Pelvic Inflammatory Disease

Pelvic Inflammatory Disease (PID)

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.

It occurs most frequently in young sexually active women and is a common problem of untreated chlamydia or gonorrhoea.

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.

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:

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.

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

AND

DOXYCYCLINE 100mg capsule twice daily for 2 weeks

AND

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.

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)
- infertility
- 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.