Pelvic Inflammatory Disease Pid

Overview

Pelvic inflammatory disease, often called PID, is an infection in the female upper reproductive organs. This includes the womb (uterus), the fallopian tubes, and the ovaries. It happens when bacteria travel up from the vaginal area and cause inflammation and infection. PID is usually caused by a sexually transmitted infection, but it can also happen after childbirth, miscarriage, or certain procedures.

Yes, PID is a common condition. It affects hundreds of thousands of women and people with female reproductive organs each year, especially in their teens, twenties, and early thirties.

PID mainly affects sexually active women and people assigned female at birth. You are more likely to get PID if you are under 25, have had a sexually transmitted infection, or have had PID before.

Symptoms

Common symptoms

• Lower belly or pelvic pain that may range from mild to severe
• Unusual or heavy vaginal discharge with a bad smell
• Pain during sex
• Bleeding between periods or after sex
• Pain or burning when peeing
• Fever or chills
• Feeling tired or generally unwell

Symptoms in children

• PID is not common in children. If symptoms do occur, they might include tummy pain, unusual vaginal discharge, or a fever.
• Any pelvic pain in a child needs to be checked by a healthcare provider promptly.

Symptoms in older adults

• In women who have been through the menopause, PID is less common but it can still happen.
• Symptoms may be milder, but they can include lower belly pain, abnormal discharge, or unexpected bleeding.
• If you are postmenopausal and have any pelvic pain or discharge, it is important to see a doctor.

Causes

Main causes

• Sexually transmitted bacteria, especially chlamydia and gonorrhoea, are the most common causes.
• Other bacteria normally found in the vagina can also be involved, sometimes together.
• PID can develop after a termination (abortion), a miscarriage, or a procedure such as inserting an intrauterine device (IUD).
• You can get PID after giving birth, especially if an infection occurs around this time.

Risk factors

• Being under 25, because the cervix is more vulnerable to certain infections
• Having multiple sexual partners, or a partner who has multiple partners
• Having a sexually transmitted infection, or a partner who has one
• Previous PID – having it once makes you more likely to get it again
• Using intrauterine contraception (IUD), especially soon after insertion
• Douching, which can push bacteria further up and change the natural balance of the vagina

When to see a doctor

See a doctor urgently if:

• If you have severe lower belly pain, a high fever, or vomiting, seek urgent care the same day.
• If you have unusual discharge or pain after recent surgery, an IUD insertion, or a pregnancy loss, contact a healthcare provider right away.

Book a routine appointment if:

• If you have mild belly pain, unusual discharge, bleeding between periods, or pain during sex, book an appointment with your GP or sexual health clinic.
• If you think you have been exposed to a sexually transmitted infection, get tested even if you feel fine. Early treatment can prevent PID.

Diagnosis

To diagnose PID, a healthcare provider will ask about your symptoms, sexual history, and any recent procedures. They will do a gentle internal examination to feel for tenderness and take a swab from the cervix. There is no single perfect test for PID, so diagnosis is based on the whole picture.

Tests that may be done

• A pelvic examination – the doctor or nurse will look at your vulva, vagina, and cervix using an instrument called a speculum
• Swabs from the vagina or cervix to check for chlamydia, gonorrhoea, and other bacteria
• Urine tests to check for infection
• Blood tests to look for signs of inflammation or infection
• An ultrasound scan may be used if there is a concern about an abscess or to look at the fallopian tubes and ovaries

What to expect at your appointment

The pelvic examination can be uncomfortable but usually takes only a few minutes. You can ask the doctor or nurse to go slowly, and you can ask for a chaperone if you would prefer one. Many people feel a little bloated or tender after the exam, but this normally settles within a day.

Treatment

PID is treated with antibiotics. Because it is often caused by more than one type of bacteria, you are usually given a combination of antibiotics. It is important to take every dose exactly as prescribed, even if you start feeling better before the course is finished.

Self-care at home

• Rest until you feel better – pelvic pain can get worse with activity.
• Drink plenty of fluids and eat light meals to keep your strength up.
• Use a hot water bottle or heating pad on your lower belly to help with pain – protect your skin with a cloth.
• Take over-the-counter pain relief as directed by your pharmacist or healthcare provider.
• Do not have sex until you have finished your treatment and the doctor confirms you are clear – sexual activity can make the infection worse and can pass it on.

Medical treatments

Treatment always involves antibiotics. Depending on how unwell you are, these may be given as tablets at home, or as an injection and tablets in hospital for a more severe infection. Your current sexual partner, and any recent partners, may need testing and treatment too – even if they have no symptoms. It is important to avoid intercourse until both you and your partner(s) have completed treatment.

When is surgery considered?

Surgery is rarely needed for PID. It is considered if you develop an abscess (a pocket of pus) in the pelvis that does not get better with antibiotics, or if the infection does not respond to medical treatment. In these cases, a drainage procedure or a laparoscopy may be performed. This is a careful decision made by your gynaecology team.

Living with this condition

During PID treatment, take time to rest. Avoid vigorous activity or heavy lifting until your pain improves. Finish all your antibiotics, even if you feel well. Go to any follow-up appointments so your doctor can confirm the infection has gone. It is also normal to feel low or anxious while recovering – give yourself time to heal.

Lifestyle tips

• Use condoms consistently and correctly to reduce the risk of future infections.
• Avoid douching – it disrupts the natural balance of bacteria in the vagina.
• Keep track of your cycles and note any new or unusual symptoms.
• Attend regular sexual health check-ups, especially if you have changed partners.
• If you have a partner, talk openly with them about getting tested and treated together.

Diet and exercise

Eating a balanced diet helps your body fight infection. Include plenty of vegetables, fruit, whole grains, and protein. You do not need a special diet for PID. Gentle movement, such as short walks, can help your recovery, but avoid strenuous exercise until your symptoms settle.

Mental health and emotional wellbeing

Having PID can bring up feelings of worry, shame, or fear – especially when it is linked to a sexually transmitted infection. These feelings are very common and nothing to be embarrassed about. If feelings of anxiety or low mood are affecting your daily life, talk to your healthcare provider. They can recommend counselling or mental health support. If you are in crisis, do not face it alone – contact your local emergency number or a mental health crisis line right away.

Prevention

Yes, PID can often be prevented. The most effective way is to prevent sexually transmitted infections. Using condoms every time you have vaginal sex significantly lowers your risk. Also, regular STI testing – and making sure your partner gets tested – helps catch infections early before they can lead to PID.

Screening programmes

If you are sexually active and under 25, or if you have a new partner, your local sexual health clinic may recommend regular chlamydia and gonorrhoea screening. This can be done with a simple urine test or a swab. Early detection and treatment of STIs is one of the best ways to prevent PID.

Complications

If left untreated

• Untreated PID can cause permanent damage to the fallopian tubes, making it harder to get pregnant (infertility).
• Scar tissue can form around the Fallopian tubes and ovaries, causing long-term pelvic pain.
• You may have a higher risk of ectopic pregnancy – a pregnancy that implants in the fallopian tube or other place outside the womb.
• An abscess may form in the pelvis, which can become very painful and might require surgery.

Long-term outlook

The outlook is very good when PID is caught and treated early. Most people make a full recovery and can go on to lead healthy lives and have healthy pregnancies. Complications can happen, but they are less likely if you complete your treatment and follow up with your doctor. Even if you have had PID before, you can take steps to protect your health going forward.

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