Pelvic inflammatory disease (PID)

What is pelvic inflammatory disease (PID)?

Pelvic Inflammatory Disease (PID) is an infection of the upper genital tract, including the uterus, fallopian tubes and ovaries. It usually begins as an infection of the vagina or cervix, which then spreads upwards. The infection can spread beyond the reproductive organs into the tissues surrounding them. Chlamydia and gonorrhea are Sexually Transmitted Infections (STIs) that commonly cause PID. For more information about chlamydia and gonorrhea, visit HealthLinkBC File #08l Chlamydia and HealthLinkBC File #08a Gonorrhea.

Other infections that are not sexually transmitted can also cause PID.

To find out if you have PID, you must be examined by a health care provider and have lab tests done.

How is it spread?

PID is most often caused by STIs. Factors that make getting PID more likely include having:

• Unprotected sex with someone with an STI such as chlamydia or gonorrhea
• A previous PID infection
• Sexual contact
• Recent medical procedures that open your cervix such as abortion, dilation and curettage (D&C), or having an Intrauterine Device (IUD) inserted
• Leaving tampons or items such as contraceptive sponges or diaphragms in the vagina too long. Bacteria can thrive and then spread from the vagina to the uterus

What are the symptoms?

People who have PID often do not have any symptoms and do not know they have it. However, when present, the most common symptoms are:

• Pain in the lower abdomen (usually both sides)
• Fever (greater than 38oC or 100.4oF)
• Pain deep inside during vaginal sex
• Abnormal vaginal bleeding or spotting between periods
• Change in the amount, colour or odour of fluid from the vagina
• Having to urinate more often
• Pain or burning feeling when urinating
• Lower back pain
• Nausea or vomiting

What are the potential complications?

If you are treated early in the infection, you are less likely to have complications. Potential complications from PID can include:

• Long lasting pelvic pain
• Trouble getting pregnant (infertility)
• Increased chance of an ectopic or tubal pregnancy (where a fertilized egg attaches to the fallopian tube or any other area outside of the uterus)
• Getting PID again
• Toxic Shock Syndrome (TSS)
• Fitz-Hugh-Curtis syndrome, a rare complication of the liver

The likelihood of having complications from PID increases each time a person has a pelvic infection.

What is the treatment for PID?

The usual treatment for PID is antibiotics. In some cases, PID may be severe enough that you need to be admitted to the hospital for intravenous (IV) antibiotic treatment.

You should return to your health care provider 3 days after starting treatment if symptoms continue. If symptoms worsen, seek urgent medical care (for example, go to a hospital emergency room).

Sexual partners from the last 2 months need to be tested and treated. If you have not had a sexual partner in the last 2 months, then your last sexual partner will need to be tested and treated. It takes time for the infection to clear from the body, so it’s important that you do not have any oral, vaginal or anal sex until after you and your partner(s) complete the antibiotic treatment.

If you or your partner(s) do not finish the treatment, miss pills or have unprotected sex before you have finished the medication, there is a chance that the infection will stay in your body or pass back to you or your partner(s), and may cause health problems later on. If that happens, talk with your health care provider to find out if you or your partner(s) need more treatment.

How can I reduce my chance of getting a sexually transmitted infection (STI)?

These are some steps you can take to reduce your chances of getting an STI:

• Get informed: Understand different STIs, how to prevent them and which sexual activities are likely to pass them
• Get tested: Get tested regularly with your partner(s) for STIs so you know and can act as soon as possible
• Have safer sex: Use condoms, barriers or lube to make sex safer
• Get vaccinated: Vaccines are available to prevent some infections, including HPV, hepatitis A and hepatitis B
• Talk to your partner(s): Discuss consent, safer sex, sexual activities and preferences, and STI testing. Communication can help protect the health of you and your partners, and help you have positive sexual relationships and experiences

For more information

For more information on how you can reduce your chance of getting an STI, visit HealthLinkBC File #08o Preventing sexually transmitted infections (STIs).