What to Know About Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) may sound scary — but it’s also common, and help is available.

Because the condition is linked to trying to conceive TTC struggles (which can be stressful enough on their own), it can take a real toll on your emotional as well as physical well-being.

(Psst. If this is where you’re at, there’s a supportive community at Peanut here to navigate this journey with you. You don’t have to do it alone.)

In this article, we’ll take you through all the details of PID.

But just know, if you’re feeling unwell at all — especially if you have pelvic pain or unusual bleeding — it’s best to check in with your doctor.

Even if it’s nothing, at least you’ll leave the appointment with some peace of mind!

Alright, let’s dive in.

In this article: 📝

What is pelvic inflammatory disease?

Pelvic inflammatory disease is an infection of the female reproductive organs that affects the ovaries, fallopian tubes, and uterus. [1]

Pathogens (disease-causing organisms) get into the lower reproductive tract (the vagina and cervix) and then travel north, infecting the upper parts of the reproductive system.

Pelvic inflammatory disease (PID) symptoms aren't always the most obvious.

In fact, they're often mild and may include:

• Pain in the lower abdomen and pelvic area, particularly when peeing or having sex
• Heavy or painful periods
• Bleeding after sex or between periods
• Yellow or green vaginal discharge that has a distinct odor

2013 data from the CDC showed that about 4.4% of sexually experienced women between the ages of 18 and 44 self-reported having had PID in their lifetime. [2]

About one-third of those who have PID will develop it again. [3]

And you’re more likely to get it when you’re 25 years old or younger. [4]

But that doesn’t mean you can’t get it when you’re older.

About 11.5% of the postmenopausal women in a recent study were diagnosed with it. [5]

So if you’re experiencing pelvic pain during or after the menopause transition, check in with your doctor.

What causes pelvic inflammatory disease?

PID is most frequently caused by a sexually transmitted disease, often chlamydia or gonorrhea. [6,7]

In fact, about a third to half of cases are attributed to the microorganisms that cause these two diseases. [8]

That means you’re more likely to get PID if you have untreated STIs, multiple sex partners, and/or a partner who has multiple partners.

But there are other reasons you might be prone to this condition.

What causes pelvic inflammatory disease without STD?

There’s a small chance that using an IUD as birth control can increase your risk of getting PID.

That’s because you’re introducing foreign microbes into your uterus.

But the risk is only really higher for the first 20 days after insertion, and it’s very rare that you’d be more susceptible after that. [9]

There’s also a possibility that douching (cleaning out the inside of the vagina with water and/or other liquids like vinegar) could put you at a higher risk for developing PID. [4]

Douching can cause an overgrowth of harmful bacteria, which can lead to bacterial vaginosis (BV).

While the exact link is still under investigation, it does appear that there’s a connection between BV and PID. [10]

Pelvic inflammatory disease vs endometriosis

PID and endometriosis (where tissue from the lining of the uterus grows outside the womb) are two separate conditions, but there’s a link between the two.

This study showed that you’re at greater risk for developing endometriosis if you have PID — though the reasons for this are not fully understood yet. [11]

The symptoms of endometriosis can also be quite similar to PID and include pelvic pain and cramping, pain during or after sex, pain when you pee, and excessive bleeding.

Endometriosis can also make it harder for you to get pregnant.

How serious is pelvic inflammatory disease?

For some people, pelvic inflammatory disease symptoms can be quite severe and could include serious pain and fever, and generally feeling very unwell.

In some cases, abscesses can develop in the fallopian tubes or ovaries.

These are known as tubo-ovarian abscesses. [12]

The good news is they can often be treated with antibiotics or, in more severe cases, be drained or removed through surgery.

On the other end of the spectrum, some people only have mild (or no) symptoms and may not even know that they have the condition — but this comes with some potential danger of its own.

What happens if PID is left untreated?

If left untreated, PID can become serious, leading to chronic pelvic pain and trouble conceiving. [13]

We know — how are you supposed to treat it if you don’t know you have it?

Quite a conundrum!

Best you can do is check in with your doctor if you display any symptoms, even if they’re mild, or if you suspect you have an STD.

Regular reproductive health check-ups are also a good idea!

How can I test myself for PID?

Unfortunately, you can’t.

You have to get help from a medical professional for this one.

If you experience pain in your pelvic area and it’s not the ovulation or period cramping that you’re used to, check in with your healthcare provider.

Same thing if you have strong-smelling vaginal discharge or any excessive or unusual bleeding.

Your doctor will talk through your symptoms and medical and sexual history.

From there, they’ll decide what to do next.

(We get it — it can be uncomfortable talking about this. The point is to get you well. No judgment.)

They’ll also likely give you a pelvic exam, where they physically examine your reproductive system through your vagina and check your vulva.

They may also take a swab from the vagina, cervix, or lining of the uterus to test for bacterial infection.

From there, they might want to do other tests, like an ultrasound or a laparoscopy, where they make a tiny cut in your abdomen and insert a little camera to view your reproductive organs from the inside.

Can pelvic inflammatory disease be cured?

If you think you may have PID, it’s important to get medical attention right away.

Pelvic inflammatory disease treatments (in the form of antibiotics) are available.

In serious cases, these may be given to you via IV in the hospital.

If you are prescribed oral antibiotics, take the full course to ensure that you get the infection out of your system.

Can you get pregnant with pelvic inflammatory disease?

The short answer is, yes, it’s definitely possible to get pregnant if you have PID.

For some people, it just may be more difficult.

According to the CDC, 1 in 8 women with a history of PID struggles to get pregnant. [4]

And because PID can cause scar tissue in the reproductive system, it can become increasingly difficult to conceive if you don’t get prompt treatment or if you get infected more than once.

However, once you've undergone treatment, studies show that those with PID have the same rates of pregnancy as the rest of the population. [13]

Another thing to be aware of is that there may be a link between PID and ectopic pregnancy. [14]

This is when a fertilized egg implants outside of the uterus.

It’s a dangerous condition that, unfortunately, leads to pregnancy loss and can cause severe pain and bleeding.

All of this can sound overwhelming and terrifying, we know.

Take things one step at a time.

The first thing to do is check in with your doctor if you’re experiencing any PID symptoms or think you might have an STI.

They’ll guide you through what to do next.

And if you need support along the way, check in with the Peanut community.

All topics are on the table.