- Pelvic Inflammatory Disease: Prevention and Treatment
- Risk Factors
- Signs and Symptoms
- Counseling for Prevention
- Pelvic Inflammatory Disease (PID) – CDC Fact Sheet
- What is PID?
- How do I get PID?
- How can I reduce my risk of getting PID?
- How do I know if I have PID?
- Can PID be cured?
- What happens if I don’t get treated?
- Where can I get more information?
- What Is Pelvic Inflammatory Disease (PID)?
- Causes and Risk Factors
- PID Symptoms
- PID Treatment
- PID Complications
- PID Prevention
Pelvic Inflammatory Disease: Prevention and Treatment
What is pelvic inflammatory disease?
Pelvic inflammatory disease, or PID, is a serious infection of a woman’s reproductive system. Every year it’s contracted by about a million women in the United States. The disease is most likely to harm your Fallopian tubes, which may be badly scarred; this problem may lead to a life-threatening tubal pregnancy if you conceive. Left untreated, PID can cause sterility or in rare cases, even death.
What causes it?
Two sexually transmitted diseases, chlamydia and gonorrhea, are the most common causes. Other bacteria can trigger the infection as well. The disease may develop over a period of days or even months after you’ve been infected. Since PID can cause permanent damage without producing any symptoms at all, you should be tested for chlamydia or gonorrhea once a year if you’re sexually active and aged 25 or younger, or if you are over 25 and at risk (meaning you have new or multiple partners).
What are the indications that I might have PID?
Acute PID appears suddenly and can be agonizingly painful, while chronic PID comes on more slowly and is harder to detect. Pay attention to any dull pain or tenderness in the lower abdomen, since this is the most common symptom of the disease. Other signs include the following:
- Bleeding between menstrual periods
- Unusually heavy bleeding during periods
- Increased or foul-smelling vaginal discharge
- Frequent or painful urination
- Pain in the lower pelvis during menstruation
- Nausea and vomiting
- Fever and chills
- Pain during sex
Who’s at risk?
Any woman can develop PID. You’re at higher risk of contracting it if any of the following applies to you:
- You’re under 25 and are having sex
- You’ve had multiple sexual partners
- You douche regularly
- You’ve had a sexual partner with gonorrhea or an illness called nongonococcal urethritis (an inflammation of the urethra that’s usually caused by chlamydia)
- You have an untreated gonorrhea or chlamydia infection
- You’ve previously had PID
- You’ve used an intrauterine device (IUD) for contraception (this risk is generally only increased among women who had an STD at the time the IUD was inserted and is greatly reduced if you are tested and treated for STDs before insertion)
How does infection occur?
Chlamydia or gonorrhea may infiltrate your uterus or one of the other reproductive organs during sex. The bacteria can also get into your pelvic area if your cervical opening is larger than usual, which may be the case after childbirth. The presence of blood (especially during menstruation) can also make it easier for you to get infected.
How can I find out whether I have PID?
If you suspect you do, you should make an appointment with your doctor immediately. The doctor will give you a pelvic exam, checking for tenderness in your uterus, Fallopian tubes, or ovaries, and will take a culture to see if bacteria are present. He or she will also take blood and urine samples and may do a rectal exam.
If the exam and the samples don’t provide enough information, the doctor may want to do a simple surgical procedure called a laparoscopy. This entails giving you an anesthetic, making a small incision in your abdomen, and using a lighted tube to look inside and check for signs of the disease.
If necessary, your doctor may do other tests to see if you have PID or a different condition that looks like PID. These tests may include an ultrasound — a procedure that uses sound waves to take pictures of the pelvic area, or an endometrial biopsy, in which a small piece of the inside lining of the womb is removed and tested.
How is PID treated?
Your treatment depends how severe the infection is. If it’s mild, you’ll be given antibiotics in pill form. (Remember, take all medications till they’re entirely used up, even if your symptoms vanish. If you don’t, the infection might not go away.) If you have a more severe infection or don’t respond to the medication, you may be treated with intravenous injections of antibiotics. Be sure to go to your follow-up appointments, and let your doctor know if the symptoms get worse.
If you’re badly infected and the antibiotics aren’t doing the trick, you may need to have surgery. That option might also be called for if you have an abscess that needs to be drained or if you’re experiencing persistent pain despite another form of treatment. In either of these cases, your doctor may suggest surgical removal or repair of the infected areas.
