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Pelvic inflammatory disease (PID)

Contents of this page:


Pelvic laparoscopy
Pelvic laparoscopy
Female reproductive anatomy
Female reproductive anatomy

Alternative Names    Return to top

PID; Oophoritis; Salpingitis; Salpingo-oophoritis; Salpingo-peritonitis

Definition    Return to top

Pelvic inflammatory disease is a general term for infection of the uterus lining, fallopian tubes, or ovaries.

See also: Endometritis

Causes    Return to top

Most cases of pelvic inflammatory disease are caused by the same bacteria that lead to sexually transmitted diseases (such as chlamydia, gonorrhea, mycoplasma, staph, and strep).

The most common cause of PID is through sexual contact. However, bacteria may also enter the body after gynecological procedures such as:

In the United States, nearly 1 million women develop PID each year. About 1 in 8 sexually active adolescent girls will develop PID before age 20. Since PID is often undiagnosed, statistics are probably greatly underestimated.

Risk factors include:

Birth control pills are thought in some cases to lead to cervical ectropion, a condition that allows easier access to tissue where bacteria may grow. However, birth control pills may protect against PID by stimulating the body to produce a thicker cervical mucus. This makes it harder for semen to carry bacteria to the uterus.

Symptoms    Return to top

The most common symptoms of PID include:

Other symptoms that may occur with PID:

Note: There may be no symptoms. People who experience an ectopic pregnancy or infertility often have silent PID, which is usually caused by chlamydia infection.

Exams and Tests    Return to top

You may have a fever and abdominal tenderness. A pelvic examination may show:

Tests and procedures may include:

Treatment    Return to top

If you are diagnosed with mild PID, you may be given antibiotics and told to closely follow-up with your health care provider.

More severe cases may require you to stay in the hospital. Antibiotics are first given by IV, and then later by mouth. Which antibiotic is used depends on the type of infection.

Surgery may be considered for complicated cases that do not improve with antibiotics. Any sexual partner(s) must also be treated. It is essential that you use condoms during treatment.

Possible Complications    Return to top

PID infections can cause scarring of the pelvic organs, possibly leading to:

When to Contact a Medical Professional    Return to top

Call your health care provider if you have symptoms of PID. Also call if you think you have been exposed to a sexually transmitted disease or if treatment of a current STD does not seem to be working.

Prevention    Return to top

Preventive measure include:

You can reduce the risk of PID by getting regular STD screening exams. Couples can be tested for STDs before starting to have sex. Testing can detect STDs that may not be producing symptoms yet.

All sexually active women ages 20 - 25 and younger should be screened each year for chlamydia and gonorrhea. All women with new sexual partners or multiple partners should also be screened.

References    Return to top

Centers for Disease Control and Prevention (CDC). Update to sexually transmitted diseases guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep. 2007;56:332-336.

U.S. Preventive Services Task Force. Screening for Gonorrhea: Recommendation Statement. Am Fam Physician. 2005;72:1783-1786.

Meyers D, Wolff T, Gregory K, et al. USPSTF recommendations for STI screening. Am Fam Physician. 2008;77:819-824.

Update Date: 9/7/2008

Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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