What is Pelvic Inflammatory Disease?

Let’s chat about Pelvic Inflammatory Disease (PID), a common but often misunderstood infection affecting over a million women in the United States each year. We hope to shed light on why early detection is crucial for women’s reproductive health, as this infection may be hard to spot.

Pelvic Inflammatory Disease is an infection of a woman’s reproductive organs. In this article, we’ll delve into what causes PID, its symptoms, its potential impact on fertility, and how to diagnose and treat it. Early detection can be the key to preventing permanent complications to your fertility.

Understanding Pelvic Inflammatory Disease

Pelvic Inflammatory Disease is an infection that targets a woman’s reproductive organs, including:

  • Cervix
  • Uterus (womb)
  • Endometrium (lining of the uterus)
  • Fallopian tubes
  • Ovaries

The primary culprits behind PID are sexually transmitted diseases (STDs), notably gonorrhea and chlamydia. However, non-sexually transmitted infections like bacterial vaginosis (BV) and even factors like frequent douching can increase the risk of developing PID by fostering bacterial growth.

While PID can affect anyone, it is more commonly observed among sexually active women in their 20s. When left untreated, these infections can escalate, spreading from the vagina and cervix to the fallopian tubes or ovaries. This progression can lead to inflammation, the formation of scar tissue, and the emergence of infected fluid-filled pockets, known as abscesses, within the reproductive tract – 15% of women diagnosed with PID may face infertility as a severe consequence.

Causes of Pelvic Inflammatory Disease

  1. Sexually Transmitted Diseases (STDs): Gonorrhea, chlamydia, and mycoplasma genitalium (MG) are the primary contributors to PID. These infections can often go unnoticed, making it crucial for individuals to undergo regular testing, especially if engaging in unprotected sexual activities.
  2. Non-Sexually Transmitted Infections: Bacterial vaginosis (BV), an overgrowth of harmful bacteria in the vagina, is a potential trigger for PID. This emphasizes the importance of maintaining overall vaginal health through proper hygiene practices.
  3. Frequent Douching: This disrupts the natural balance of bacteria in the vagina, creating an environment conducive to infection. This, in turn, elevates the risk of PID.
  4. Bowel infection: Infections affecting the bowel, such as gastroenteritis, can contribute to developing PID.
  5. Some surgical procedures: This may include dilatation and curettage (D&C), insertion of an intrauterine device (IUD), or surgical abortion, which poses a risk for PID.

Symptoms of Pelvic Inflammatory Disease

Symptoms of PID vary in severity; some women may have such mild symptoms that they are unaware of being affected by the condition.

Common indicators include: 

  • Pain in your lower abdomen and pelvic area
  • Abnormal or foul-smelling vaginal discharge
  • Irregular menstrual periods
  • Vaginal bleeding between menstrual periods
  • Pain during sex
  • Painful urination
  • Fever and chills
  • Nausea and vomiting

Recognizing these signs and seeking prompt consultation with a gynecologist is essential, as they may signify PID or other severe reproductive health issues.

Impact on Fertility

PID can have severe and lasting consequences, with approximately 1 in 10 women affected by PID experiencing infertility. The scarring in the fallopian tubes can obstruct the efficient travel of the egg from the ovaries to the uterus.

Furthermore, PID-related scarring increases the risk of ectopic pregnancies, where the fertilized egg implants itself in the fallopian tube. If left unaddressed, ectopic pregnancies pose the risk of rupturing the fallopian tube. This is a life-threatening concern and often requires emergency surgical intervention.

Risk Factors

Understanding the risk factors that contribute to infertility resulting from PID is crucial for early intervention and preventive measures. These factors include:

  • Infectious cause: Infertility linked to PID is more likely when chlamydia is the infectious cause.
  • Delay in treatment: A delay in PID treatment increases the likelihood of infertility.
  • Recurrent episodes: Individuals with recurrent episodes of PID face a higher risk of fallopian tube blockage.


Early detection of PID is crucial and involves a thorough medical history assessment and a pelvic examination. The diagnostic process may vary based on the cause of PID, and it often includes:

  • Physical Examination: A pelvic examination is conducted to check for tenderness and swelling in the pelvic area.
  • Laboratory Tests: Blood tests, urine tests, and swabs of the vagina and cervix are performed to identify potential infectious agents, such as gonorrhea and chlamydia.
  • Imaging Tests: Ultrasound, either pelvic or transvaginal, may be conducted to detect the reproductive organs for any abnormalities.
  • Laparoscopy: Sometimes, a laparoscopy is necessary to diagnose PID accurately. This minimally invasive procedure involves the insertion of a thin tube with a camera (endoscope) through a small incision, usually near the navel. The laparoscope allows visualization of the pelvic organs, aiding in identifying inflammation, scarring, or other abnormalities. Sometimes, your doctor will take a tissue sample (biopsy) to confirm the diagnosis further.


Antibiotics are the primary form of treatment for PID. These medications aim to eliminate the underlying bacterial infection.

It is essential to seek prompt medical attention to diagnose and treat PID. The choice of diagnostic methods and treatment plans is tailored to individual cases, emphasizing the need for a comprehensive and personalized approach to care.

Prevention of Pelvic Inflammatory Disease

Preventing PID requires a proactive approach to reproductive health. Key preventive measures include:

  1. Safe Sex Practices: The use of condoms can significantly reduce the risk of acquiring STDs that may lead to PID.
  2. Regular STI Testing: Routine testing for sexually transmitted infections is essential, especially for individuals engaging in unprotected sex or those with multiple sexual partners.
  3. Avoiding Frequent Douching: Maintaining a healthy balance of bacteria in the vagina is crucial, and avoiding frequent douching supports this natural equilibrium.
  4. Prompt Consultation: If any negative symptoms suggestive of PID arise, seeking prompt consultation with a gynecologist is imperative for early diagnosis and intervention.
  5. Limiting Sexual Partners: Minimizing the number of sexual partners can contribute to reducing the risk of PID.

Take Control of Your Reproductive Wellness: Brentwood’s Trusted Choice, Cool Springs OBGYN

Pelvic Inflammatory Disease is not just a common infection; it poses a severe threat to women’s reproductive health, with potentially lasting consequences such as infertility and ectopic pregnancy. Understanding the causes, recognizing symptoms, and adopting preventive measures are pivotal for early detection and effective management.

Regular consultations with healthcare providers, practicing safe sex, and maintaining overall reproductive health are vital steps toward ensuring a woman’s well-being.

Cool Springs Obstetrics & Gynecology has provided quality women’s healthcare for over 20 years. Led by Dr. Lodge, our experienced team specializes in various aspects of women’s health, including reproductive health, prenatal care, and more. Our commitment extends to empowering women with knowledge to make informed decisions about their fertility.

If you suspect you may be experiencing PID or have concerns about your reproductive health, don’t hesitate to reach out to our dedicated team. We are here to provide the necessary support and guidance to ensure your well-being.