This article will help you understand what Pelvic Inflammatory Disease is, its causes, symptoms, risk factors, and most importantly—how it can be prevented and treated.
What is Pelvic Inflammatory Disease (PID)?
Pelvic Inflammatory Disease is an infection of the female reproductive organs, including the uterus (womb), fallopian tubes, and ovaries. It typically occurs when bacteria from the vagina or cervix travel upward into these organs, causing inflammation and infection.
The infection can lead to the formation of scar tissue and blockages in the fallopian tubes, which may result in infertility, chronic pain, or even ectopic pregnancy (a pregnancy outside the uterus).
While PID most commonly develops as a complication of sexually transmitted infections (STIs), it can also occur due to poor hygiene or unsafe medical practices during childbirth, abortion, or insertion of intrauterine devices (IUDs).
How Does PID Develop?
The female reproductive system has a natural barrier to protect itself from infection. However, certain factors can weaken this defense and allow bacteria to enter the upper reproductive tract.
Usually, the bacteria responsible for PID first infect the vagina or cervix. If the infection is left untreated, it can spread upward to the uterus, fallopian tubes, and ovaries. Once the infection reaches the fallopian tubes, it can cause inflammation, scarring, and sometimes even pus formation.
Over time, these changes can interfere with fertility by blocking the tubes and preventing the egg and sperm from meeting.
Causes of Pelvic Inflammatory Disease
The most common causes of PID are sexually transmitted infections (STIs). However, several other non-sexual factors can also contribute.
Let’s explore them in detail:
1. Sexually Transmitted Infections (STIs)
Nearly 85% of PID cases are caused by bacteria associated with sexually transmitted infections — mainly Chlamydia trachomatis and Neisseria gonorrhoeae (the bacteria that cause chlamydia and gonorrhea).
Chlamydia trachomatis often produces mild or no symptoms in women, allowing the infection to progress unnoticed.
Gonorrhea can cause noticeable symptoms such as vaginal discharge and pain, but if untreated, it can quickly spread to the uterus and fallopian tubes.
When these infections are left untreated, the bacteria multiply and travel deeper into the reproductive organs, leading to PID.
2. Bacterial Vaginosis (BV)
Bacterial Vaginosis is a condition in which the normal balance of bacteria in the vagina is disrupted, allowing harmful bacteria to overgrow. Although BV itself isn’t sexually transmitted, it can increase the risk of developing PID because it makes the vaginal environment more susceptible to infection.
3. Unsafe Abortions or Childbirth
Infections introduced during unsafe abortions or deliveries performed under unhygienic conditions can cause PID. If medical instruments are not properly sterilized, they can carry bacteria into the uterus and surrounding organs.
4. Intrauterine Device (IUD) Insertion
While modern IUDs are generally safe, inserting an IUD without proper sterilization or in the presence of an existing infection can trigger PID. This risk is especially high within the first few weeks after insertion.
5. Multiple Sexual Partners and Unprotected Sex
Having multiple sexual partners or engaging in unprotected sex significantly increases the risk of acquiring sexually transmitted infections, which in turn raises the chances of developing PID.
6. Douching
Many women believe that douching (cleaning the vagina with fluids) helps maintain hygiene. However, douching can actually push harmful bacteria further up into the uterus and fallopian tubes, increasing the risk of infection and PID. It also disrupts the natural bacterial balance of the vagina.
7. Poor Hygiene During Menstruation or Procedures
Lack of proper menstrual hygiene or the use of unclean sanitary products can also introduce bacteria into the reproductive tract. Similarly, procedures such as endometrial biopsy or hysteroscopy, when not performed under sterile conditions, can cause infection.
Risk Factors for PID
Some women are more at risk of developing PID than others. Risk factors include:
Being sexually active under the age of 25
Having multiple sexual partners
History of sexually transmitted infections
Recent use of an intrauterine device (IUD)
Douching regularly
Recent miscarriage, abortion, or childbirth
Partner with untreated STIs
Understanding these risk factors helps in taking proactive measures to prevent infection.
Symptoms of Pelvic Inflammatory Disease
PID can sometimes be silent, showing no obvious symptoms. However, when symptoms appear, they can vary from mild to severe.
