Pelvic Inflammatory Disease: Causes and Treatment

Gainesville well woman care physicians at All About Women discuss the sometimes difficult to diagnose Pelvic Inflammatory Disease

Pelvic Inflammatory Disease (PID) is a serious women's health issue and yet, you probably don't even know what it is. That's because PID can be vague, sometimes asymptomatic, and difficult to diagnose. And yet, PID can lead to serious complications including infertility. All women should educate themselves about the potential symptoms of PID and be prepared to call their well woman care provider should they ever experience them.

PID occurs when one or more of a woman's reproductive organs become inflamed from harmful bacteria that have entered the reproductive tract. This inflammation can cause abscesses or scar tissue to form in places such as the fallopian tubes. If left untreated, the abscesses and tissue can, in turn, cause several conditions:

  • Chronic pelvic pain. Untreated PID can cause severe pelvic pain for months or years.

  • Infertility. If enough scar tissue forms in the fallopian tubes, it can prevent the ability of sperm to join with an egg.

  • In the case of pregnancy, an ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg begins to grow somewhere other than the uterus, usually in the fallopian tubes. The Centers for Disease Control and Prevention (CDC) reports that PID is one of the main causes of ectopic pregnancy. Ectopic pregnancy can be deadly and must be treated immediately.

Causes of PID

Undetected chlamydia and gonorrhea are the two main causes of PID. Both of these sexually transmitted infections (STIs) are usually asymptomatic in women and thus often go unnoticed. These STIs highlight the importance of all women having an annual well woman care exam and being screened for relevant STIs. You can learn more about these infections in our article Silent STIs: Chlamydia and Gonorrhea.

Pelvic Inflammatory Disease is sometimes caused by bacteria that are not associated with gonorrhea and chlamydia. Other potential causes of PID include bacterial vaginosis and picking up a bacteria through a surgical procedure such as an endometrial biopsy or abortion.

Who's at Risk for PID?

Those that are at high risk for pelvic inflammatory disease include women who are:

  • Under the age of 25
  • Have more than one sex partner
  • Have chlamydia or gonorrhea
  • Have a past history of PID or any STIs

Women who douche are also at a higher risk for PID. This may be because douching upsets the natural flora balance in the reproductive tract, allowing harmful bacteria to grow. It may also push harmful bacteria higher up the reproductive tract. The American College of Obstetricians and Gynecologists (ACOG) does not recommend douching.


According to the National Institutes of Health, the most common signs of PID are:

  • Tenderness or pain in the pelvic region, abdomen, or back
  • Foul smelling or off-colored vaginal discharge
  • A fever that comes and goes

If you have any of these symptoms, you should call your well woman care provider immediately. You may have a case of PID that needs to be treated, or you may have another serious condition such as appendicitis or ectopic pregnancy.

Other symptoms of PID may include:

  • Painful intercourse
  • Painful, frequent urination
  • Spotting; irregular or heavy menstrual periods
  • Pain in the upper right abdomen
  • Nausea or vomiting

Some women who have PID will have no symptoms. These are the most dangerous cases of PID because they are less likely to be detected and more likely to cause significant damage to a woman's reproductive organs.

Because of the wide array of possible symptoms, or the lack of symptoms altogether, PID can be difficult to diagnose. Having an annual well woman exam that includes screening for STIs and being honest about your sexual history with your health care provider can help protect your reproductive health.

Diagnosis and Treatment

PID is diagnosed through a pelvic exam that can reveal any tenderness of the uterus or ovaries. Women may have a tender cervix that bleeds easily. If so, your doctor will test you for certain bacteria, including chlamydia and gonorrhea. Your doctor may also perform an ultrasound or laparoscopy to investigate the amount of damage done by PID.

Antibiotics, either oral or by shot, are used to treat PID. The course of treatment is usually 10 to 14 days. Even if symptoms are relieved before the end of an antibiotic round, you should always complete the antibiotic to ensure the bacteria will not begin to grow back. You should not have sex while you are being treated for PID, and you should ensure your sex partner is free of STIs before having sex again to prevent reinfection.

While antibiotics will kill the bacteria causing PID, they are unable to undo any damage done by the disease.

Pelvic inflammatory disease, while easily treated, can be difficult to recognize and diagnose. Untreated PID can have serious complications. That's why it's important for all women to receive an annual exam from a well woman care provider who they have an ongoing relationship with. The well woman care physicians of All About Women in Gainesville and Lake City provide compassionate and attentive care for women at all stages of life.

If you need to make an appointment or have questions about PID or other reproductive health concerns, don't hesitate to contact our office today.