Pelvic Inflammatory Disease (PID): symptoms, treatment and prevention

Pelvic inflammatory disease (PID) is an infection of the womb, fallopian tubes and ovaries. It is usually a result of chlamydia and gonorrhoea in people with a cervix, but may also be caused by bacterial vaginosis and other infections.

PID is easily treated with antibiotics. However, if not treated, PID can lead to infertility (not being able to have children), ectopic pregnancy (where the pregnancy starts to grow in the tubes instead of the womb) or chronic (on-going) pelvic pain.

What are the symptoms of pelvic inflammatory disease?

The symptoms of PID can include:

• Pain passing urine (pee)
• Pain in the abdomen (tummy or belly area)
• Pain during or after sex
• Raised temperature
• Nausea or vomiting
• Bleeding after sex
• Bleeding between periods
• Change in your normal vaginal discharge

How do you get pelvic inflammatory disease?

PID can develop after:

• An untreated STI (such as chlamydia or gonorrhoea)
• An infection in the abdomen, which may not be sexually transmitted
• Surgery to the womb (such as a pregnancy termination or other surgery)
• Insertion of a coil

How does pelvic inflammatory disease develop?

PID starts in the cervix (entrance to the womb). If a person develops an infection it can move upwards into the womb and then spread to the fallopian tubes and ovaries.

There are a number of different types of bacteria that can cause PID. However, the most frequent causes are chlamydia and gonorrhoea. 

• The bacteria that cause chlamydia are responsible for 50-65% of cases while the bacteria that cause gonorrhoea are responsible for about 14% of cases.
• About 8% of those with PID are infected with both chlamydia and gonorrhoea
• You may also pick up the infection if you have genital contact with an infected person

Pelvic inflammatory disease not from sex

Sometimes bacteria introduced into the vagina or upper genital tract during childbirth, an abortion or miscarriage, or a procedure to take a sample of tissue from the inside of the womb can cause PID.

PID can also develop as a result of appendicitis, treatment of the cervix or after the fitting of an intrauterine device or coil (these are both contraceptives).

Sometimes it’s just not clear what causes it at all. It could be the case that normally harmless bacteria from the vagina get past the cervix and into the reproductive organs where they can actually cause infection.

What is the test for pelvic inflammatory disease

If you think you may have PID it is important to go for an STI check-up or visit your GP. There’s no single test that can tell you if you have PID or not, so your doctor will need to examine you to check for tenderness in your pelvic area and any abnormal discharge.

When testing for PID:

• Your doctor will take swabs from your vagina and cervix and send them to a laboratory to find out what kind of bacteria is causing your infection
• Sometimes a swab test won’t be able to diagnose PID, so you might have to give a urine sample or blood test too
• Ultrasound scans and keyhole surgery may also be used to diagnose PID, but only for more severe cases where there may be other possible causes of the symptoms, such as appendicitis

What is the treatment for pelvic inflammatory disease?

It’s very important to treat PID because if you don’t it can lead to complications later in life. The infection can spread to your reproductive system causing scarring and lead to infertility, an ectopic pregnancy, repeated PID infections and long term pain.

• If it’s diagnosed fairly early on you’ll be able to treat PID quickly and efficiently with antibiotics prescribed by your GP or sexual health clinic
• Any sexual partners you’ve been with in the six months before your symptoms began may need to be tested and treated too so it’s important to refer them on
• In extreme cases, you may be admitted to hospital for surgery

When can I have sex again?

You will have to wait until you have finished the antibiotics and have had a check-up by your doctor before having sex again, even sex with a condom or oral sex.If you were diagnosed with an STI, it is really important that you don’t have sex with your partner before they are tested and treated as you could become infected again.

Do I have to tell my partner/s I have pelvic inflammatory disease?

As PID can be caused by a sexually transmitted infection (STI), your partner will also need to be tested and may need treatment with antibiotics. You may feel nervous about telling your partner you have an STI but it is the best to thing to do to help protect their health. Your sexual health nurse or doctor will be able to give you advice on having this converstation. You can also find more information by reading our article on how to tell your partner you have an STI.

Sometimes previous partners will need to be tested too – your doctor or nurse will discuss this with you.

How can I protect myself against pelvic inflammatory disease?

There are many great options to help protect your sexual health, but none of them are 100% effective. Even if you use condoms every time you have penetrative sex, you are still at risk of getting genital warts and herpes, as these can be passed through skin-to-skin contact. Going for an STI check or taking a home STI testing kit with a partner before having sex, can be a great way of protecting yourself and those you have sex with against STIs and HIV. However, not all STI checks check for all STIs, so it is important to speak to your healthcare provider and ask them what are being tested for as part of your screening.

Discussing with your sexual partners the type of contraception or protection options available to you, and agreeing on a type that works for everyone involved can help to reduce the risk of pregnancy, STIs and HIV. Looking out for sores or symptoms on a partner’s genitals before having sex with them, can help to identify STIs that they may not be aware of. If you do see any signs that someone may have an STI, do not have sex with them until you know for certain it is safe to do so. Asking someone about their sexual health history is the responsible thing to do before having sex, and it should not be taken as an insult if someone asks you about yours.  

Looking after your mental health after an STI diagnosis

If you are diagnosed with an STI, you might feel a mixture of emotions. Unfortunately, there is still stigma in our society surrounding STIs that can cause some people to feel shame about having one. However, like any other healthcare diagnosis, you are not to blame for your STI and have not done anything “wrong”. Being diagnosed with an STI can have a negative impact on your mental health and wellbeing and if you don’t feel comfortable telling friends or family about it, you might feel isolated and alone. If you have found out you have an STI and you’re finding it difficult to cope, there are things you can do to support your mental health. 

• Remember that STIs are common and lots of people have one at some point in their life, even though they aren’t talked about a lot 
• Take time out to do something you enjoy and practice self-care
• Reach out for mental health support if you need it. If you don’t feel comfortable talking to a friend or family member, our 24/7 anonymous text service, 50808, can help
• Be patient with yourself and allow yourself to feel your emotions. It’s ok to be upset when you find out you need healthcare treatment. It’s important to take the time you need to adjust

Feeling overwhelmed and want to talk to someone?

• Get anonymous support 24/7 with our text message support service
• Connect with a trained volunteer who will listen to you, and help you to move forward feeling better
• Free-text SPUNOUT to 50808 to begin
• Find out more about our text message support service

If you are a customer of the 48 or An Post network or cannot get through using the ‘50808’ short code please text HELLO to 086 1800 280 (standard message rates may apply). Some smaller networks do not support short codes like ‘50808’.