First the Facts

  • Pelvic inflammatory disease (PID) is an infection of the womb, fallopian tubes, and ovaries. Any or all of these parts may be affected.
  • It may or may not be caused by a sexually transmitted infection (STI).
  • It is treated by antibiotics. Rarely surgery is needed.
  • If treatment is delayed, then the risk of complications in the future is increased, which include subfertility, chronic pain and ectopic pregnancy.

What Causes Pelvic Inflammatory Disease?

  • PID is usually caused by an infection which moves from the vagina and cervix (the neck of the womb) to the upper genital tract, infecting the womb, fallopian tubes or ovaries.
  • The infection can continue to spread and cause areas of infection in the abdomen and can even affect other organs of the abdomen like the bladder or bowel.
  • PID is usually caused by a bacterial infection. Often this is an STI, but it can be caused by bacteria from the vagina.
  • The risk of infections travelling up from the vagina to the upper genital tract is increased after a gynaecological procedure such as having a ‘coil’ fitted, after miscarriage, abortion or childbirth.

How Will I Know If I Have Pelvic Inflammatory Disease?

  • The symptoms of PID can be non-specific, and it can be difficult to diagnose.
  • Symptoms may appear suddenly; they may come and go or be constant.
  • Symptoms include:
    • Unusual vaginal discharge that may have a different colour or smell.
    • Heavier or more painful periods, or bleeding between periods.
    • Pain during sex.
    • Pain in the lower abdomen and pelvis.

How Can I Protect Myself?

  • Protecting yourself against STIs is the best way to prevent PID. Using condoms can help to prevent transmission of STIs
  • Getting regular tests for STIs and getting treated if you are found to have an STI is important to help to prevent the infection spreading to the upper genital tract
  • If you have had unprotected sex with a new partner, you should both get tested for STIs so that you can be treated before potentially passing an infection on to someone else
  • It is better to have tests before you have sex with someone new, and these are available by online request
  • If you are due a gynaecological procedure, the doctor may take a sexual history and offer testing for STIs

Where and When Can I Get a Test?

  • There is no single test for PID; it is often diagnosed by a healthcare professional after they have examined you.
  • During the examination, tests for STIs and non-sexually transmitted genital infections (including thrush and bacterial vaginosis) are usually performed. If these tests are negative (showing no infection) then you might still have PID, but if the tests are positive, it helps to guide treatment.
  • You may need blood tests or an ultrasound scan if you have severe or unusual symptoms.
  • If you are worried you have symptoms of PID, you should see a doctor or a nurse at:
    • A sexual health or genitourinary medicine clinic
    • Your GP surgery.

If you have severe lower abdominal pain and feel generally unwell or have a fever, then you should go to your local emergency department.

 What Happens If I Have Pelvic Inflammatory Disease?

  • You will receive antibiotic treatment. This is usually as tablets you can take at home.
  • If treated early, then most people respond well. You are usually required to take antibiotics for 2 weeks, and it is really important that you complete your treatment to prevent bacteria developing resistance to these antibiotics.
  • If your symptoms do not improve or get worse after 48–72 hours of treatment, you should see your doctor again.
  • If you have severe abdominal pain or you are unwell with symptoms of the infection, then it might be recommended for you to have antibiotics intravenously (through a drip) in hospital.
  • You will also be offered testing for other STIs if this has not already been done
  • You must tell your partner, as they will need to be tested and possibly treated as well.
  • Do not have sex until you have completed your treatment, as you risk passing the infection back and forth. A condom can split, so it is better to not have sex at all at this time.

What If I Don’t Get Treated for Pelvic Inflammatory Disease?

  • If it is not treated, the infection can spread further and cause infection/abscess in the abdomen or pelvis. This may need surgical treatment, usually via laparoscopy (keyhole) surgery.
  • Scar tissue can form from the inflammation caused by the infection, and this can lead to chronic pain later in life.
  • If scar tissue forms in the fallopian tubes, it can cause a blockage, making it difficult for an egg to pass through. This can affect future fertility (if eggs and sperm cannot meet). The risk of subfertility increases with repeated infections and also with delayed treatment.
  • Scarring can also increase the risk of an ectopic pregnancy, where a fertilised egg implants outside of the womb. Most commonly this is in the fallopian tube, and this can cause internal bleeding, and if the tube ruptures, this could potentially be fatal.


Written by: Dr Nikki Kersey and Dr Paula Briggs
Last updated: January 2021

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