Pelvic Inflammatory Disease (PID)
Pelvic Inflammatory Disease (PID) is a serious infection of the uterus and fallopian tubes. The consequence of PID include scarring of the fallopian tubes that can lead to ectopic pregnancy, infertility, and pelvic infections, which also increases the risk of chronic pelvic pain.1
Chronic pelvic pain is seen in as many as one-third of women with PID. The pain is thought to be related to inflammation, scarring, and adhesions from the infectious process.
PID is typically an ascending infection, spreading from the lower genital tract, specifically the vaginal microbiome. The majority of cases of PID are related to a Sexually Transmitted Infection (STI), such as gonorrhoeae or chlamydia.
Other microbes, including Mycoplasma genitalium, Bacterial Vaginosis (BV) associated microbes e.g. Peptostreptococcus species, and Aerobic Vaginitis (AV) associated microbes, e.g. E.coli, Group B strep, have been implicated in PID.
Symptoms of PID include:
- Pain, ranging from mild to severe, in the lower abdomen and pelvis
- Unusual or heavy vaginal discharge that may have an unpleasant odour
- Unusual bleeding from the vagina, especially during or after sex, or between periods
- Pain during sex
- Fever, sometimes with chills
- Painful, frequent or difficult urination
PID requires antibiotics for treatment, and treatment should be sought quickly to reduce the risk of complications that can occur from this infection.
Risk factors for PID include:
- Being sexually active and younger than 25 years old
- Having multiple sexual partners
- Being in a sexual relationship with someone who has more than one sex partner
- Having sex without a condom
- Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and might mask symptoms
- Having a history of PID or STI
Reference
- National Institutes of Health. Pelvic inflammatory disease. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499959/ Last accessed March 12, 2025.
