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Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information. This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer. Pelvic inflammatory diseasePelvic inflammatory disease (PID) is an infection of a woman's reproductive organs. In 2013, about 88,000 women ages 15–44 in the United States were diagnosed with PID.1 PID is often caused by a sexually transmitted infection (STI). If left untreated, PID can cause problems getting pregnant, problems during pregnancy, and long-term pelvic pain. What is PID?PID is an infection of a woman's reproductive organs. The reproductive organs include the uterus (womb), fallopian tubes, ovaries, and cervix. PID can be caused by many different types of bacteria. Usually PID is caused by bacteria from STIs. Sometimes PID is caused by normal bacteria found in the vagina.
Who gets PID?PID affects about 5% of women in the United States.2 Your risk for PID is higher if you:3
How do you get PID?A woman can get PID if bacteria move up from her vagina or cervix and into her reproductive organs. Many different types of bacteria can cause PID. Most often, PID is caused by infection from two common STIs: gonorrhea and chlamydia. The number of women with PID has dropped in recent years. This may be because more women are getting tested regularly for chlamydia and gonorrhea.5 You can also get PID without having an STI. Normal bacteria in the vagina can travel into a woman's reproductive organs and can sometimes cause PID. Sometimes the bacteria travel up to a woman's reproductive organs because of douching. Do not douche. No doctor or nurse recommends douching. What are the signs and symptoms of PID?Many women do not know they have PID because they do not have any signs or symptoms. When symptoms do happen, they can be mild or more serious. Signs and symptoms include:
PID can come on fast, with extreme pain and fever, especially if it is caused by gonorrhea. How is PID diagnosed?To diagnose PID, doctors usually do a physical exam to check for signs of PID and test for STIs. If you think that you may have PID, see a doctor or nurse as soon as possible. If you have pain in your lower abdomen, your doctor or nurse will check for:
Your doctor may do tests to find out whether you have PID or a different problem that looks like PID. These can include:4
A Pap test is not used to detect PID. How is PID treated?Your doctor or nurse will give you antibiotics to treat PID. Most of the time, at least two antibiotics are used that work against many different types of bacteria. You must take all of your antibiotics, even if your symptoms go away. This helps to make sure the infection is fully cured. See your doctor or nurse again two to three days after starting the antibiotics to make sure they are working. Your doctor or nurse may suggest going into the hospital to treat your PID if:
If you still have symptoms or if the abscess does not go away after treatment, you may need surgery. Problems caused by PID, such as chronic pelvic pain and scarring, are often hard to treat. But sometimes they get better after surgery. What can happen if PID is not treated?Without treatment, PID can lead to serious problems like infertility, ectopic pregnancy, and chronic pelvic pain (pain that does not go away). If you think you may have PID, see a doctor or nurse as soon as possible. Antibiotics will treat PID, but they will not fix any permanent damage done to your internal organs. Can I get pregnant if I have had PID?Maybe. Your chances of getting pregnant are lower if you have had PID more than once. When you have PID, bacteria can get into the fallopian tubes or cause inflammation of the fallopian tubes. This can cause scarring in the tissue that makes up your fallopian tubes. Scar tissue can block an egg from your ovary from entering or traveling down the fallopian tube to your uterus (womb). The egg needs to be fertilized by a man's sperm and then attach to your uterus for pregnancy to happen. Even having just a little scar tissue can keep you from getting pregnant without fertility treatment. Scar tissue from PID can also cause a dangerous ectopic pregnancy (a pregnancy outside of the uterus) instead of a normal pregnancy. Ectopic pregnancies are more than six times more common in women who have had PID compared with women who have not had PID.6 Most of these pregnancies end in miscarriage. How can I prevent PID?You may not be able to prevent PID. It is not always caused by an STI. Sometimes, normal bacteria in your vagina can travel up to your reproductive organs and cause PID. But, you can lower your risk of PID by not douching. You can also prevent STIs by not having vaginal, oral, or anal sex. If you do have sex, lower your risk of getting an STI with the following steps:
The steps work best when used together. No single step can protect you from every single type of STI. Can women who have sex with women get PID?Yes. It is possible to get PID, or an STI, if you are a woman who has sex only with women. Talk to your partner about her sexual history before having sex, and ask your doctor about getting tested if you have signs or symptoms of PID. Did we answer your question about PID?Sources
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All material contained on these pages are free of copyright restrictions and maybe copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated. Page last updated: February 22, 2021 How do I know if I have pelvic inflammatory disease?How do I know if I have PID?. Pain in your lower abdomen;. Fever;. An unusual discharge with a bad odor from your vagina;. Pain and/or bleeding when you have sex;. Burning sensation when you urinate; or.. Bleeding between periods.. What is the most common manifestation of pelvic inflammatory disease?When signs and symptoms of PID are present, they most often include:. Pain — ranging from mild to severe — in your lower abdomen and pelvis.. Unusual or heavy vaginal discharge that may have an unpleasant odor.. Unusual bleeding from the vagina, especially during or after sex, or between periods.. Pain during sex.. What usually causes pelvic inflammatory disease?The main cause of PID is through a sexually transmitted infection (STI) such as chlamydia, gonorrhoea or mycoplasma genitalium. These bacteria usually only infect the cervix, where they can be easily treated with antibiotics.
What does inflammation of the pelvis feel like?pain around the pelvis or lower tummy. discomfort or pain during sex that's felt deep inside the pelvis. pain when peeing. bleeding between periods and after sex.
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