Pelvic Inflammatory Disease (PID): Causes, Symptoms, and Prevention

Medically reviewed by
dr. Muhammad Ardianto Airlangga, SpOG

Pelvic Inflammatory Disease (PID) is an infection that affects the female reproductive organs, including the uterus, fallopian tubes, and ovaries. This infection often occurs due to bacteria spreading from the vagina to the upper reproductive organs. PID is one of the common causes of infertility in women, making it crucial to understand its symptoms, causes, and preventive measures. 

What Is Pelvic Inflammatory Disease (PID)? 

Pelvic Inflammatory Disease (PID) is a serious medical condition usually caused by bacterial infections, particularly sexually transmitted bacteria such as Chlamydia trachomatis and Neisseria gonorrhoeae. These bacteria can move from the vagina to the uterus and other parts of the reproductive system, causing inflammation in the pelvic area. If left untreated, PID can lead to severe complications, including permanent damage to reproductive organs and infertility. 

Causes and Risk Factors of PID 

PID is primarily caused by sexually transmitted bacterial infections (STIs). Women who are sexually active and have multiple sexual partners are at higher risk of developing pelvic inflammatory disease. Additionally, the use of intrauterine devices (IUDs) or procedures that manipulate the reproductive organs can also increase the risk of infection. Maintaining hygiene and reproductive health and practicing safe sex are essential steps in preventing pelvic inflammatory disease. 

Signs and Symptoms of Pelvic Inflammatory Disease 

The symptoms of PID are often subtle and can be mild or even absent altogether. However, some of the most common signs of pelvic inflammatory disease that should be monitored include: 

• Lower abdominal or pelvic pain. 
• Unusual vaginal discharge with a strong odor. 
• Fever, sometimes accompanied by chills. 
• Pain during sexual intercourse. 
• Pain or burning sensation during urination. 
• Irregular menstrual bleeding, especially between cycles. 

If you experience any of these symptoms, it is important to consult a healthcare professional promptly for diagnosis and treatment. These signs of pelvic inflammation should not be ignored, as if left untreated, PID can lead to severe complications. 

Diagnosis and Treatment 

Diagnosis of PID typically involves a pelvic examination, laboratory tests to detect infections, and possibly imaging such as ultrasound. Treatment for pelvic inflammatory disease includes administering antibiotics to eliminate the infection. It is vital to complete the full course of treatment, even if symptoms improve, to ensure the infection is entirely resolved. In severe cases, surgery may be necessary to address abscesses or tissue damage. 

Long-term Complications 

If pelvic inflammatory disease is not properly treated or is identified late, it can trigger a range of serious long-term complications, including: 

• Infertility: One of the most severe complications of pelvic inflammatory disease is infertility or the inability to conceive. Untreated infections can cause scarring in the fallopian tubes, hindering the journey of sperm to the egg and preventing fertilization. The risk of infertility increases with the severity of the infection and the number of PID episodes experienced. It is estimated that 1 in 10 women who have PID are at risk of infertility. 
• Ectopic Pregnancy: Scarring in the fallopian tubes also increases the risk of ectopic pregnancy, a condition in which a fertilized egg implants outside the uterus, typically in the fallopian tube. This is a dangerous condition as the fallopian tubes are not designed to support a pregnancy. Ectopic pregnancies can lead to life-threatening internal bleeding and require emergency medical intervention. 
• Chronic Pelvic Pain: Some women who experience pelvic inflammatory disease report chronic pelvic pain, which can persist for months or even years after the initial infection has resolved. This occurs due to prolonged inflammation and tissue damage in the pelvic area. This pain can disrupt daily activities and significantly reduce quality of life. 
• Tubovarian Abscess: PID can also lead to the formation of a tubovarian abscess, which is a pus-filled cavity in the fallopian tube or ovary. This abscess occurs as the body’s response to severe infection. If not treated promptly, the abscess can cause permanent reproductive organ damage or spread the infection to other parts of the body, which can be fatal. 

These complications highlight the importance of early diagnosis and treatment of symptoms related to pelvic inflammatory disease. Timely detection and appropriate management can prevent permanent damage to reproductive organs and other serious health risks. 

Prevention of PID 

Preventing pelvic inflammatory disease is crucial for maintaining women’s reproductive health. Here are some preventive measures that can be taken: 

• Practice Safe Sex: Using condoms is the most effective way to reduce the risk of sexually transmitted infections (STIs), which are the primary cause of PID. It is also important to choose sexual partners with clear sexual health histories and to mutually undergo STI testing. Education about sexual health and open communication with partners are also vital aspects of safe sexual practices. 
• Routine Check-ups: Regular sexual health check-ups are essential preventive measures, especially for women who are sexually active. These check-ups should include tests for STIs as well as comprehensive assessments of reproductive health. Early detection of STIs can help avoid the spread of infections and prevent PID. It is recommended to consult a doctor at least once a year or more frequently if at high risk. 
• Immediate Treatment of STIs: If diagnosed with an STI, it is crucial to start appropriate treatment immediately. Delaying treatment can allow the infection to spread to the reproductive organs, increasing the risk of PID. Make sure to follow all of your doctor’s instructions and complete the entire prescribed course of antibiotics, even if symptoms have improved. Additionally, it is important to inform sexual partners about the diagnosis so they can receive the necessary treatment. 
• Avoid Douching: Douching or washing the vagina with certain solutions can disrupt the natural balance of bacteria in the vagina. This balance is essential for preventing the growth of pathogenic bacteria. By disturbing the normal flora, douching can actually increase the risk of infections, including PID. It is advisable to simply clean the genital area with water and mild soap to maintain hygiene without disrupting the natural vaginal ecosystem. 

Pelvic inflammatory disease is a serious condition that requires immediate attention. Recognizing the signs of pelvic inflammation and understanding the symptoms of pelvic inflammatory disease early on is key to preventing further complications such as infertility or ectopic pregnancy. With appropriate preventive measures and regular check-ups, the risk of experiencing PID can be minimized. Take care of your reproductive health and always consult with medical professionals if you have any concerning symptoms. 

For more in-depth information about reproductive health, pregnancy programs, or infertility issues, you can consult with professional obstetricians at Morula IVF Indonesia. This fertility clinic offers comprehensive and professional obstetric consultations. With over 26 years of experience, Morula IVF has a dedicated team of specialists committed to helping couples have healthy children. For more information, you can contact or explore the official Morula IVF website for inquiries or consultations. 

References: 

• American College of Obstetricians and Gynecologists. (n.d.). Pelvic Inflammatory Disease. Accessed October 2024. 
• Centers for Disease Control and Prevention. (n.d.). Pelvic Inflammatory Disease. Accessed October 2024. 
• National Institutes of Health. (2016). Pelvic Inflammatory Disease. In Harrison’s Principles of Internal Medicine (19th ed.). Accessed October 2024. 
• Naber, K. G., et al. (2014). Pelvic Inflammatory Disease. New England Journal of Medicine, 371(3), 242-250. Accessed October 2024. 
• U.S. Department of Health and Human Services. (n.d.). Pelvic Inflammatory Disease. Accessed October 2024.