Women's Health

Pelvic Pain and Pelvic Inflammatory Disease

NetWellness receives many questions about pelvic pain. Pelvic Inflammatory Disease (PID) is a common cause of pelvic pain. Approximately two million women in the United States have Pelvic Inflammatory Disease. About half of them have been diagnosed while the other half are unaware of their condition.

PID is an infection of the female reproductive system (ovaries, uterus, fallopian tubes and cervix) and is caused by one or more types of bacteria. PID is treatable but if not treated with antibiotics can progress to scar tissue and infertility.

Risk Factors for PID

Women who are likely to develop PID are:

Sexually active women under the age of 25
Black and Hispanic women
Women who use IUD's (intrauterine devices and have multiple sex partners
Women with multiple sex partners
Women who have already had PID in the past
Women who are at risk for other sexually transmitted diseases and infections such as Chlamydia or Gonorrhea. Often PID is a resulting complication of contracting either of these diseases.

Symptoms of PID

Because of the serious complications caused by this disease it is important to consult your healthcare provider immediately if you suspect you are suffering from PID. Here are some common symptoms that may help you to be more aware of what is normal and abnormal for your body:

Fever
Vaginal discharge that may have an odor
Painful intercourse or bleeding after intercourse
Painful urination
Irregular menstrual bleeding
Pain in the upper right abdomen (rare)
Sometimes PID occurs suddenly with extreme pain and fever, especially if it is caused by gonorrhea.

Diagnosing PID

If you are suffering from any or all of these symptoms see your health care provider right away. He or she may conduct the following tests to determine the cause of your symptoms:

Pelvic exam ? A pelvic exam is performed to detect irregular vaginal discharge, masses near your ovaries and tubes, and tenderness or pain of your abdomen, cervix, uterus, and ovaries. Your doctor will also take a swab (culture) of the cervix to determine the type of bacteria causing the infection.

Laparoscopy ? Laparascopy is performed to allow direct view of a patient's abdomen or pelvis, including the fallopian tubes, ovaries, uterus, small bowel, large bowel, appendix, liver, and gallbladder.

Uterine biopsy ? A uterine biopsy is a test where a tissue sample is taken from the lining of the uterus (endometrium), and is checked under a microscope for any abnormal cells or signs of cancer.

These are all very minor procedures that can help your healthcare provider to determine the cause of your symptoms and to offer treatment.

Treating PID

Treatment for you - If your healthcare provider discovers that you do have PID he or she will probably prescribe an antibiotic which you should finish even after you start to feel better, (finishing all of your meds will keep the infection from returning).

Treatment for your partner - Because PID is bacterial infection most commonly caused by chlamydia and gonorrhea; it can be passed back and forth between sexual partners. If you have been diagnosed and treated for PID and have a current sexual partner, he or she should also be treated with antibiotics (which he or she should finish) whether or not there are symptoms of PID.

Pelvic Inflammatory Disease is not only treatable but is also preventable. Correct and consistent use of condoms greatly reduces the risk of contracting PID, especially when it is caused by chlamydia and gonorrhea.

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Last Reviewed: May 05, 2011

Esa M Davis, MD, MPH
Adjunct Assistant Professor of Family Medicine
School of Medicine
Case Western Reserve University