Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) is an infection of internal organs such as uterus (womb), fallopian tube (tube which carries egg from ovary to the womb) and sometimes the ovaries. In addition to these reproductive organs, the surrounding tissues also get infected. This infection usually spreads from the vagina travels through the cervix (neck of the womb) into the uterus and along the fallopian tubes it enters the pelvis (tummy). Most of the times, the lady gets such infection through sexual intercourse, hence it is called sexually transmitted infection. PID can be of two types acute and chronic depending on the severity of infection.

What is acute / chronic pelvic inflammatory disease?
  • When the infection is active and you have sever tummy pain and fever it is known as acute PID
  • Sometimes this infection can stay in your body for long time and is known as chronic PID.
What are the causes?

There are a number of reasons, which increase the risk of getting pelvic inflammatory disease.

  • More than one sexual partner
  • Being sexually active with a person who has multiple sex partners
  • Having unprotected sex
  • History of sexually transmitted infection like chlamydia and gonorrhea
  • Intrauterine device (IUD) does not carry an increased risk of pelvic inflammatory disease. The risk if any is generally limited to the initial three weeks after insertion.
  • Rarely can happen after delivery / abortion / D&C
What are the symptoms?

Sometimes you may not have any symptoms despite of the infection, but commonly seen symptoms are

  • Foul smelling vaginal discharge, this can be greenish / thick white discharge,
  • Abnormal vaginal bleeding such as, bleeding after sexual intercourse, bleeding in-between your periods and heavy periods,
  • Sever pain in lower tummy,
  • Fever, nausea, vomiting
  • Sever back pain
  • Pain during sexual intercourse, this pain can be at the entrance of the vagina and sometimes pain can be with deep penetration.
  • Pain when you pass urine
  • Sometimes you can have pus formation in your pelvis and this is called abscess formation.

* Please note: you may notice similar type of symptoms in other conditions, hence it you have any such symptoms please consult your doctor

What tests will be required for diagnosis?

There is no single test to diagnose PID. Your doctor will first note down your symptoms and examine you. In examination your doctor will feel your tummy first to see for any tenderness (pain on touch) and then do internal examination at this point of time, they may take a swab from the vagina for test to see what type of infection you have.

You may be advice to undergo further test, to help in the diagnosis such as

  1. Blood test
  2. Urine test
  3. Ultrasound (USG)
  4. Endometrial biopsy to take a sample of cells from the inside of your uterus and check them for infection
  5. Sometime you may require diagnostic laparoscopy (put telescope into your tummy, this is surgery) for accurate diagnosis of PID.
What are the treatment options available?
  • Mainstay of treatment is taking antibiotics. Depending upon your severity of PID, you may be prescribed oral or injectable antibiotics. You may sometimes be advised to take antibiotics for 2 weeks. If you have been prescribes oral antibiotics, you will be advised to monitor your symptoms for 48 to 72 hrs, if you notice that your symptoms are not subsiding then you should go back and see your doctor.
  • Sometimes you may require hospitalization to get injectable antibiotics, this can happen if your are very unwell, your oral antibiotics not working, unable to take oral antibiotics,
  • Along with antibiotics you will also be prescribed painkillers for the pain.
  • If you have abscess (pus formation in your pelvis), your doctor may advise laparoscopy to remove the pus.
  • It is very important to follow your doctors advice to prevent long term complications.
Should my partner undergo any test or treatment?
  • If you have acquired this infection through sexually transmitted infection then your partner doesn’t need any test but your partner should be treated.
When can I have sex again?
  • You should avoid sexual intercourse till both you and your partner have completed full course of treatment. This is to prevent cross infection.
What are the long-term side effects of PID?

With proper antibiotics PID can be successfully treated without any long-term sides-effects. But if PID is not treated well, you can have side effects such as

  • Fallopian tube scaring – this can lead to infertility (difficult to become pregnant), ectopic pregnancy, pus formation in the fallopian tube
  • Chronic pain is another long-term side effect.
Can I become pregnant after PID treatment?
  • If you have had proper treatment, you should not have any issues to become pregnant. But, if you have not taken treatment you can have issues to become pregnant.
Key points:
  • PID is infection of the pelvic organs and this is usually transmitted by sexually transmitted infections. PID can also happen following abortion, delivery and after having copper-T (coil) insertion.
  • Abnormal bleeding / white discharge, fever and tummy pain could be common symptoms.
  • Diagnosis is made by symptoms, examination (abdominal and internal) and test reports (blood, vaginal swab and USG).
  • Mainly treated with antibiotics.