Pelvic inflammatory disease is a general term for infection of the uterus lining, fallopian tubes, or ovaries.
See also: Endometritis
PID; Oophoritis; Salpingitis; Salpingo-oophoritis; Salpingo-peritonitis
Pelvic inflammatory disease (PID) occurs when bacteria move from the vagina or cervix into the uterus, fallopian tubes, ovaries, or pelvis.
Most cases of PID are due to the bacteria that cause chlamydia and gonorrhea . These are sexually transmitted infections (STIs). The most common way a woman develops PID is by having unprotected sex with someone who has a sexually transmitted infection.
However, bacteria may also enter the body during some surgical or office procedures, such as:
In the United States, nearly 1 million women develop PID each year. About 1 in 8 sexually active adolescent girls will develop PID before age 20.
You are more likely to develop PID if you have:
The most common symptoms of PID include:
Other symptoms that may occur with PID:
You may have a fever and abdominal tenderness. A pelvic examination may show:
Lab tests that look for signs of infection are:
Other tests include:
Your doctor will often start you on antibiotics while waiting for your test results.
If you are diagnosed with milder PID, you will usually be given an antibiotic injection or shot, and then sent home with antibiotic pills to take for up to 2 weeks. You will need to closely follow up with your health care provider.
More severe cases of PID may require you to stay in the hospital. Antibiotics are first given by IV, and then later by mouth. Which antibiotic is used depends on the type of infection.
Sexual partners must be treated to prevent passing the infection back and forth. You and your partner must finish all of the antibiotics. Use condoms until you both have finished taking your antibiotics.
Complicated cases that do not improve with antibiotics may need surgery.
PID infections can cause scarring of the pelvic organs, possibly leading to:
Call your health care provider if:
Preventive measures include:
You can reduce the risk of PID by getting regular STI screening exams. Couples can be tested before starting to have sex. Testing can detect infections that are not yet causing symptoms.
All sexually active women ages 20 - 25 and younger should be screened each year for chlamydia and gonorrhea. All women with new sexual partners or multiple partners should also be screened.
Birnbaumer DM, Anderegg C. Sexually transmitted diseases. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 96.
Workowski KA, Berman S; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010 Dec 17;59(RR-12):1-110.
Meyers D, Wolff T, Gregory K, et al. USPSTF recommendations for STI screening. Am Fam Physician. 2008;77:819-824.