What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is an infection of a woman's upper reproductive organs. This includes the uterus, fallopian tubes, ovaries, and surrounding tissues.

PID is most common among young women who have sexual intercourse, especially with multiple partners. It rarely occurs after menopause.

How does it occur?

Pelvic inflammatory disease may occur:

• from a sexually transmitted disease, such as a chlamydial infection or gonorrhea

• after a miscarriage, abortion, or childbirth.

PID most often results from an infection that enters a woman's body during sexual intercourse. Sometimes the specific cause or specific type of bacteria cannot be determined.

What are the symptoms?

Possible symptoms of PID are:

• pain and tenderness in the lower abdomen

• abnormally heavy vaginal discharge that smells bad

• irregular or heavy menstrual periods

• pain in the pelvic or abdominal area during sexual intercourse (may be severe)

• flulike symptoms such as fever, general discomfort, fatigue, back pain, or vomiting.

How is it diagnosed?

Your health care provider will ask about your recent symptoms and do a physical exam. Lab tests of samples of your blood, vaginal discharge, and urine may be done to try to find out what is causing the infection.

In some cases, abdominal pain and vaginal bleeding can be symptoms of an ectopic pregnancy (when the fertilized egg implants outside the uterus). Both are life-threatening emergencies. For this reason a pregnancy test may be done.

A laparoscopy may be necessary to confirm the diagnosis of PID. A laparoscopy is a surgical procedure performed while you are under anesthesia. The doctor makes a small incision at the navel and inserts a slim telescope (laparoscope) through the incision to view the organs in the abdomen and pelvis. If you have PID, your tubes and ovaries will be swollen and inflamed.

What is the treatment?

• Mild PID, without fever or severe pain, is usually treated with a combination of injected and oral antibiotics.

• Moderate PID may be treated with several days of intravenous (IV) antibiotics given once or twice a day. This can be done at your health care provider's office, the emergency room or clinic, or sometimes at home with visits from a nurse.

• If you have an IUD, your health care provider may remove it.

• If you have an abscess, a collection of pus in the pelvis, you may need surgery to drain it.

• If you have severe PID, you may need to stay at a hospital for continuous IV antibiotic treatment.

How long will the effects last?

If the infection is not treated, it could spread to other parts of your body or create an abscess in the fallopian tubes or ovaries. PID can cause scarring of the fallopian tubes. This scarring could make it hard for you to get pregnant. Prompt and complete treatment is very important to try to preserve your ability to have children. Scarring of the fallopian tubes also increases your risk of having a tubal pregnancy in the future.

How can I take care of myself?

• Call your health care provider as soon as you notice any new symptoms.

• Take the full course of treatment that your health care provider recommends.

• Follow any special directions for taking your prescribed medicine, which may include avoiding dairy products or alcohol.

• Do not have sexual intercourse until your health care provider tells you it is OK.

• Rest and take acetaminophen, ibuprofen, or aspirin for pain relief.

• Call your health care provider if your condition does not improve in 3 days.

• If your health care provider thinks your infection may be caused by a sexually transmitted disease, your sexual partner must be examined and treated as well.

What can be done to help prevent pelvic inflammatory disease?

The following practices may help prevent PID:

• Have just one sexual partner.

• Use a latex condom to reduce the risk of infection every time you have sex.

• Have yearly pelvic exams, including tests for infection.