Pelvic inflammatory disease (PID) is an infection that affects a woman’s reproductive organs, and according to the Centers for Disease Control and Prevention, in the United States it’s estimated 2.5 million women will have a reported lifetime history of a PID diagnosis.
To learn more, we spoke with William Schweizer, clinical associate professor in the department of obstetrics and gynecology at NYU Langone Health, for his expert insight into PID, its symptoms, treatment options, and more.
What is PID?
Pelvic inflammatory disease, according to Schweizer, “is an infection of the female reproductive organs. It occurs when bacteria move from the vagina or cervix upward toward the uterus, ovaries, or fallopian tubes.” He explained that gonorrhea and chlamydia are a main cause of PID. While those are sexually transmitted diseases, bacteria that are not sexually transmitted may also be a cause.
What are the symptoms of PID?
PID can come with mild symptoms or even an absence of them. Schweizer explains, “Sometimes the symptoms are vague and often unappreciated by women or their doctors. PID may start with abnormal vaginal discharge. Lower abdominal pain or painful urination may be early symptoms of an infection beginning.” Additionally, abnormal menstrual bleeding can be a symptom, and as the infection progresses women may experience “fever and or chills, and nausea and vomiting can occur,” he says.
Schweizer also explains that painful intercourse or upper abdominal pain near the liver, due to adhesions, also known as Fitz Hugh Curtis Syndrome, may also occur in some cases.
PID is treatable. “Treatment options include antibiotics,” Schweizer says, adding, “Treatment requires broad antimicrobial coverage against likely organisms, including gonorrhea and chlamydia and also the common bacteria that create the cervical and vaginal flora.” Other additional antibiotics can be used in more severe or complicated cases.
Intramuscular shots are available for initial therapy. Schweizer explains, “Initial outpatient therapy for mild or moderate PID is treatment with one intramuscular shot of ceftriaxone along with doxycycline twice daily for two weeks. Metronidazole twice daily for 14 days can also be added.“
Effects on Fertility
Unfortunately, pelvic inflammatory disease can affect a woman’s fertility, and according to the CDC, one in eight women who have had PID struggle to get pregnant. Schweizer explains, “Scarring and adhesions can occur and cause infertility by causing damage to the fallopian tube.” However, he also advises, “Prompt treatment is important to reduce short- and long-term complications.”
He also noted that sometimes the diagnosis can be difficult to make and laparoscopic surgery can be performed to help diagnose.
PID is preventable. As with many communicable diseases, Schweizer advises using condoms, as barrier contraception is the “best protection against STDs.”