Pelvic inflammatory disease (PID)

Pelvic inflammatory disease or 'PID' is an infection and inflammation of the upper reproductive organs, including the uterus (womb), fallopian tubes, and ovaries. If it is not treated early, PID can sometimes lead to serious long-term health problems including:

• Chronic pelvic pain
• Ectopic pregnancy
• Difficulty getting pregnant.

PID happens when bacteria travel up from the vagina or cervix (the entrance of your uterus/womb) into the uterus and upper reproductive tract.

The most common cause is an untreated sexually transmitted infection, especially chlamydia or gonorrhoea, but in many cases no single cause is found. PID can also happen:

• After pelvic procedures, including IUD insertion
• After childbirth
• After miscarriage or abortion.

PID can be hard to recognise. Some people have mild symptoms, and others have no symptoms at all.

Symptoms may include:

• Pain, cramping, or tenderness in the lower abdomen or pelvis
• Pain that may get worse with movement
• Pain during sex
• Unusual vaginal discharge
• Bleeding between periods or after sex
• Fever
• Nausea or vomiting
• Feeling unwell.

Not having symptoms does not rule out PID.

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Pelvic inflammatory disease can occasionally cause infertility (difficulty getting pregnant), ectopic pregnancy (a baby growing in a place outside the womb), or long-term pain. These things are more likely to happen if the treatment is late, so it’s important to get treated straight away.

there is no single test that confirms PID. Diagnosis is usually based on your symptoms, an examination, and other tests to help rule out other causes.

If PID is suspected, treatment is often started straight away rather than waiting for test results.

PID is treated with antibiotics, and early treatment is important.

For mild to moderate PID, treatment usually includes:

• One antibiotic injection
• Plus two weeks of antibiotic tablets.

It is important to:

• Take all the medication exactly as prescribed, even if you start to feel better
• Use simple pain relief if needed
• Seek urgent review if symptoms are getting worse or you feel very unwell.

More severe cases may need hospital treatment.

You should be reviewed after treatment to make sure your symptoms are improving, and retesting at 3 months is recommended because reinfection is common.

Using condoms correctly every time you have sex helps reduce the risk of STIs and PID.

Getting tested and treated early for STIs, especially chlamydia and gonorrhoea, also helps reduce the risk of PID and its complications.

If you are diagnosed with PID, sexual partners from the last 3 months should be told, checked, and treated if needed. Partner notification is important to prevent reinfection and reduce transmission. Your doctor, nurse, or sexual health clinic can help you with this.

Avoid sex, or use condoms, for 2 weeks from the start of treatment and until your partner or partners have been tested and treated.