Symptoms and causes

Symptoms

Signs and symptoms of pelvic inflammatory disease might include:

  • Pain in your lower abdomen and pelvis
  • Heavy vaginal discharge with an unpleasant odor
  • Abnormal uterine bleeding, especially during or after intercourse, or between menstrual cycles
  • Pain or bleeding during intercourse
  • Fever, sometimes with chills
  • Painful or difficult urination

PID might cause only mild signs and symptoms or none at all. When severe, PID might cause fever, chills, severe lower abdominal or pelvic pain — especially during a pelvic exam — and bowel discomfort.

When to see a doctor

See your doctor or seek urgent medical care if you experience:

  • Severe pain low in your abdomen
  • Nausea and vomiting, with an inability to keep anything down
  • Fever, with a temperature higher than 101 F (38.3 C)
  • Foul vaginal discharge

If your signs and symptoms persist but aren't severe, 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 occur, stop having sex and see your doctor soon. Prompt treatment of an STI can help prevent PID.

Causes

Many types of bacteria can cause PID, but gonorrhea or chlamydia infections are the most common. These bacteria are usually acquired during unprotected sex.

Less commonly, bacteria can enter your reproductive tract anytime the normal barrier created by the cervix is disturbed. This can happen after childbirth, miscarriage or abortion.

Risk factors

A number of factors might 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
  • Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and might mask symptoms
  • Having a history of pelvic inflammatory disease or a sexually transmitted infection

Most experts now agree that having an intrauterine device (IUD) inserted does not increase the risk of pelvic inflammatory disease. Any potential risk is generally within the first three weeks after insertion.

Complications

Untreated pelvic inflammatory disease might cause scar tissue. You might also develop collections of infected fluid (abscesses) in your fallopian tubes, which could damage your reproductive organs.

Other complications might include:

  • Ectopic pregnancy. PID is a major cause of tubal (ectopic) pregnancy. In an ectopic pregnancy, the scar tissue from PID prevents the fertilized egg from making its way through the fallopian tube to implant in the uterus. Ectopic pregnancies can cause massive, life-threatening bleeding and require emergency medical attention.
  • Infertility. PID might 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 might last for months or years. Scarring in your fallopian tubes and other pelvic organs can cause pain during intercourse and ovulation.
  • Tubo-ovarian abscess. PID might cause an abscess — a collection of pus — to form in your uterine tube and ovaries. If left untreated, you could develop a life-threatening infection.
May 18, 2017
References
  1. Frequently asked questions. Gynecologic problems FAQ077. Pelvic inflammatory disease (PID). American Congress of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Pelvic-Inflammatory-Disease-PID. Accessed Jan. 17, 2017.
  2. Pelvic inflammatory disease fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/pid/stdfact-pid.htm. Accessed Jan. 16, 2017.
  3. Ferri FF. Pelvic inflammatory disease. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Jan. 16, 2017.
  4. Lee M. Pelvic inflammatory disease. Journal of the American Academy of Physician Assistants. 2017;30:47.
  5. Klausner JD, et al. Pelvic inflammatory disease. In: Current Diagnosis & Treatment of Sexually Transmitted Diseases. 1st ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com. Accessed Jan. 16, 2017.
  6. Livengood CH, et al. Clinical features and diagnosis of pelvic inflammatory disease. http://www.uptodate.com/home. Accessed Jan. 16, 2017.
  7. Peipert JF, et al., eds. Long-term complications of pelvic inflammatory disease. http://www.uptodate.com/home. Accessed Jan. 20, 2017.
  8. Butler Tobah YS (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 27, 2017.