Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs, including the uterus, fallopian tubes, and ovaries. It most often results from sexually transmitted bacteria (such as chlamydia or gonorrhea) spreading upward from the vagina and cervix.

Symptoms

PID symptoms can be mild, subtle, or even absent, making diagnosis challenging. When present, symptoms may include:

- Lower abdominal or pelvic pain (most common)
- Unusual or heavy vaginal discharge (often with a bad odor)
- Pain during sex (deep pelvic pain)
- Painful or frequent urination
- Bleeding between periods or after sex
- Heavy or painful periods
- Fever and chills
- Nausea and vomiting
- Fatigue
- Lower back or rectal pain
- Loss of appetite

Some women may have no symptoms and only discover PID when evaluated for infertility or chronic pelvic pain.

When to Seek Medical Attention

Seek urgent care if you experience:

Severe lower abdominal pain
High fever (over 101°F/38.3°C)
Nausea and vomiting with inability to keep food down
Fainting or signs of shock

Even with milder symptoms (unusual discharge, pain with urination, bleeding between periods), see your healthcare provider promptly, as early treatment helps prevent complications.

Diagnosis

Diagnosis is based on:

Clinical symptoms and pelvic examination (checking for tenderness, abnormal discharge, or pain on touching the cervix)
Swabs from the vagina or cervix to test for STIs (chlamydia, gonorrhea)
Urine and blood tests for infection markers
Imaging (pelvic ultrasound or CT) to rule out other causes and assess for complications like tubo-ovarian abscess
Pregnancy test to exclude ectopic pregnancy
Laparoscopy (in select cases) for direct visualization if diagnosis is uncertain or symptoms are severe

Complications if Untreated

Infertility (due to scarring of fallopian tubes)
Chronic pelvic pain
Ectopic pregnancy (risk increases with tubal damage)
Tubo-ovarian abscess (pocket of infection)
Recurrent PID

Key Points

- PID is often caused by sexually transmitted infections but can result from other bacteria.
- Many women have mild or no symptoms, so routine STI screening and early evaluation of symptoms are important.
- Prompt diagnosis and treatment reduce the risk of long-term reproductive complications.