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Diseases & Conditions

Pelvic Inflammatory Disease (PID)

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. PID usually is contracted through sexual contact. PID can damage the uterus, ovaries, fallopian tubes or other parts of the female reproductive system. It also can cause severe pain and make it difficult to become pregnant.

How common is PID?

Each year, more than 1 million women in the United States experience an episode of PID, and almost 15 percent of women will suffer from PID at some point in their lives. As a result of PID, more than 100,000 women become infertile each year. In addition, a large proportion of the 70,000 ectopic (tubal) pregnancies that occur each year can be linked to PID. The rate of infection is highest among teenagers.

What causes PID?

Normally, the cervix prevents bacteria that enter the vagina from spreading to the internal reproductive organs. If the cervix is exposed to a sexually transmitted disease—such as gonorrhea and chlamydia—the cervix itself becomes infected and less able to prevent the spread of organisms to the internal organs. PID occurs when the disease-causing organisms travel from the cervix to the upper genital tract. Untreated gonorrhea and chlamydia cause about 90 percent of all cases of PID. Other causes include abortion, childbirth and pelvic procedures.

What are the symptoms of PID?

The symptoms of PID can vary, but may include the following:

  • Dull pain or tenderness in the stomach or lower abdominal area, or pain in the right upper abdomen
  • Abnormal vaginal discharge that is yellow or green in color and that has an unusual odor
  • Irregular periods
  • Spotting or cramping throughout the month
  • Chills or high fever
  • Nausea and vomiting
  • Pain during sex

What are the risk factors for PID?

  • Women with sexually transmitted diseases—especially gonorrhea and chlamydia—are at greater risk for developing PID.
  • Women who have had a prior episode of PID are at higher risk for another episode.
  • Sexually active teenagers are more likely to develop PID than are older women.
  • Women with many sexual partners are at greater risk for sexually transmitted diseases and PID.

Some studies suggest that douching may contribute to PID. Douching may push bacteria into the upper genital tract and may mask the discharge that could alert a woman to seek medical attention.

How is PID diagnosed?

Your doctor will begin with a detailed history of your general health and sexual activity. He or she will perform a pelvic exam to check the health of your reproductive organs, and look for evidence of gonorrhea and chlamydia infection.

If your doctor suspects PID, he or she may order other diagnostic tests, including:

  • Blood tests, analyzing blood for evidence of infection
  • Ultrasound (sonogram), the use of sound waves to form an image of the reproductive organs
  • Endometrial biopsy, a procedure in which a small sample of tissue from the lining of the uterus (endometrium) is removed for evaluation and testing
  • Laparoscopy, a procedure during which a thin, lighted instrument (laparoscope) is inserted through a small cut in the lower abdomen to allow the doctor to examine the internal reproductive organs
  • Culdocentesis, a procedure in which a needle is inserted behind the vagina (Fluid is removed through the needle and examined for signs of bleeding or infection.)

How is PID treated?

If the findings of your exam and tests suggest PID, treatment is begun immediately. The initial treatment for PID usually consists of one or more antibiotic medications taken by mouth (orally). If treatment is not effective, if you cannot take antibiotics by mouth or if the infection is severe, you may need to be hospitalized to receive medication intravenously (directly into a vein).

If you are diagnosed with PID, your sexual partner(s) also must be treated. Otherwise, PID will likely recur when you have sex again.

What are the complications of PID?

Recurrent episodes of PID can result in scarring of the fallopian tubes, which can lead to infertility, ectopic (tubal) pregnancy or chronic pelvic pain. Infertility occurs in about 20 percent of women who have PID.

How is PID prevented?

  • Avoid multiple sexual partners.
  • Use barrier methods of birth control (condoms and/or a diaphragm) and spermicides – even if you use birth control pills.
  • Seek treatment immediately if you notice signs of PID or any sexually transmitted disease, including unusual vaginal discharge, pelvic pain or bleeding tween periods.
  • Have regular gynecologic check-ups and screenings, because many cervical infections can be identified and treated before they spread to the internal reproductive organs.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/1/2007…#9129