PID is the infection and swelling of the female reproductive organs. It can involve the vagina, uterus, fallopian tubes and ovaries. The risk of pelvic inflammatory disease (PID) increases if one has STDs/STIs (sexually transmitted diseases/infection), such as gonorrhea and chlamydia or a history of STD.

What causes pelvic inflammatory disease?

The majority of PID is sexually transmitted. Nonsexual PID may occur in

Septic abortions
During the medical termination of pregnancy if there is improper sterilization of tools
Procedures like dilation and curettage
Rupture of an abscess inside the abdomen and it has spread to the uterine tubes

The most common causative microorganisms of PID are sexually transmitted. They include

Gonorrhea (most common)
Chlamydia (most common)
Trichomonas
Mycoplasma

Several other bacteria can also cause PID, such as

Staphylococcus
Klebsiella
E.coli
Fusobacteria
Clostridia
Actinomyces
Bacteroides

What are the risk factors of pelvic inflammatory disease?

Some factors that can increase the risk of PID are

Having unprotected sexual intercourse
Being a sexually active women younger than 25 years old
Having multiple sexual partners
Being in a sexual relationship with a person who has multiple sexual partners
Frequent vaginal douching that creates an imbalance of good versus harmful bacteria in the vagina
Using a tampon, intrauterine device (IUD) or douche within the 3- to 6-week-long period after an abortion or childbirth when the mouth of the uterus remains open and is susceptible to infection
Using a long-term birth control device, such as an IUD
Having a history of STDs or PID

What are the signs and symptoms of pelvic inflammatory disease?

The signs and symptoms of pelvic inflammatory disease vary with each individual. Some may have mild or no signs and symptoms while others may have severe symptoms. Some common signs and symptoms include

Lower abdominal pain that may be mild or severe
Fever with or without chills
Heavy, foul smelling vaginal discharge
Abnormal uterine bleeding, especially between menstrual cycles and during or after intercourse
Pain during urination and increased frequency of urination
Painful sexual intercourse

When to see a doctor

The following require immediate medical attention

Severe abdominal pain
Nausea and vomiting
High-grade fever, above 101° F (38.3° C)
Worsening of odor and quantity of vaginal discharge
Profuse vaginal bleeding

Can pelvic inflammatory disease be prevented?

The following can help reduce the risk of pelvic inflammatory disease

Safe sexual practices: Using a condom every time during intercourse, limiting the number of sexual partners and being aware of the partner's sexual history can reduce the risk of STDs and PID.


Consulting a doctor about contraception: Only barrier methods of contraception, such as condoms and diaphragms, can reduce the risk of PID and STDs. Using long-term birth control devices like IUDs can increase the risk of PID. The doctor can recommend alternate birth control methods.


Maintaining hygiene: Maintaining hygiene of the reproductive area and overall body hygiene can reduce the risk of PID.
Avoiding vaginal douching: Douching causes an imbalance between good and bad bacteria, negatively affecting vaginal health.


Safe childbirth and abortions: It is advised to avoid home births because they can increase the risk of infection after delivery, which can lead to PID. It is also advised to avoid getting an abortion done in centers that are not licensed because they may not follow standard hygiene protocols.


Getting tested regularly: It is advised that sexually active women and men, who are at risk of getting an STD, get tested regularly. This helps in early diagnosis and treatment, reducing the risk of complications.


Periodic visits to the gynecologist: Since PID can be caused by a wide range of microorganisms and many women may be asymptomatic for a long time, periodic consultations with the gynecologist can help detect diseases early and maintain reproductive health.