Your partner should also be seen by a urologist and treated; both of you should avoid sex until you are completely cured. If your partner goes untreated, he or she could reinfect you when you resume having sex.
How can I guard against PID?
The American Social Health Association says that the best way to prevent PID is to keep from getting sexually transmitted diseases, and suggests using a latex condom whenever you have sex. For other tips on practicing safe sex, check their Web site at www.ashastd.org. You should also take the following precautions:
- Have regular pelvic exams
- If you’re sexually active, get tested once a year for STDs
- Avoid douching
- Get prompt treatment for any sexually transmitted disease
- Avoid having intercourse or putting anything such as tampons in your vagina for two to three weeks following a miscarriage or an abortion and for six weeks following childbirth
Can men help prevent PID?
Definitely. Wearing a condom during intercourse helps prevent the STDs that often cause this disease. Also, your male partner should tell you right away if he’s having any symptoms of a sexually transmitted disease; these include a pus-like discharge from the penis and pain or burning during urination. By warning you that you need to be tested, he will help you ward off long-term damage to your reproductive system.
Pelvic Inflammatory Disease. Frequently Asked Questions. US Department of Health and Human Services. 2010
Centers for Disease Control. Pelvic Inflammatory Disease CDC Fact Sheet. April 7, 2008.
Gareen IF et al. Intrauterine devices and pelvic inflammatory disease: meta-analyses of published studies, 1974-1990. Epidemiology 2000 Sep;11(5):589-97.
The Self-Care Advisor:230 The Health Publishing Group 1996.
Brigham Narins, Editor. World of Health:872-74. The Gale Group 2000.
Pelvic inflammatory disease, or PID, is an infection of the organs of a women’s reproductive system. They include the uterus, ovaries, fallopian tubes, and cervix. It’s usually caused by a sexually transmitted infection (STI), like chlamydia or gonorrhea, and is treated with antibiotics.
You might not notice any symptoms of PID early on. But as the infection gets worse, you can have:
- Pain in your lower belly and pelvis
- Heavy discharge from your vagina with an unpleasant odor
- Bleeding between periods
- Pain during sex
- Fever and chills
- Pain when you pee or a hard time going
Call your doctor right away if you have any of these.
PID can cause serious problems if it’s not treated. For example, you might have trouble getting pregnant or have pain in your pelvic area that doesn’t go away.
In some cases, PID can bring on more intense symptoms, and you’ll need to go to the emergency room. Get medical help right away if you have:
- Severe pain in your lower belly
- Signs of shock, like fainting
- Fever higher than 101 F
Some of these also can be signs of other serious medical conditions, like appendicitis or an ectopic pregnancy (a pregnancy that happens in a fallopian tube outside the womb). You would need medical help right away for these as well.
US Pharm. 2016;41(9):38-41.
ABSTRACT: Pelvic inflammatory disease (PID) remains a relevant public health concern due to long-term effects on reproductive potential. Despite being the most common gynecologic infection, programs focusing on prevention are lacking. Given the correlation between PID and sexual activity, practitioners should be cognizant of this disease in adolescents and young adults. The treatment of PID should include antimicrobials with activity against common sexually transmitted pathogens as well as other vaginal microflora.
Pelvic inflammatory disease (PID) is a polymicrobial infection of the female genital tract that frequently results in acute or chronic pelvic pain, as well as infertility in women.1,2 The CDC estimates that nearly 1 million cases of PID are diagnosed each year, with 20% of cases occurring in adolescents, making it the most common gynecologic infection in the United States.1,3
Sexually active women aged 15 to 24 years comprise 25% of the sexually active population; however, they represent nearly 50% of the 18.9 million sexually transmitted diseases (STDs) reported in the U.S. each year. Younger women are at a greater risk for PID development than older women with greatest risk in those aged 15 to 20 years.4 From 2006-2010, approximately 5% of women reported being treated for PID in their lifetime,1 yet actual incidence may be higher due to many subclinical infections.
