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Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is a general term that refers to infection of the uterus, fallopian tubes and other female reproductive organs. It is a common and serious complication of some sexually transmitted infections, especially chlamydia and gonorrhea.

Make an appointment at any of our clinics in Greater Victoria to get tested for pelvic inflammatory disease, or to find out more.

For further reading, see our BCCDC’s page on PID

What causes pelvic inflammatory disease?

Almost 100,000 Canadians get PID each year, though the exact number is difficult to measure. And while all sexually active females are at risk, some are considered more likely to contract PID. These include females:

  • with more than one sexual partner
  • under 25 years of age
  • who have previously had an episode of PID
  • who have had a recent procedure in the upper genital tract (i.e. abortion, D&C, IUD insertion)

Pelvic inflammatory disease prevention

To prevent pelvic inflammatory disease, use good sex safety skills including regular infection screening. Sexually transmitted infections (STI/STDs), mainly untreated chlamydia or gonorrhea, are the main preventable cause of PID.

  • Use condoms to reduce the risk of chlamydia and gonorrhea infections.
  • Make an appointment to get tested for pelvic inflammatory disease.

The surest way to avoid transmission of STIs is to abstain from sexual intercourse until both partners are tested, to use condoms consistently and/or to be in a long-term relationship with a partner (s) who has been tested and is known to be uninfected.

Pelvic inflammatory disease symptoms

Symptoms of PID vary from none to severe.

  • The most common symptom of PID typically is pain in the lower abdomen. This pain can vary from cramp like pain to a consistent low grade ache. Some people with PID report the pain being worse during sex or when urinating or defecating.

Other signs and symptoms include:

  • fever
  • unusual vaginal discharge that may have a foul odor
  • painful intercourse
  • painful urination
  • irregular menstrual bleeding
  • pain in the right upper abdomen (rare)

Risks of untreated pelvic inflammatory disease

PID can damage the fallopian tubes and tissues in and near the uterus and ovaries. Untreated PID can lead to serious consequences including infertility, ectopic pregnancy (a pregnancy in the fallopian tube or elsewhere outside of the womb), abscess formation, and chronic pelvic pain.

Females with repeated episodes of PID are more likely to suffer infertility, ectopic pregnancy, or chronic pelvic pain.

Pelvic inflammatory disease tests and diagnosis

PID is difficult to diagnose because the symptoms are often subtle and mild. Many episodes of PID go undetected because the person with PID or their health care provider fails to recognize the implications of mild or nonspecific symptoms. If you have symptoms,  the Dr or nurse will perform a pelvic exam and swabs for chlamydia and gonorrhea are taken. The Dr. or nurse will also feel for pain and tenderness in the internal organs and may also order an ultrasound or further testing.

Because there are no specific tests for PID, a diagnosis is usually based on clinical findings. If symptoms such as lower abdominal pain are present, a health care provider should perform a physical examination. If the findings suggest PID, treatment is necessary. The doctor may order other tests such as a pelvic ultrasound or blood tests.

Pelvic inflammatory disease treatment

PID can be cured with several types of antibiotics. A health care provider will determine and prescribe the best therapy. However, antibiotic treatment does not reverse any damage that has already occurred to the reproductive organs. Prompt antibiotic treatment can prevent severe damage to reproductive organs.

The longer a person delays treatment for PID, the more likely she is to become infertile or to have a future ectopic pregnancy because of damage to the fallopian tubes. Even if symptoms go away, the person should finish taking all of the prescribed medicine. This will help prevent the infection from returning.

A person who is being treated for PID should be re-evaluated by their health care provider two to three days after starting treatment to be sure the antibiotics are working to cure the infection. In addition, their sex partner(s) should be treated to decrease the risk of re-infection, even if the partner(s) has no symptoms.