.

What Causes Pelvic Inflammatory Disease?

Normally, the cervix prevents bacteria that enter the vagina from spreading to the internal reproductive organs. If the cervix is exposed to a sexually transmitted disease -- such as gonorrhea and/or chlamydia -- the cervix itself becomes infected and less able to prevent the spread of organisms to the internal organs. PID occurs when the disease-causing organisms travel from the cervix to the upper genital tract. Untreated gonorrhea and chlamydia cause about 90% of all cases of PID. Other causes include abortion, childbirth, and pelvic procedures.

What Are the Symptoms of Pelvic Inflammatory Disease?

The symptoms of PID can vary, but may include the following:

Dull pain or tenderness in the stomach or lower abdominal area, or pain in the right upper abdomen.
Abnormal vaginal discharge that is yellow or green in color or that has an unusual odor.
Irregular and/or painful periods.
Painful urination.
Spotting or cramping throughout the month.
Chills or high fever.
Nausea and vomiting.
Pain during sex.

What Puts a Person at Risk for Pelvic Inflammatory Disease?

There are several things which would put a woman at risk for PID, including:

Women with sexually transmitted diseases -- especially gonorrhea and chlamydia -- are at greater risk for developing PID.
Women who have had a prior episode of PID are at higher risk for another episode.
Sexually active teenagers are more likely to develop PID than are older women.
Women with many sexual partners are at greater risk for sexually transmitted diseases( STDs) and PID.

Some studies suggest that douching may contribute to PID. Douching may push bacteria into the upper genital tract and may mask the discharge that could alert a woman to seek medical attention.

How Is Pelvic Inflammatory Disease Diagnosed?

Your doctor will begin with a detailed history of your general health and sexual activity. He or she will perform a pelvic exam to check the health of your reproductive organs, and look for evidence of gonorrhea and chlamydia infection. Your doctor may find the abnormal cervical discharge and tenderness of the cervix, fallopian tubes and cervix on examination. This discharge will be tested to determine the cause of the infection, including cultures for gonorrhea and chlamydia.

If your doctor suspects PID, he or she may order other tests, including:

Blood tests to analyze blood for evidence of infection.
Ultrasound (sonogram) to view the reproductive organs.
Other tests less commonly performed include:
Endometrial biopsy, a procedure in which a small sample of tissue from the lining of the uterus (endometrium) is removed for evaluation and testing
Laparoscopy, a procedure during which a thin, lighted instrument (laparoscope) is inserted through a small cut in the lower abdomen to allow the doctor to examine the internal reproductive organs
Culdocentesis, a procedure in which a needle is inserted through the vaginal wall just behind the uterus. (Fluid is removed through the needle and examined for signs of bleeding or infection.)

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WebMD Medical Reference provided in collaboration with the Cleveland Clinic

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Prescribing Information