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Pelvic Inflammatory Disease

Many different types of bacteria can cause Pelvic Inflammatory Disease (PID), but most cases are the result of a chlamydiaor gonorrhoea infection.

How it’s caught

Pelvic Inflammatory Disease (PID) is a bacterial infection of the female upper genital tract, including the womb, fallopian tubes and ovaries. Most cases of PID are caused by an infection in the vagina or the neck of the womb (cervix) that has spread to the reproductive organs higher up.

Many different types of bacteria can cause PID, but most cases are the result of a chlamydiaor gonorrhoea infection.

In some cases, the cause of the infection that leads to PID is unknown. Such cases may be the result of normally harmless bacteria found in the vagina. These bacteria can sometimes get past the cervix and into the reproductive organs. Although harmless to the vagina, these types of bacteria can cause infection in other parts of the body. Infection in this way is most likely to happen when there has been damage to the cervix, or if you have had PID before.

Symptoms

The symptoms of Pelvic Inflammatory Disease (PID) are fairly general, which means the condition can be difficult to diagnose. The warning signs include:

  • Pain around the pelvis or lower abdomen
  • Discomfort or pain during sex that is felt deep inside the pelvis
  • Bleeding between periods and after sex
  • Unusual vaginal discharge, especially if it is yellow or green
  • Fever and vomiting
  • Pain in the rectum (back passage)

You may have PID without being aware of it. Sometimes, there are no symptoms at all or symptoms may not be obvious. For example, you may only experience mild discomfort.

The more often a woman gets PID, the more likely she is to get it in the future. If an initial episode of PID damages the cervix, it can become easier for bacteria to move into the reproductive organs in the future, making you more susceptible to developing the condition again. Repeated episodes of PID are associated with an increased risk of infertility.

Abscesses

Sometimes, PID can cause abscesses in the fallopian tubes and/or ovaries. An abscess is a collection of infected fluid. It can usually be treated with antibiotics. If an abscess does not respond to antibiotics, you may require surgery to drain the infected fluid. It is important that abscesses inside the pelvis are either treated or removed, as an abscess that bursts inside you can be potentially life threatening.

Ectopic pregnancy

The word 'ectopic' means in the wrong place. In a normal pregnancy, the fertilised egg implants in the womb lining. An ectopic pregnancy is one that occurs outside the womb. Over 95% of ectopic pregnancies occur in a fallopian tube. If PID develops in the fallopian tubes, it can scar the lining of the tubes, making it more difficult for eggs to pass through. If a fertilised egg gets stuck and begins to grow inside the tube, it can cause the tube to burst, which can sometimes lead to severe internal bleeding. Ectopic pregnancy is a potentially fatal condition if not recognised and treated.

Infertility

It is estimated that one in five women may become infertile as a result of PID. This means they will be unable to get pregnant naturally. PID can make a woman infertile by scarring the fallopian tubes so severely that it makes it virtually impossible for the egg to travel down into the womb. Delaying treatment for PID or having repeat episodes of PID can increase your chances of becoming infertile.

Testing

There is no single test for diagnosing pelvic inflammatory disease (PID). Your doctor will diagnose PID based on your symptoms and on a examination. When your doctor examines you, they will look for tenderness in your pelvic region and an abnormal vaginal discharge. This will usually involve a gentle internal examination by the doctor or nurse which might feel a little uncomfortable or strange.

The doctor will usually take swabs from inside your vagina and cervix, which will be sent to a laboratory to try to identify the type of bacteria causing the infection. However, a swab test cannot be relied on to diagnose PID as some women with PID have a negative swab result.

Because PID is difficult to diagnose by the symptoms alone, you may have a blood test or an ultrasound scan. Scans can identify severe PID but will not show up mild disease. It is, therefore, possible to have a normal scan and still have PID.

Treatment

If it is diagnosed at an early stage, pelvic inflammatory disease (PID) can be treated quickly and efficiently with antibiotics. You will probably be given antibiotics to take by mouth for at least two weeks. Severe cases may be admitted to hospital for observation and treatment with antibiotic injections. The longer PID goes untreated the more likely it is that the fallopian tubes and other reproductive organs will be damaged and you may need surgery to stop the spread of damage, surgery may not be able to stop you becoming infertile if it is left too late.

Always see your doctor or nurse if you think you might have PID as the sooner you are treated, the better. If you are given treatment, always make sure that you take all of your antibiotics and finish the entire course.

Prevention

The most effective way to prevent Pelvic Inflammatory Disease (PID) is to protect yourself from sexually transmitted infections (STIs).

This means using a condom for vaginal or anal sex, a dam or condom for oral sex or practicing safer sex alternatives.

 

For more information call  0800 22 44 88 or use our sexual health service finder to look for help in your area.