Pelvic Inflammatory Disease
(PID)
In this condition factsheet:
The Facts on Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is the most serious complication of sexually transmitted infections (STIs, also known by the older name of sexually transmitted diseases or STDs) such as chlamydia and gonorrhea.
PID affects the upper female genital tract including the cervix, uterus, ovaries, and fallopian tubes. Each year, there are approximately 100, 000 cases of symptomatic PID in Canada, and up to two-thirds of cases go unrecognized. It's the leading cause of tubal infertility in young assigned female at birth, but it can usually be prevented if STIs are detected and treated early. One of the long-term consequences of PID is chronic pelvic pain
Causes of Pelvic Inflammatory Disease
PID is caused by a bacterial infection in parts of the upper reproductive tract. The most commonly affected organs include the fallopian tubes, ovaries, and uterus. The bacteria most commonly associated with PID are Neisseria gonorrheae and Chlamydia trachomatis, but bacteria normally present in the vagina and cervix may also be involved. The cervix produces mucus that normally prevents bacteria from spreading to the upper reproductive tract.
Researchers believe that the bacteria migrate upwards when this normal body defense is not working at its strongest (i.e., during ovulation and menses). It rarely develops before onset of first menses, after menopause, or during pregnancy.
Risk factors for PID include:
- being sexually active
- being under age 25
- number of sexual partners (the more partners, the greater the risk)
- current or past STIs
- douching
- previous diagnosis of PID
- use of an intrauterine device (IUD) for birth control - it may slightly increase the risk of PID only within the first 20 days of getting it placed (this risk is lowered when people are tested and treated for infections before getting an IUD)
Symptoms and Complications of Pelvic Inflammatory Disease
Symptoms of PID can vary widely, from none at all to severe.
The most common symptoms of PID are:
- lower abdominal pain
- abnormal vaginal discharge that may be foul-smelling
- fever
- pain during intercourse
- irregular menstrual bleeding
Complications of PID can be prevented with early treatment. Without treatment, PID can cause infertility, ectopic (tubal) pregnancy, chronic pelvic pain, and abscesses. Infertility occurs in up to 20% of people with PID and is caused by the development of scar tissue that partially or totally blocks the fallopian tubes.
Ectopic pregnancies occur when a fertilized egg attaches outside of the uterus (usually in the fallopian tube) instead of inside the uterus. If not caught and treated early, ectopic pregnancies can be fatal. Scarring can also lead to chronic pelvic pain.
Some other complications may include the development of endometritis (inflammation of the endometrium), salpingitis (inflammation of the fallopian tubes), and oophoritis (inflammation to the ovaries).
The most serious complication of PID is the rupture of either an abscess or of the walls of one of the infected organs. This requires immediate medical attention. This may cause bacteria to pour out into the abdominal cavity, causing a general abdominal infection, known as peritonitis. Bacteria can also get into the bloodstream (a condition known as sepsis). Rupture of an abscess will cause a sharp increase in symptoms. Intense lower abdominal pain will be followed by nausea, then weakness and possibly fainting.
