Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries.

How do you get PID?

Most cases of PID are caused by an infection in the vagina or the neck of the womb (cervix) that has spread higher up.

Many different types of bacteria can cause PID. However most cases are the result of a chlamydia or gonorrhoea infection.

In some cases, the cause of the infection that leads to PID is unknown. Such cases may be the result of normally harmless bacteria found in the vagina. These bacteria can sometimes get past the cervix and into the reproductive organs.

Symptoms of PID

The symptoms of PID are fairly general, which means it can be difficult to diagnose. The symptoms may include:

• pain around the pelvis or lower abdomen
• discomfort or pain during sex that is felt deep inside the pelvis
• bleeding between periods or after sex
• unusual vaginal discharge
• fever and vomiting
• pain in the rectum (back passage)

If diagnosed and treated early, the complications of PID can be prevented.

If treatment is delayed some of the complications are:

• pelvic abscess formation
• long term or recurrent pelvic pain
• reduced fertility or infertility – this affects 1 in 10 women with PID and is more likely in severe infection or repeated episodes
• ectopic pregnancy – a serious condition where the baby grows outside the womb, most commonly the fallopian tube

Testing for PID

If you think you have PID you can make an appointment with your GP or local sexual health services.

There is no single test for diagnosing PID. Your doctor will diagnose PID based on your symptoms and an examination, as well as tests.

When your doctor examines you, they'll look for tenderness in your pelvic region and an abnormal vaginal discharge. This will usually involve a gentle internal examination by the doctor or nurse. 

The doctor will usually take swabs from inside your vagina and cervix. The swabs will be sent to a lab to try to identify the type of bacteria causing the infection. However, a swab test can't be relied on to diagnose PID, as some women with PID have a negative swab result.

You may have an ultrasound scan. Scans can identify severe PID but will not show up mild disease. It's possible to have a normal scan and still have PID.

Online appointment booking

You may be able to book an appointment for an STI test online using the online booking system. This varies for different NHS board areas.

Treatment for PID

If it's diagnosed at an early stage, PID can be treated quickly and efficiently with antibiotics. You will probably be given antibiotics to take by mouth for at least 2 weeks.

Severe cases may be admitted to hospital for observation and treatment with antibiotic injections.

Always see your doctor or nurse if you think you might have PID, as the sooner you are treated, the better. If you're given treatment, always make sure that you take all of your antibiotics and finish the entire course.

It's advised that your partner(s) are treated and that you avoid sex until your treatment is completed.

Reducing the risk of PID

The most effective way to prevent PID is to protect yourself from sexually transmitted infections (STIs).

This means using a condom for vaginal, anal or oral sex.

STIs

If you have been diagnosed with pelvic inflammatory disease it’s recommended you get tested for all STIs including:

• chlamydia
• gonorrhoea
• syphilis