Risk for PID is greatest in adolescence and young adulthood (age <25 y).5 Additionally, patients who engage in sexual activity at an early age (<15 years), have sex during menstruation, participate in casual sex while traveling, have a new sexual partner within the past 12 months, and/or multiple sexual partners are at increased risk.5-7 In rare cases, PID can occur in adolescent women who have not started menstruation or engaged in sexual activity.5 Use of contraception, vaginal douching, and a history of PID will also increase the patient’s risk for PID.5 PID also occurs more frequently in African-American women, but exact causes increasing infection rates are unknown.7
Intrauterine devices (IUDs) have been identified as a risk factor for PID; however, the newer generation levonorgestrel and copper IUDs have a decreased risk comparatively. Rates of PID have been found to be higher with the copper IUD in women <25 years of age.8 Risk peaks after the first month of insertion; women should be counseled about the small increase in risk. Women should be screened via history and physical examination for risk of PID prior to IUD insertion. Those with increased risk should be tested; however, IUD placement does not need to be delayed. As described below, PID can also be treated without removal of an IUD, unless the patient requests removal.8
Adolescent females are often considered poor candidates for IUDs as contraception due to the perceived risk of PID; however, both the World Health Organization (WHO) and the CDC view benefits likely outweighing real or theoretical risks.4 Thus, IUDs can be used in both nulliparous women and adoles-cents. IUDs should be offered to teenagers with a thorough sexual history, effective STD screening, and follow-up with age-specific counseling.4
Signs and Symptoms
Approximately 60% of patients with PID are asymptomatic.2 This predisposes patients to long-term sequelae if left untreated, including chronic pelvic pain and infertility in nearly 20% of patients. Unfortunately, symptoms are generally nonspecific and may range from mild abdominal pain to severe pelvic pain.1,5,9 A recent report found that rates of PID infection were higher in servicewomen ages 17 to 20 years who had a chlamydia diagnosis after basic training,10 which may represent a patient population where more efforts are needed for screening and education.
Cardinal symptoms include cervical motion tenderness, uterine tenderness, or adnexal tenderness.1,2,11 Other symptoms patients may experience include pelvic pain and tenderness, lower abdominal pain and tenderness, pain with sexual intercourse, irregular menstrual bleeding, or purulent vaginal discharge.1,2,11 Patients may also experience nonspecific symptoms such as lower back pain, nausea, and vomiting.9 When patients do report symptoms, 36% report mild-to-moderate symptoms and 4% report severe symptoms.11 Most women will present with lower abdominal or pelvic pain, although it is frequently mild, leading to a missed diagnosis or patients not seeking care.9
PID may also present with generalized systemic inflammation as a result of a suspected or known infection. Symptoms manifesting from these responses include an oral temperature >38.3°C (101°F), elevated erythrocyte sedimentation rate or C-reactive protein, or presence of white blood cells on microscopy of vaginal secretions.1,2,11
Pathophysiology and Diagnosis
Diagnosis of PID is made by clinical examination; there is no specific test confirming PID diagnosis.10 PID should always be part of the differential diagnosis in women aged 15 to 44 years who present with lower abdomen or pelvic pain.4,9 It is estimated that 10% to 20% of women with chlamydial or gonorrheal infections develop PID if untreated, which is likely to occur given that 80% to 90% of women with a chlamydial infection and 10% with a gonorrheal infection are asymptomatic.9 Despite a growing focus on antimicrobial stewardship, practitioners should initiate treatment when there is a reasonable suspicion of PID due to long-term sequelae and high risks of a missed diagnosis.4 Currently, the CDC recommends that providers screen all sexually active females younger than 25 years old, and older women with risk factors (e.g., new sexual partner, multiple sexual partners, or a sexual partner with an STD) for both chlamydia and gonorrhea.1 All women diagnosed with acute PID should be tested for HIV, gonorrhea, and chlamydia.1
In healthy women, the predominant vaginal-endocervical flora microbe is Lactobacillus. It is thought that Lactobacillus serves an important role in maintaining a healthy vaginal flora, acting as a defense mechanism by inhibiting colonization of pathogenic bacteria.9 Approximately 25% of asymptomatic women lack Lactobacillus-dominated flora, with nearly 50% having a vaginal pH >4.5.12 A dearth of Lactobacillus dominance may contribute to overgrowth of pathogenic bacteria, resulting in the subsequent development of PID.9 Bacterial vaginosis (BV) is a clinical syndrome where alternation in the vaginal flora occurs, with declining Lactobacilli. BV-associated organisms have been found to be associated with PID, and BV is an independent risk for both STDs and PID.13,14 It is unclear if identification and treatment of BV reduce the incidence of PID.1
