Pelvic inflammatory disease (PID) is a common but serious bacterial infection affecting the female reproductive system. It happens when bacteria spread from the vagina and cervix to the uterus, fallopian tubes, or ovaries, leading to inflammation and potential long-term complications. This article offers an in-depth look at PID, covering its causes, symptoms, diagnosis, treatment choices, and preventive measures.

What is Pelvic Inflammatory Disease?

PID, often referred to as an ascending infection, is characterised by inflammation of the female reproductive organs, primarily the uterus, fallopian tubes, and ovaries. This inflammatory response is typically triggered by bacteria, most commonly sexually transmitted ones such as Chlamydia trachomatis and Neisseria gonorrhoeae. However, other bacteria found in the vagina can also contribute to PID, including those associated with bacterial vaginosis. When left untreated, PID can lead to significant health complications, including chronic pelvic pain, infertility, and ectopic pregnancy.

bacterial infection of female reproductive system

Causes of Pelvic Inflammatory Disease

Pelvic inflammatory disease can be attributed to various factors, primarily involving the introduction of bacteria into the upper reproductive tract. Understanding the specific causes and risk factors associated with PID is crucial for prevention and effective management. Here are some key points to consider:

Sexually Transmitted Infection (STI)

STIs such as Chlamydia trachomatis and Neisseria gonorrhoeae are the most common culprits behind PID. These bacteria are typically transmitted through unprotected sexual intercourse with an infected partner.

Multiple Sexual Partners

People who are sexually active with multiple partners increase the risk of exposure to different pathogens, including those responsible for PID. Each new sex partner introduces the possibility of encountering STIs that can lead to PID.

Previous History of PID or STIs

People with a history of PID or previous sexually transmitted infections are at higher risk of developing recurrent episodes of PID. Past infections may have left the reproductive organs more vulnerable to subsequent bacterial invasions.

IUD Insertion

Although rare, the insertion of intrauterine devices (IUDs) for contraception can introduce bacteria into the reproductive tract, potentially leading to PID. Proper sterilisation techniques during insertion can help lower this risk.


Douching, or the practice of rinsing the vagina with water or a cleansing solution, can disrupt the natural balance of bacteria in the vaginal environment. This disruption may create an opportunity for harmful bacteria to enter, increasing the likelihood of developing PID.

Postpartum Infections

Infections that occur after childbirth, such as endometritis (inflammation of the uterine lining), can ascend into the upper reproductive tract and trigger PID. Prompt recognition and treatment of postpartum infections are essential for preventing complications like PID.

Cervical Procedures

Certain medical procedures involving the cervix, such as cervical biopsies or loop electrosurgical excision procedures (LEEP), may increase the risk of PID. These procedures can disrupt the protective barrier of the cervix, allowing bacteria to enter the uterus and fallopian tubes.

By addressing these potential causes and risk factors, you can take proactive measures to reduce your susceptibility to PID. Practising safe sex, maintaining good hygiene practices, and seeking prompt medical attention for any signs of infection are essential for preventing PID and preserving reproductive health.

intrauterine device iud insertion

Symptoms of Pelvic Inflammatory Disease

PID can manifest with a variety of symptoms, which may vary in severity and presentation. Common signs include pelvic pain, particularly during intercourse or menstruation, abnormal vaginal discharge that may be yellow or green and have a foul odour, fever, chills, painful urination, and irregular menstrual bleeding. However, it’s important to note that some individuals with PID may experience mild or no symptoms at all, making diagnosis challenging.

Diagnosis for Pelvic Inflammatory Disease

Diagnosing PID requires a thorough evaluation, often involving a combination of clinical assessments, laboratory tests, and imaging studies. During a pelvic exam, healthcare providers may observe signs of inflammation, such as tenderness or abnormal discharge

Laboratory tests, including vaginal swabs and blood tests, can detect the presence of infection and identify the specific bacteria responsible. Imaging studies such as ultrasound or MRI may be used to assess the extent of inflammation and detect any complications, such as abscesses or fluid collection.

diagnosis for pelvic inflammatory disease


Untreated PID can lead to various complications, ranging from chronic pelvic pain to serious reproductive health issues. Chronic pelvic pain, resulting from inflammation and scarring of the reproductive organs, can significantly impact quality of life. Scarring of the fallopian tubes can increase the risk of ectopic pregnancy, where a fertilised egg implants outside the uterus. 

PID can also cause infertility by blocking the fallopian tubes or damaging the delicate structures of the reproductive system. In severe cases, untreated PID can lead to life-threatening conditions such as sepsis or peritonitis.

Treatment Options

Treatment for PID typically involves a combination of antibiotics to eliminate the underlying infection and medications to manage symptoms. The choice of antibiotics depends on the severity of the infection and the suspected causative bacteria. In mild to moderate cases, oral antibiotics may be prescribed, while intravenous antibiotics are often necessary for severe infections or when complications are present. 

Pain management medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may be recommended to ease discomfort. In some cases, surgical intervention may be required to drain abscesses or repair damaged reproductive organs.

oral antibiotics

Preventing Pelvic Inflammatory Disease

Preventing PID involves adopting healthy behaviours and practices that reduce the risk of bacterial infections. Practising safe sex, including consistent and correct condom use, can help prevent the transmission of STIs that can lead to PID. Limiting the number of sexual partners and avoiding high-risk behaviours can also reduce the likelihood of infection. Avoiding douching and ensuring proper hygiene during menstruation can help maintain a balanced vaginal environment and reduce the risk of bacterial overgrowth.

Living with Pelvic Inflammatory Disease

Managing PID involves ongoing care and attention to reproductive health. Adhering to prescribed treatment regimens and attending follow-up appointments are essential for monitoring progress and preventing recurrence. It’s important to communicate openly with healthcare providers about any concerns or symptoms experienced during treatment. 

Practising self-care techniques, such as maintaining a healthy lifestyle and managing stress, can support overall well-being. Seeking support from friends, family, or support groups can also provide valuable emotional support during the treatment and recovery process.

Pelvic inflammatory disease is a significant health concern with potentially serious consequences if left untreated. By understanding its causes, symptoms, and treatment options, you can take proactive steps to protect your reproductive health and prevent long-term complications.

If you suspect you have PID or are experiencing symptoms associated with the condition, seek medical advice promptly. Early detection and treatment are key to minimising the risk of complications. For more information on PID and reproductive health, consult a healthcare professional.