Common symptoms include:
Pain in the lower abdomen or pelvis
Heavy or irregular menstrual bleeding
Pain during sexual intercourse
Unusual or foul-smelling vaginal discharge
Pain or burning during urination
Fever, fatigue, or chills
Nausea or vomiting in severe cases
If you experience any of these symptoms, it’s important to consult a gynaecologist immediately for diagnosis and treatment.
Complications of Untreated PID
Ignoring or delaying treatment for PID can have serious long-term consequences. The infection may cause permanent damage to the reproductive organs.
Common complications include:
1. Infertility
PID is one of the leading causes of infertility in women. Even one episode of PID can cause scarring in the fallopian tubes, making it difficult for the egg to meet the sperm.
2. Ectopic Pregnancy
When the fallopian tubes are damaged, the fertilized egg may implant outside the uterus — most often in the tube itself. This is called an ectopic pregnancy, which can be life-threatening if not treated promptly.
3. Chronic Pelvic Pain
Long-term pelvic or lower abdominal pain is another possible outcome of PID due to the formation of scar tissue.
4. Tubo-Ovarian Abscess
Sometimes, severe infections can cause a collection of pus around the fallopian tubes and ovaries. This abscess can rupture and spread infection throughout the pelvis and abdomen.
Diagnosis of PID
Diagnosing PID involves a combination of medical history, physical examination, and diagnostic tests. Your doctor may recommend:
Pelvic Examination: To check for tenderness or swelling.
Vaginal or Cervical Swabs: To detect bacteria causing infection.
Ultrasound Scan: To identify abscesses or inflammation in reproductive organs.
Blood and Urine Tests: To check for signs of infection.
Laparoscopy (in severe cases): A minor surgical procedure that allows direct visualization of pelvic organs.
At Chetna Hospital, Sambhajinagar, Chinchwad, we provide advanced diagnostic facilities including ultrasound and laboratory testing for accurate detection and timely treatment.
Treatment of PID
The good news is that PID is treatable, especially when detected early.
1. Antibiotic Therapy
Doctors usually prescribe a combination of antibiotics to target the range of bacteria responsible for the infection. It’s crucial to complete the full course of medication even if symptoms subside.
2. Hospitalization
In severe cases, or when abscesses are present, hospitalization may be necessary for intravenous antibiotics and close monitoring.
3. Surgical Treatment
If abscesses do not respond to antibiotics or if they rupture, surgery may be required to drain them or repair damaged tissues.
4. Partner Treatment
Since STIs are a common cause, it’s essential that sexual partners are also tested and treated to prevent reinfection.
5. Lifestyle and Follow-Up
Avoid sexual intercourse until the infection is fully cleared. Follow-up visits are necessary to ensure complete recovery and prevent recurrence.
Prevention of Pelvic Inflammatory Disease
Preventing PID starts with maintaining good sexual and reproductive hygiene.
Here are some effective preventive measures:
Practice Safe Sex: Always use condoms to reduce the risk of STIs.
Limit Sexual Partners: Fewer partners mean lower risk.
Regular Health Check-ups: Routine gynaecological exams and STI screenings help detect issues early.
Avoid Douching: Let your body’s natural flora maintain vaginal balance.
Proper Hygiene During Menstruation: Change sanitary pads frequently and maintain cleanliness.
Seek Immediate Treatment for Infections: Never ignore vaginal infections or unusual symptoms.
Ensure Sterile Medical Procedures: Always choose qualified doctors and hygienic facilities for procedures like IUD insertion or abortion.
Conclusion
Pelvic Inflammatory Disease is a preventable and treatable condition — but only if detected early. Women should never ignore signs like pelvic pain, unusual discharge, or fever. Maintaining safe sexual practices, regular check-ups, and seeking timely treatment are key to protecting reproductive health.
At Chetna Hospital, Sambhajinagar, Chinchwad, our experienced Gynaecologist, Dr. Bharati Patil, provides comprehensive care for all women’s health issues including PID, menstrual disorders, pregnancy care, and infertility management.
If you experience any symptoms or concerns, don’t delay — early diagnosis can prevent complications and preserve your fertility.