PID is most commonly associated with Chlamydia trachomatis or Neisseria gonorrhoeae; however, causation by these pathogens is decreasing, with <50% of acute PID cases testing positive for either of these organisms.1,5 Other associated pathogens include Haemophilus influenzae, Gardnerella vaginalis, Group B Streptococcus, Mycoplasma genitalium, Ureaplasma urealyticum, and Cytomegalovirus (CMV), among many other potential pathogens.1,5 Patients with IUDs have been found to have greater infection rates with Peptostreptococcus and Fusobacterium species, which may be associated with complicated PID.9
PID is not limited to pathogens found in the vagino-cervical endogenous flora due to the ascending infection from the cervix and vagina to upper genital structures.5 Microorganisms implicated in PID are believed to spread to upper genital tract tissues to cause further infection in a multitude of ways. Infection may travel intra-abdominally from the cervix to the endometrium and then into the peritoneal cavity, may travel through lymphatic systems (e.g., infection of the parametrium from an IUD), or through hematogenous routes, but this last route is thought to be rare.9
Young adolescent females (<15 years of age) are at greatest risk for PID due to differences in cell composition in the genital tract. Less differentiated epithelial cells are less resistant to gonococcal and chlamydial infections when compared with cells seen in older adolescents and adult women. This is further complicated by immune system reactions to chlamydial infection, resulting in inflammation and subsequent chronic injury to genital tract tissue.5
The treatment of PID can be divided into inpatient and outpatient treatment strategies as shown in TABLES 1 and 2, respectively.11 In females with mild-to-moderate disease, IV regimens appear to have equal efficacy to oral regimens.15 Patients who fail outpatient therapy are classified as complicated (e.g., tubo-ovarian abscess, pregnancy, unable to take oral medications) or are deemed to be surgical emergencies, should be considered for inpatient therapy. Patients who are treated with an IV regimen initially can often be transitioned to oral or IM therapy within 24 to 48 hours. Regardless of patient status, the selected regimen should provide adequate coverage of commonly implicated pathogens.15
Several antimicrobial regimens have demonstrated efficacy in achieving clinical and microbiologic cure in randomized clinical trials.16,17 Notably, most regimens contain at least one agent with activity against anaerobic organisms due to some association with PID in both in vivo and in vitro studies. Some patients may also have concurrent BV, thus necessitating the addition of metronidazole. Because of this as well as the potential role of anaerobic pathogens in PID, the use of agents with anaerobic activity is recommended for the guidelines. N gonorrhoeae is also particularly problematic because of increasing rates of resistance to cephalosporins.18 Due to concerns for treatment failure, fluoroquinolone therapy should only be utilized when parenteral therapy is not feasible or patient allergies preclude other therapies from being selected. Doxycycline, a common component of both inpatient and outpatient regimens, should be administered orally whenever possible as it demonstrates similar bioavailability regardless of route and is caustic to veins when administered IV. Data using azithromycin in the treatment of PID is sparser and may not always be reliable against M genitalium and C trachomatis infections.19-21
Finally, adjunctive therapies such as use of nonsteroidal anti-inflammatory drugs (NSAIDs) or removal of IUDs does not improve clinical outcome.22,23 A systematic review comparing PID treatment courses in women who retained IUDs versus women with removal of IUDs overall showed comparable, if not better, outcomes in duration of hospitalization and improvement of clinical signs and symptoms.9 Hormonal contraceptives also offer benefit in prevention of PID, reducing the risk by 50% to 60%; subsequently, this reduces the risk of ectopic pregnancy and infertility issues associated with PID. When patients do become infected with PID during hormonal contraceptive use, PID appears to have less severe inflammation.24
As pharmacists, it is imperative to be cognizant of the potential adverse effects associated with these regimens. Doxycycline, a common component in many of the regimens, has the potential to cause photosensitivity as well as gastrointestinal (GI) upset. Patients should be counseled to wear sunscreen if they plan to be outdoors for extended periods of time and take with a meal to minimize GI symptoms. Metronidazole may cause a disulfiram reaction if combined with alcohol or alcohol-containing products and thus patients should be counseled on avoidance of alcohol during the treatment course. This drug can also be associated with taste disturbance and urine discoloration. Levofloxacin and other fluoro-quinolones are associated with GI upset, tendinopathy, and photosensitivity.25
As with any antimicrobial therapy, it is worth noting that perturbing the normal vaginal flora may result in a yeast infection, especially in those patients who are prone to such infections. Anecdotal evidence suggests taking probiotics during the treatment course may help avoid yeast infections and this is often done in practice; however, data to support this is lacking. Lactobacilli strains such as Lactobacillus acidophilus have shown promise for improvement of vaginal symptoms and redness in patients with yeast infections.26
