Pelvic inflammatory disease: Symptoms, causes, treatment, and prevention

Pelvic inflammatory disease is an inflammation of the female reproductive organs. It can lead to scar formations with fibrous bands that form between tissues and organs.

It can affect the uterus, or womb, the fallopian tubes, the ovaries, or a combination.

Complications include chronic, persistent, pelvic pain, ectopic pregnancy, and infertility. According to the Centers for Disease Control and Prevention (CDC), 1 in 8 women who have had pelvic inflammatory disease (PID) have difficulty becoming pregnant.

Most cases result from an untreated infection in the vagina or cervix that spreads.

Sexually transmitted infections (STIs) are a common cause, but it can develop from infections due to other causes.

The National Health and Nutrition Examination Survey (NHANES) 2013 to 2014 found that, out of 1,171 sexually experienced women of reproductive age in the United States (U.S.), 4.4 percent reported having ever had PID.

Around 800,000 women receive a diagnosis of PID each year in the U.S.

Fast facts about pelvic inflammatory disease

Pelvic inflammatory disease (PID) often stems from an untreated sexually transmitted infection or other gynecological infection.

Symptoms may not be noticeable, but they can include pain and fever.

Untreated PID can lead to scarring, fertility problems, or an abscess.

Treatment is usually with antibiotics, but surgery may be necessary.

Prevention strategies include practicing safe sex and not having multiple sexual partners.

Symptoms

Pelvic inflammatory disease can cause pain and lead to infertility.
Pelvic inflammatory disease can cause pain and lead to infertility.

Many women with PID have no symptoms. If symptoms appear, they can vary from mild to severe. However, untreated PID can have serious consequences.

Possible symptoms include:

pain, possibly severe, especially in the pelvic area

fever

fatigue

bleeding or spotting between periods

irregular menstruation

pain in the lower back and the rectum

pain during sexual intercourse

unusual vaginal discharge

frequent urination

vomiting

Sometimes the symptoms resemble those of an ovarian cyst, appendicitis, endometriosis, or a urinary tract infection (UTI).

PID can be acute, lasting up to 30 days, or chronic if it lasts more than 30 days.

One difficulty with treating PID is that the symptoms are varied and that some women may have no symptoms.

Anyone who experiences symptoms or who thinks they may have been exposed to an STI or other cause of infection should see a doctor.

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Causes and risk factors

PID usually starts with an infection that begins in the vagina and spreads to the cervix. It can then move to the fallopian tubes and the ovaries.

The cause of infection can be bacterial, fungal, or parasitic, but it is more likely to involve one or more types of bacteria.

Sexually transmitted bacteria are the most common cause of PID. Chlamydia is the most common, followed by gonorrhea.

The American Family Physician (AFP) estimates that between 80 and 90 percent of women with chlamydia and 10 percent of those with gonorrhea have no symptoms.

Some 10 to 15 percent of women with chlamydia or gonorrhea go on to develop PID as a secondary infection.

Risk factors

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