What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is the term given to infection of the female reproductive system - the fallopian tubes, cervix, womb and ovaries. It is a common and potentially serious complication of sexually transmitted infections (STIs), such as chlamydia and gonorrhoea. Occasionally, PID can occur after certain gynaecological procedures.

How did I get this infection?

PID is common in women under the age of 25 because chlamydia and gonorrhoea infections are common in this age group. You can become infected with chlamydia and gonorrhoea by having unprotected sex (not using a condom) with someone who has these infections. However, tests for STIs are often negative in women with PID.

What are the symptoms of PID?

The symptoms can vary from very mild to severe. The most noticeable symptoms are:

• pain or tenderness in the tummy or lower abdomen
• abnormal vaginal discharge
• heavy or painful periods
• unusual bleeding such as after sex or between periods 
• pain during sex.

These symptoms are especially important if you have had unprotected sex with a new partner in the last three months.

What should I do if I think I have PID?

If you have had recent unprotected sex with a new partner, or have any of the symptoms mentioned above, then it's time for a sexual health check. This involves having a vaginal examination and tests taken for STIs including chlamydia and gonorrhoea. This check can be done at your local sexual health service, doctor or family planning clinic.

There is no specific, single test for PID and the doctor will rely on your symptoms and examination findings to decide if you have PID.

What are the possible complications of PID?

If left untreated, PID can lead to infertility (difficulty getting pregnant), ectopic pregnancy (baby growing outside the womb), and chronic (long term) pain and abscess formation. This happens because the infection damages tissues, often permanently. If you get PID more than once you are at even greater risk of developing these complications.

Treatment and follow-up

If your doctor thinks it is very likely you have PID you will be given a course of antibiotics, usually before test results are available. This is to lower the risk of any possible long term complications.

 It is very important to:

• finish the course of treatment, even if your tests are all clear and you are feeling better
• do not have sex again until your treatment is finished and any recent sexual partners are also treated
• if you don't have a regular partner, advise all partners from the last three months to get a sexual health check
• return to your doctor or clinic for a follow-up check after treatment.

How can I avoid PID in the future?

Most PID in young women is the result of infection with an STI. You can prevent these infections by using a condom every time you have sex, especially when having sex with new partners. Make sure sexual partners are tested and treated. The complications of PID get worse with repeat infections, so prevention is essential.

Original material provided by Auckland Sexual Health Services. Reviewed by everybody in May 2008.