Counseling for Prevention
The most effective measure for the prevention of PID is prevention of STDs.27 To reduce the risk of STDs, patients should be encouraged to use latex condoms and receive routine screening for STDs, including HIV.1 Due to the possibility of severe complications from PID, female patients should be evaluated by an OB/GYN at least annually. Women should be counseled on the signs and symptoms of both STDs and PID, educated about avoidance of high-risk behaviors, and advised of the benefits of consistent condom use.4 Screening women for and treating cervical C trachomatis infection can reduce a woman’s risk of PID by approximately 30% to 50% over 1 year.28 If a female has been diagnosed with PID, she should be encouraged to abstain from sexual intercourse until she and her partner(s) have completed treatment.1,2,11
Sexual partners of women with PID should be screened for STDs, including partners from the previous 2 months. Treatment should cover both chlamydia and gonorrhea. If the last sexual encounter was >60 days before diagnosis, the most recent sexual partner should be screened. Education of women, especially adolescents, is critical. Discussion should include prevalence of asymptomatic infections and how PID episodes can result from future infections. Screening for reinfection should occur in 3 to 6 months.5
Vaccine development for the STD pathogens that ultimately cause PID has remained challenging. There are unique and complex immunologic characteristics of the male and female reproductive tracts, making them distinct from other mucosal tissues. Antibodies alone are not protective, only neutralizing infections. Despite challenges in previous vaccines against pathogens such as Treponema pallidum, C trachomatis, and N gonorrhoeae, new technologies provide hope for development of safe and effective vaccines against STDs, ultimately decreasing PID infection rates as well.27-29
PID remains a challenging condition to identify and treat due to high prevalence of asymptomatic infections. Screening for chlamydia and gonorrhea in all sexually active females younger than 25 years and in older women with high-risk behaviors is an important strategy in identifying patients with or at risk for PID and initiating early treatment. PID should be part of the differential diagnosis in all women aged 15 to 44 years with nonspecific abdominal pain. While antimicrobial therapy is highly effective, the focus of practitioners’ efforts should be to prevent long-term reproductive sequelae associated with PID. When pharmacists are involved in provision of treatment therapies for PID, it is important to discuss appropriate administration, duration of use, and common adverse effects associated with therapies.
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Pelvic Inflammatory Disease (PID) – CDC Fact Sheet
Untreated sexually transmitted diseases (STDs) can cause pelvic inflammatory disease (PID), a serious condition, in women. 1 in 8 women with a history of PID experience difficulties getting pregnant. You can prevent PID if you know how to protect yourself.
Basic Fact Sheet | Detailed Version
Basic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases. The content here can be .
What is PID?
Pelvic inflammatory disease is an infection of a woman’s reproductive organs. It is a complication often caused by some STDs, like chlamydia and gonorrhea. Other infections that are not sexually transmitted can also cause PID.
How do I get PID?
You are more likely to get PID if you
- Have an STD and do not get treated;
- Have more than one sex partner;
- Have a sex partner who has sex partners other than you;
- Have had PID before;
- Are sexually active and are age 25 or younger;
- Use an intrauterine device (IUD) for birth control. However, the small increased risk is mostly limited to the first three weeks after the IUD is placed inside the uterus by a doctor.
How can I reduce my risk of getting PID?
The only way to avoid STDs is to not have vaginal, anal, or oral sex.
If you are sexually active, you can do the following things to lower your chances of getting PID:
- Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results;
- Using latex condoms the right way every time you have sex.
How do I know if I have PID?
There are no tests for PID. A diagnosis is usually based on a combination of your medical history, physical exam, and other test results. You may not realize you have PID because your symptoms may be mild, or you may not experience any symptoms. However, if you do have symptoms, you may notice
- Pain in your lower abdomen;
- An unusual discharge with a bad odor from your vagina;
- Pain and/or bleeding when you have sex;
- Burning sensation when you urinate; or
- Bleeding between periods.
- Be examined by your doctor if you notice any of these symptoms;
- Promptly see a doctor if you think you or your sex partner(s) have or were exposed to an STD;
- Promptly see a doctor if you have any genital symptoms such as an unusual sore, a smelly discharge, burning when peeing, or bleeding between periods;
- Get a test for chlamydia every year if you are sexually active and younger than 25 years of age.
- Have an honest and open talk with your health care provider if you are sexually active and ask whether you should be tested for other STDs.
Can PID be cured?
