Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries.

PID is a common condition, although it is not clear how many women are affected in the UK because it doesn't always have any obvious symptoms.

PID mostly affects sexually active women from the age of 15 to 24.

Symptoms of pelvic inflammatory disease

PID can be difficult to recognise if the symptoms are mild, and some women don’t have any symptoms.

Most women have mild symptoms that may include one or more of the following:

pain around the pelvis or lower abdomen (tummy)
discomfort or pain during sex that is felt deep inside the pelvis
pain during urination
bleeding between periods and after sex
heavy or painful periods
unusual vaginal discharge, especially if it is yellow or green

A few women become very ill with:

severe lower abdominal pain
a high temperature (fever)
nausea and vomiting

When to seek medical advice

It’s important to visit your GP or a sexual health clinic if you experience any of the above symptoms. If you have severe pain you should seek urgent medical attention from your GP or local emergency department. Delaying treatment for PID or having repeated episodes of PID can increase your risk of serious and long-term complications (see below).

There is no simple test to diagnose PID. Diagnosis is based on your symptoms and the finding of tenderness on a vaginal (internal) examination. Swabs will be taken from your vagina and cervix (the neck of the womb), but negative swabs do not exclude PID.

Causes of pelvic inflammatory disease

Most cases of PID are caused by a bacterial infection that has spread from the vagina or the cervix to the reproductive organs higher up.

Many different types of bacteria can cause PID. In about one in every four cases it is caused by a sexually transmitted infection (STI) such as chlamydia or gonorrhoea. In many other cases it is caused by bacteria that normally live in the vagina.

How pelvic inflammatory disease is treated

If diagnosed at an early stage, PID can be treated with a course of antibiotics, which usually lasts for 14 days. You will be given a mixture of antibiotics to cover the most likely infections, and often an injection as well as tablets.

It is important to complete the whole course and avoid having sexual intercourse during this time to help ensure the infection clears.

Your recent sexual partners will also need to be tested and treated to stop the infection recurring or being spread to others.

Complications of pelvic inflammatory disease

The fallopian tubes can become scarred and narrowed if they are affected by PID. This can make it difficult for eggs to pass from the ovaries into the womb, which can increase your chances of having an ectopic pregnancy (a pregnancy in the fallopian tubes instead of the womb) in the future, and can make some women infertile.

It's estimated that around one in every 10 women with PID becomes infertile as a result of the condition, with the highest risk in women who have had delayed treatment or repeated episodes of PID. However, most women who are treated for PID will still be able to get pregnant without any problems.

Read more about the complications of PID.

Preventing pelvic inflammatory disease

You can help reduce your risk of PID by always using condoms with a new sexual partner until they have had a sexual health check. Chlamydia is very common in young men, and most do not have any symptoms.

If you are worried you may have an STI, visit your local GUM or sexual health clinic for advice. Find your local sexual health clinic.

If you need an invasive gynaecological procedure, such as insertion of a coil or an abortion, make sure that you have a check-up beforehand.