Pelvic Inflammatory Disease
Pelvic Inflammatory Disease (PID)
What is Pelvic Inflammatory Disease?
- Pelvic Inflammatory Disease is usually shortened to PID.
- It means infection of a woman’s reproductive organs including the uterus (womb), fallopian tubes (tubes that carry eggs from ovary to womb) and ovaries.
- PID is usually caused by sexually transmitted infections such as chlamydia or gonorrhoea.
- Early signs of PID include bleeding between periods and lower abdominal pain – particularly during sex.
- If left untreated PID can lead to serious problems such as infertility, ectopic pregnancy (baby in the tube), abscess formation and chronic pelvic pain.
- If you have PID we recommend that you should have a full STI screen including an HIV test.
How common is PID?
- It occurs most frequently in young sexually active women and is a common problem of untreated chlamydia or gonorrhoea.
How do you catch PID?
- PID is caused by a bacterial infection that spreads from the cervix (neck of the womb) up into the uterus (womb), fallopian tubes and ovaries.
- The most common cause is a sexually transmitted infection such as chlamydia or gonorrhoea.
- Sometimes PID is caused by bacterial infections spreading from other abdominal organs e.g. during acute appendicitis.
- Very occasionally fitting a coil may lead to PID – but this is only if there is an existing infection in the neck of the womb – so best to test for STIs before having a coil fitted.
- A previous episode of PID increases the risk of getting another one – you don’t need to catch another infection for this to happen.
What would I notice if I had PID?
- Two thirds of women may not notice much at all – it is possible to get PID and associated tubal damage without realising it.
- Some women get severe lower abdominal pain, fever and nausea / vomiting which needs treatment in hospital.
- Most women get mild symptoms that may include the following:
- Lower abdominal pain, aching or bloating – a bit like a period pain
- Pain deep inside during sex
- Bleeding in-between periods or after sex
- Unusual vaginal discharge
How do I get tested for PID?
- It is often difficult to tell if a woman has PID as there is no precise test.
- A woman needs a full assessment by a doctor who will perform an internal examination as well as some other tests including a STI screen.
- Often the STI screen is negative – but it is still possible to have PID.
- If there is any suggestion of PID you will be given immediate treatment in the clinic.
How is PID treated?
- PID is treated with a mixture of antibiotics to cover all possible infections.
- At the Wolverton you will usually be given:
- CEFTRIAXONE 250mg as a single injection
- DOXYCYCLINE 100mg capsule twice daily for 2 weeks
- METRONIDAZOLE 400mg tablet twice daily for 2 weeks
- Avoid alcohol whilst taking metronidazole and for 48 hours following completion.
- All treatments at the Wolverton are free and are given to you in the clinic.
- Do not take doxycycline on an empty stomach as it will make you feel sick and avoid sunbathing as you may get a rash.
- The antibiotics may interfere with the contraceptive pill and make it less effective – use condoms for 7 days after finishing the antibiotics and when you finish your current pack of pills immediately start the next pack i.e. omit the 7 day break
- You will be advised to rest, drink plenty of fluids and take pain killers such as ibuprofen or paracetamol.
- All women will be advised to attend the clinic for review in 1-2 weeks to check that the treatment is working.
- Taking your treatment and resting will minimise your risk of developing the serious complications of PID.
- If your symptoms (pain/ fever/ sickness) get worse you should come back to the clinic, see your GP or attend A&E.
What about my partner?
- PID is usually caused by a sexually transmitted infection so it is important that all current partners are tested and treated with antibiotics.
- Sometimes ex-partners will need to be tested too – the nurse will advise about this.
- Make sure that both you and your partner complete your courses of antibiotics before having sex again.
What problems can untreated PID lead to?
- Multiple episodes of PID can lead to scarred and blocked fallopian tubes.
- This can cause:
- an ectopic pregnancy (baby in a tube)
- chronic or recurrent bouts of pelvic pain
- pelvic abscess
- Prompt treatment of PID can minimise these risks.
- For this reason we take PID very seriously and treat immediately if there is any suspicion of PID.
Will PID come back again after treatment?
- Women who have had one bout of PID are at higher risk of another bout because damaged tissues are more susceptible to re-infection.
- Recurrent infections may be due to a wide range of bacterial infections – some may be sexually transmitted and others may not be.
- It is important that recurrent episodes of PID are treated promptly with antibiotics.
- To prevent getting PID again it is important to use condoms with new partners and both get tested for STIs before having sex without a condom.
- We advise women to be tested for STIs prior to coil fitting.