Signs and symptoms of pelvic inflammatory disease may include:
- Pain in your lower abdomen and pelvis
- Heavy vaginal discharge with an unpleasant odor
- Irregular menstrual bleeding
- Pain during intercourse
- Painful or difficult urination
PID may cause only minor signs and symptoms or none at all. PID with mild or no symptoms is especially common when the infection is due to chlamydia.
When to see a doctor
Go to the emergency room if you experience the following severe signs and symptoms of PID:
- Severe pain low in your abdomen
- Signs of shock, such as fainting
- Fever, with a temperature higher than 101 F (38.3 C)
If your signs and symptoms aren't severe, but they're persistent, see your doctor as soon as possible. Vaginal discharge with an odor, painful urination or bleeding between menstrual cycles can be associated with a sexually transmitted infection (STI). If these signs and symptoms appear, stop having sex and see your doctor soon. Prompt treatment of an STI can help prevent PID.
Pelvic inflammatory disease can be caused by a number of bacteria but are most often caused by gonorrhea or chlamydia infections. These bacteria are usually acquired during unprotected sex.
Less commonly, bacteria may enter your reproductive tract anytime the normal barrier created by the cervix is disturbed. This can happen after intrauterine device (IUD) insertion, childbirth, miscarriage or abortion.
A number of factors may increase your risk of pelvic inflammatory disease, including:
- Being a sexually active woman younger than 25 years old
- Having multiple sexual partners
- Being in a sexual relationship with a person who has more than one sex partner
- Having sex without a condom
- Having had an IUD inserted recently
- Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and may mask symptoms that might otherwise cause you to seek early treatment
- Having a history of pelvic inflammatory disease or a sexually transmitted infection
Untreated pelvic inflammatory disease may cause scar tissue and collections of infected fluid (abscesses) to develop in your fallopian tubes and damage your reproductive organs. Complications may include:
- Ectopic pregnancy. PID is a major cause of tubal (ectopic) pregnancy. In an ectopic pregnancy, the fertilized egg can't make its way through the fallopian tube to implant in the uterus. Ectopic pregnancies can cause massive, life-threatening bleeding and require emergency surgery.
- Infertility. PID may damage your reproductive organs and cause infertility — the inability to become pregnant. The more times you've had PID, the greater your risk of infertility. Delaying treatment for PID also dramatically increases your risk of infertility.
- Chronic pelvic pain. Pelvic inflammatory disease can cause pelvic pain that may last for months or years. Scarring in your fallopian tubes and other pelvic organs can cause pain during intercourse and ovulation.
To reduce your risk of pelvic inflammatory disease:
- Practice safe sex. Use condoms every time you have sex, limit your number of partners and ask about a potential partner's sexual history.
Talk to your doctor about contraception. Some forms of contraception may affect your risk of developing pelvic inflammatory disease. A contraceptive intrauterine device (IUD) may increase your risk of PID temporarily for the first few weeks after insertion, but a barrier method, such as a condom, reduces your risk.
Use of a birth control pill alone offers no protection against acquiring STIs. But the pill may offer some protection against the development of PID by causing your body to create thicker cervical mucus, making it more difficult for bacteria to reach your uterus, fallopian tubes or ovaries. It's still important to use a condom every time you have sex, however.
- Get tested. If you're at risk of an STI, such as chlamydia, make an appointment with your doctor for testing. Set up a regular screening schedule with your doctor, if you need to. Early treatment of an STI gives you the best chance of avoiding pelvic inflammatory disease.
- Request that your partner be tested. If you have pelvic inflammatory disease or an STI, advise your partner to be tested and, if necessary, treated. This can prevent the spread of STIs and possible recurrence of PID.
- Don't douche. Douching upsets the balance of bacteria in your vagina.
- Pay attention to hygiene habits. Wipe from front to back after urinating or having a bowel movement to avoid introducing bacteria from your colon into the vagina.