Yes, if PID is diagnosed early, it can be treated. However, treatment won’t undo any damage that has already happened to your reproductive system. The longer you wait to get treated, the more likely it is that you will have complications from PID. While taking antibiotics, your symptoms may go away before the infection is cured. Even if symptoms go away, you should finish taking all of your medicine. Be sure to tell your recent sex partner(s), so they can get tested and treated for STDs, too. It is also very important that you and your partner both finish your treatment before having any kind of sex so that you don’t re-infect each other.
You can get PID again if you get infected with an STD again. Also, if you have had PID before, you have a higher chance of getting it again.
What happens if I don’t get treated?
If diagnosed and treated early, the complications of PID can be prevented. Some of the complications of PID are
- Formation of scar tissue both outside and inside the fallopian tubes that can lead to tubal blockage;
- Ectopic pregnancy (pregnancy outside the womb);
- Infertility (inability to get pregnant);
- Long-term pelvic/abdominal pain.
Where can I get more information?
STD information and referrals to STD Clinics
In English, en Español
CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
E-mail [email protected]
American Sexual Health Association (ASHA)external icon
P. O. Box 13827
Research Triangle Park, NC 27709-3827
- Chlamydia – CDC Fact Sheet
- Gonorrhea – CDC Fact Sheet
- STDs during Pregnancy – CDC Fact Sheet
American College of Obstetricians and Gynecologists (ACOG). Pelvic Inflammatory Disease. ACOG Patient Education Pamphlet, 1999.
What Is Pelvic Inflammatory Disease (PID)?
About 1 in 8 women with a history of PID has trouble getting pregnant.
Pelvic inflammatory disease (PID) is an infection of a woman’s reproductive organs.
It happens when bacteria from your vagina or cervix spreads to the uterus, fallopian tubes, or ovaries.
More than one million women in the United States get PID every year, according to Planned Parenthood. It’s most common between ages 15 and 24.
If untreated, PID can cause pelvic pain, problems getting pregnant, and issues during pregnancy.
Causes and Risk Factors
You can get PID any time bacteria enter the reproductive tract.
Most often, PID is caused by the bacteria that cause chlamydia and gonorrhea, which are sexually transmitted infections (STIs). These bacteria are usually spread during unprotected sex.
Less commonly, PID can happen after childbirth, an abortion, douching, a miscarriage, or insertion of an intrauterine device (IUD).
You’re at higher risk for PID if you:
- Have an STI
- Are sexually active and are younger than 25
- Have unprotected sex
- Have had PID in the past
- Douche your vagina
- Have more than one sexual partner
- Have a partner who has more than one sexual partner
- Have recently had an IUD inserted
Symptoms of PID may include:
- Pain in the pelvis, lower abdomen, or lower back
- Pain during intercourse
- Heavy vaginal discharge that has an unpleasant odor
- Painful or difficult urination
- Irregular menstrual bleeding
- Menstrual cramps that are more painful than usual
- Fever and chills
- Nausea or vomiting
Many women with PID don’t have any signs of the infection. Others, though, experience extreme pain and other symptoms that come on fast.
Doctors can diagnose PID during a simple pelvic exam. Your doctor may also order other tests to help assess your condition.
Your healthcare provider will most likely prescribe a combination of antibiotics to treat your PID.
If you have a very serious infection that doesn’t improve with standard treatment, you may need to begin treatment with intravenous (IV) antibiotics — and, later, additional antibiotic pills — or surgery to repair or remove your reproductive organs.
You may need to avoid sexual intercourse until your PID has been effectively treated.
Your partner may also need to be treated if your infection was caused by an STI.
If PID isn’t treated, it can cause scarring of the pelvic organs, which can lead to:
- Chronic pelvic pain
- An ectopic pregnancy (pregnancy outside the womb)
- Infertility (inability to get pregnant)
- An abscess in the fallopian tubes or ovaries
Your infection can also spread to your blood or other parts of the body.
It’s important to see a doctor right away if you think you may have PID. Antibiotics can treat your infection, but they won’t reverse any permanent damage to your internal organs.
You can help prevent PID by:
Practicing safe sex Use a condom when you have sex and limit your number of sexual partners.
Not douching This cleansing method can disrupt the balance of bacteria in your vagina.
Getting tested for STIs Treating an STI as early as possible can lower your chances of getting PID.
Adopting good hygiene habits Be sure to wipe from front to back after a bowel movement to avoid spreading bacteria from the rectal area to the vagina.