Pelvic inflammatory disease (PID) is a serious infection in the upper genital tract/reproductive organs (uterus, fallopian tubes and ovaries) of a female. PID can be sexually transmitted or naturally occurring. It can lead to infertility in women (unable to have children) or life-threatening complications.
How common is it?
Women between ages 15 and 25 have the highest incidence of PID. In the United States, PID is the leading cause of infertility in women (the inability to have children).
How is it transmitted?
Two other sexually transmitted infections (STIs), chlamydia and gonorrhea, are the most common causes of PID. Other bacteria or germs can also cause PID. If you have an infection in the genital tract and do not get treated right away, it can cause PID. The infection spreads from the cervix into the uterus, fallopian tubes, and ovaries. It can take anywhere from several days to several months after being infected to develop PID.
What can cause an infection to spread into the upper genital tract?
Using an intrauterine device (IUD). According to the Centers for Disease Control and Prevention (CDC), the risk for PID associated with IUD use is primarily confined to the first 3 weeks after insertion and is uncommon thereafter.
Douching. Women who douche once or twice a month are more likely to have PID than those who douche less than once a month. Douching may also ease symptoms of an infection, thus delaying effective treatment.
What are the symptoms?
Dull pain or tenderness in the lower abdomen
Burning or pain when you urinate (pee)
Nausea and vomiting
Bleeding between menstrual periods
Increased or changed vaginal discharge
Pain during sex
Fever and chills
It is possible for a woman to have PID and be asymptomatic (without symptoms), or have symptoms too mild to notice, for an unknown period of time.
PID can also be misdiagnosed as appendicitis, ectopic pregnancy, ruptured ovarian cysts or other problems.
How is it diagnosed?
The diagnosis of PID can be made when all three of the following symptoms are found during a pelvic exam:
Lower abdominal tenderness
Tenderness of fallopian tubes and ovaries
Tenderness of the cervix
All other explanations for these findings must have been ruled out, so your healthcare provider may also order tests to identify the organism which led to the infection (such as chlamydia or gonorrhea) or to distinguish between PID and other problems with similar symptoms.
A pelvic ultrasound is a helpful procedure for diagnosing PID. An ultrasound can view the pelvic area to see whether the fallopian tubes are enlarged or whether an abscess (pus-filled area) is present.
In some cases, a laparoscopy may be necessary to confirm the diagnosis. A laparoscopy is a surgical procedure in which a thin, flexible tube with a lighted end (laparoscope) is inserted through a small incision in the lower abdomen. This procedure enables the doctor to view the internal pelvic organs and to take specimens for laboratory studies, if needed.
How is it treated?
Broad-spectrum antibiotics are the recommended treatment, as they can cover the likely pathogens.
Treatment may include antimicrobial agents to treat gonorrhea, chlamydia, streptococci and other gram-negative bacteria.
Ofloxacin (oh-flox-ah-sin) tablets (FLOXIN) can be used alone to treat PID.
Aggressive treatment of PID is recommended for women with HIV, who may be more likely to require surgical intervention.
Sex partners of patients who have PID should be examined and treated if they have had recent sexual contact to avoid re-infection.
Take all medications as directed.
You may need a follow-up exam 48 to 72 hours after start of treatment to make sure the medicine is working.
Return for another exam after completion of treatment to make sure the infection is completely gone.
Tell your partner to get tested and treated.
Remember: Do not have sex until you and your partner(s) have been treated and cured.
Hospitalization to treat PID may be recommended if the woman:
is severely ill (nausea, vomiting, and high fever);
does not respond to or cannot take oral medi