Can PID cause infertility?

Yes, untreated PID can scar the fallopian tubes, leading to infertility in about 10–15% of women after a single episode. The risk increases with each subsequent episode of PID. Early treatment significantly reduces this risk.

Yes, PID can be effectively treated with antibiotics, especially when caught early. However, antibiotics cannot reverse damage already done to the reproductive organs. This is why prompt treatment is crucial.

Can PID occur without having an STI?

Yes, while most PID cases are caused by STIs, normal vaginal bacteria can sometimes migrate to the upper reproductive tract and cause infection. This can occur after certain procedures or in women with bacterial vaginosis.

ReproductiveICD-10: N73.0About 1 million cases of PID are diagnosed annually in the United States

Pelvic Inflammatory Disease

Also known as: PID

Pelvic inflammatory disease (PID) is an infection of the female upper reproductive tract, including the uterus, fallopian tubes, and ovaries, most commonly caused by sexually transmitted bacteria such as Chlamydia trachomatis and Neisseria gonorrhoeae. If left untreated, PID can cause chronic pelvic pain, tubal scarring leading to infertility, and life-threatening ectopic pregnancy. Early antibiotic treatment is essential to prevent long-term complications.

Symptoms

Lower abdominal or pelvic pain (most common symptom)

Abnormal vaginal discharge with an unusual odor

Irregular menstrual bleeding or bleeding between periods

Pain during intercourse (dyspareunia)

Painful or difficult urination

Fever and chills

Nausea and vomiting (in severe cases)

Causes

Chlamydia trachomatis (most common causative organism)
Neisseria gonorrhoeae
Normal vaginal bacteria ascending to the upper reproductive tract
Mycoplasma genitalium and anaerobic bacteria

Risk Factors

Sexually active women under 25
Multiple sexual partners
History of STIs or previous PID
Not using barrier contraception
Recent IUD insertion (slight increased risk in the first 3 weeks)
Vaginal douching

Diagnosis

Clinical diagnosis based on pelvic pain and cervical motion tenderness on exam
Testing for chlamydia and gonorrhea (NAAT)
Elevated inflammatory markers (ESR, CRP, WBC)
Pelvic ultrasound to evaluate for tubo-ovarian abscess
Endometrial biopsy showing endometritis (definitive but rarely needed)

Treatment

Empiric antibiotic therapy (ceftriaxone + doxycycline ± metronidazole)
Treatment of sexual partners to prevent reinfection
Hospitalization and IV antibiotics for severe PID, tubo-ovarian abscess, or pregnancy
Follow-up within 48–72 hours to assess clinical improvement
Surgical drainage if tubo-ovarian abscess does not respond to antibiotics

Prevention

Consistent condom use during sexual intercourse
Regular STI screening for sexually active women under 25
Prompt treatment of chlamydia and gonorrhea infections
Avoiding vaginal douching
Limiting the number of sexual partners

When to See a Doctor

Lower abdominal pain with abnormal vaginal discharge
Pain during intercourse or urination
Fever with pelvic symptoms
Known exposure to an STI

Frequently Asked Questions

Related Conditions

Chlamydia

Infectious

Gonorrhea

Infectious

Endometriosis

Reproductive

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