Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries.

PID is a common condition, although it's not clear how many women are affected in the UK.

It mostly affects sexually active women aged 15 to 24.

Symptoms

PID often doesn't cause any obvious symptoms.

Most women have mild symptoms that may include 1 or more of the following:

• pain around the pelvis or lower abdomen (tummy)
• discomfort or pain during sex that's felt deep inside the pelvis
• pain during urination
• bleeding between periods and after sex
• heavy periods
• painful periods 
• unusual vaginal discharge, especially if it's yellow or green

A few women become very ill with:

• severe lower abdominal pain
• a high temperature (fever)
• nausea and vomiting

When to seek medical advice

It's important to visit your GP or a sexual health clinic if you experience any of the above symptoms.

If you have severe pain, you should seek urgent medical attention from your GP or local A&E department. 

Delaying treatment for PID or having repeated episodes of PID can increase your risk of serious and long-term complications.

There's no simple test to diagnose PID. Diagnosis is based on your symptoms and the finding of tenderness on a vaginal (internal) examination.

Swabs will be taken from your vagina and cervix (neck of the womb), but negative swabs don't rule out PID.

Read more about diagnosing PID.

Causes

Most cases of PID are caused by a bacterial infection that's spread from the vagina or the cervix to the reproductive organs higher up.

Many different types of bacteria can cause PID. In about 1 in 4 cases, it's caused by a sexually transmitted infection (STI) such as chlamydia or gonorrhoea.

Another type of STI, called mycoplasma genitalium, is thought to be increasingly responsible for cases of PID.

In many other cases, it's caused by bacteria that normally live in the vagina.

Read more about the causes of PID.

Treatment

If diagnosed at an early stage, PID can be treated with a course of antibiotics, which usually lasts for 14 days.

You'll be given a mixture of antibiotics to cover the most likely infections, and often an injection as well as tablets.

It's important to complete the whole course and avoid having sexual intercourse during this time to help ensure the infection clears.

Your recent sexual partners also need to be tested and treated to stop the infection recurring or being spread to others.

Read more about treating PID.

Complications

The fallopian tubes can become scarred and narrowed if they're affected by PID.

This can make it difficult for eggs to pass from the ovaries into the womb.

This can then increase your chances of having an ectopic pregnancy (a pregnancy in the fallopian tubes instead of the womb) in the future, and can make some women infertile.

It's estimated around 1 in 10 women with PID become infertile as a result of the condition.

Women who have delayed treatment or had repeated episodes of PID are most at risk.

But most women treated for PID are still able to get pregnant without any problems.

Read more about the complications of PID.

Prevention

You can reduce your risk of PID by always using condoms with a new sexual partner until they have had a sexual health check.

Chlamydia is very common in young men, and most don't have any symptoms.

If you're worried you may have an STI, visit your local genitourinary medicine (GUM) or sexual health clinic for advice.

Find your local sexual health clinic

If you need an invasive gynaecological procedure, such as insertion of a coil or an abortion, have a check-up beforehand.

Read more advice about STIs.