Pelvic Inflammatory Disease

(PID)

In this factsheet:
• The Facts on Pelvic Inflammatory Disease
• Causes of Pelvic Inflammatory Disease
• Symptoms and Complications of Pelvic Inflammatory Disease
• Diagnosing Pelvic Inflammatory Disease
• Treating and Preventing Pelvic Inflammatory Disease

The Facts on Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is the most serious complication of sexually transmitted diseases (STDs) such as chlamydia and gonorrhea.

PID affects the upper genital tract including the uterus, ovaries, and fallopian tubes. Well over a million women get PID each year in North America. It's the leading cause of tubal infertility in young women, but it can usually be prevented if STDs are detected and treated early. One of the long-term consequences of PID is constant pelvic pain.

Causes of Pelvic Inflammatory Disease

PID is caused by a bacterial infection in parts of the upper reproductive tract. The most commonly affected organs include the fallopian tubes, ovaries, and uterus. The bacteria most commonly associated with PID are Neisseria gonorrheae and Chlamydia trachomatis, but bacteria normally present in the vagina and cervix may also be involved. The cervix produces mucus that normally prevents bacteria from spreading to the upper reproductive tract. Researchers believe that the bacteria migrate upwards when this normal body defense is not working at its strongest (i.e., during ovulation and menses).

Risk factors for PID include:

• number of sexual partners (the more partners, the greater the risk)
• being sexually active before age 25 (women)
• current or past STDs
• douching more than once or twice a month
• use of intrauterine device (IUD) contraception - it may slightly increase the risk of PID (this risk is lowered when women are tested and treated for infections before getting an IUD)

Symptoms and Complications of Pelvic Inflammatory Disease

Symptoms of PID can vary widely - from none at all to severe.

The most common symptoms of PID are:

• lower abdominal pain
• abnormal vaginal discharge which may be foul-smelling
• fever
• pain during intercourse
• irregular menstrual bleeding

Complications of PID can be prevented with early treatment. Without treatment, PID can cause infertility, ectopic (tubal) pregnancy, chronic pelvic pain, and abscesses. Infertility occurs in up to 20% of women with PID and is caused by the development of scar tissue that partially or totally blocks the fallopian tubes.

Ectopic pregnancies occur when a fertilized egg attaches to the fallopian tube, instead of in the uterus. If not caught and treated early, ectopic pregnancies can be fatal. Scarring can also lead to chronic pelvic pain

The most serious complication of PID is the rupture of either an abscess or of the walls of one of the infected organs. This requires immediate medical attention. This may cause bacteria to pour out into the abdominal cavity, causing a general abdominal infection, known as peritonitis. Bacteria can also get into the bloodstream (a condition known as sepsis). Rupture of an abscess will cause a sharp increase in symptoms. Intense lower abdominal pain will be followed by nausea, then weakness and possibly fainting.

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