What Is Pelvic Inflammatory Disease (PID)?
Medically reviewed by Peter Weiss, MD
Pelvic inflammatory disease (PID) is an infection of the female reproductive organs, including the ovaries, uterus, and fallopian tubes. Most people assigned female at birth develop PID due to an underlying sexually transmitted infection (STI), such as chlamydia or gonorrhea.
If the infection is left untreated, it can lead to serious health complications, including infertility—or, your ability to achieve pregnancy. That's why knowing the symptoms, learning how to prevent PID, and understanding when to seek medical care can be so important.
Symptoms
Symptoms of PID can vary from person to person. Some people may have very mild symptoms or none at all, while others experience more severe symptoms of the condition. If you do develop symptoms of PID, it's common to experience:
Abnormal vaginal discharge
Burning sensation or pain when you pee
Irregular menstrual cycles
Bleeding in between periods
It's important to note that symptoms of PID can mimic the symptoms of other health conditions. That said, it can sometimes be difficult to get a diagnosis for PID right away. If your healthcare provider isn't able to treat your condition and help you reduce your symptoms, you may want to seek an opinion from another provider.
Causes
Pelvic inflammatory disease occurs when bacteria from the vagina or cervix spread to the uterus, ovaries, or fallopian tubes. Usually, this happens because of an untreated sexually transmitted infection (STI), such as:
However, non-sexually transmitted bacterial infections can also cause PID. These may include:
Escherichia coli (E. coli infection)
Streptococcus (also causes strep throat and scarlet fever)
Risk Factors
PID is particularly common among sexually active people assigned female at birth who are ages 25 and younger. You’re especially at risk for developing PID if you have an untreated STI or if you’ve had PID in the past.
Other risk factors for PID include:
Having multiple sex partners
Engaging in sex with a partner who has multiple sex partners
Vaginal douching
Using an intrauterine device (IUD) for birth control
Diagnosis
No single test can diagnose PID at this time. Instead, your healthcare provider will learn about your medical history and current symptoms, perform a physical exam, and conduct a pelvic exam to make an accurate assessment of your health.
To diagnose you with PID and rule out any other potential health conditions that may be causing your symptoms, your healthcare provider may order one or more of the following tests:
Imaging tests such as an ultrasound
Lab tests such as taking a sample of your vaginal discharge
Urine tests
Endometrial biopsy
Laparoscopy
Treatment
The goal of treatment for PID is to clear up the underlying infection that is causing your symptoms. The first line of treatment usually involves antibiotics. The exact antibiotic medications that you receive will depend on the bacteria that is causing your symptoms—which your healthcare providers can determine during your diagnostic process.
Generally, you'll need a two-week course of an oral antibiotic, such as Monodox (doxycycline). While you may feel symptom relief after just a few days of the antibiotics, it's imperative to finish the entire course of medication to eliminate the bacteria from your system.
Healthcare providers also recommend that if you have PID, your sexual partner(s) should also receive treatment to prevent the bacteria from spreading again. They may also suggest practicing safe sex (e.g., wearing a condom) as you complete your antibiotics to lower the risk of reinfection.
In some cases, more robust treatment may be necessary. Your healthcare provider may recommend intravenous (IV) antibiotics if you:
Can’t take oral antibiotics
Have a high fever or are vomiting frequently
It's important to note that while treatment can improve your symptoms and remove the bacteria from your system, it cannot undo damage to your reproductive system. If your condition is left untreated or you receive treatment late, you may be at a higher risk of complications such as abscesses (pus-filled lumps), scarring of your reproductive organs, or infertility.
How to Prevent Pelvic Inflammatory Disease
While you can't always prevent every case of PID, there are some things you can do to lower your risk of developing the infection. Some prevention strategies include:
Avoiding douching the vaginal area
Using condoms during sex
Getting tested regularly for STIs
Limiting the number of sexual partners you have
Seeking out support from your healthcare provider if you develop symptoms of an STI
Complications
Untreated PID can lead to a number of medical complications, including infertility. This may occur because of permanent scarring in the fallopian tubes. In fact, about 10% of people who develop PID (and don’t treat it quickly enough) may have difficulty getting pregnant later in life.
Other complications of PID may include:
Ectopic pregnancy, or when the egg grows outside of the uterus
Chronic pelvic pain
Preterm labor, or giving birth before 37 weeks of pregnancy
Tubo-ovarian abscess (TOA), which can cause a mass (lump) to develop in your reproductive system
To avoid these complications, it's best to reach out to your primary healthcare provider or obstetrician-gynecologist (OB-GYN) to get evaluated for PID if you think you may have symptoms of the condition.
A Quick Review
Pelvic inflammatory disease (PID) is an infection of the female reproductive organs that mainly affects people who were assigned female at birth. The most common cause of PID is bacterial infections, including sexually transmitted infections (STI), such as chlamydia or gonorrhea.
If the condition is left untreated, you may experience worsening symptoms (e.g., severe pelvic pain) or develop complications like infertility or ectopic pregnancy. To prevent PID, it’s important to take precautions while having sex and getting tested for STIs with your partner(s) regularly. If you think you are having symptoms of PID, it's good practice to talk to your healthcare provider to get evaluated and learn about treatment options, if necessary.
Frequently Asked Questions
How long does it take an STI to turn into PID?
It takes many people over a year to develop PID, if the underlying cause is a sexually transmitted infection (STI). However, some people develop the condition much earlier. In rare cases, people notice PID symptoms right away after contracting chlamydia or gonorrhea.
Can you get PID without being sexually active?
Most cases of PID are caused by STIs. However, it’s sometimes possible to get PID from other kinds of bacteria if you’re not sexually active. Examples include Streptococcus and Escherichia coli (E. coli) bacteria.
Does PID show up on an STI test?
An STI test alone isn’t enough to diagnose pelvic inflammatory disease. Your healthcare provider may use an STI test along with a pelvic examination, ultrasound, and/or urine test to make an accurate diagnosis.
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