Health Library

Categories > Menstrual Health > Painful periods

Understanding pelvic inflammatory disease
The causes
Diagnosis and treatment
Untreated PID

Know the signs
Know the signs

The first step in minimizing PID is catching it early. Symptoms include:

  • pain in the lower abdomen
  • heavy vaginal discharge with a strong odor
  • irregular menstrual bleeding
  • pain during intercourse
  • frequent, painful urination
  • back pain
  • fever, fatigue, diarrhea or vomiting

Easing PID discomfort
Easing PID discomfort

Women with PID may find some relief with these at-home remedies in conjunction with medical care:

  • Place a heating pad or hot-water bottle on your abdomen or back.
  • Take frequent hot baths. This may reduce the foul odor of the discharge, relax muscles and relieve discomfort. Sit in a tub of hot water for 10 to 15 minutes as often as necessary.
  • Use sanitary pads to absorb the discharge.
  • Don’t douche, use a tampon or have sexual intercourse during treatment.

Women who shrug off “feminine” symptoms such as a heavy vaginal discharge or lower abdominal pain because they are too embarrassed to see a healthcare provider may be risking their reproductive health. Such is the case with pelvic inflammatory disease (PID).

Each year, one million women are diagnosed with PID, and 20 percent of them become infertile as a result of it, according to the National Institutes of Health. Knowing what symptoms to watch for and how to prevent PID can help you avoid the condition and related problems.

The causes

Women develop PID when bacteria enters the vagina and travels to the cervix, causing an infection. If it doesn’t get treated right away, the infection can spread to the uterus, fallopian tubes and ovaries.

Sexual intercourse or an untreated sexually transmitted disease (STD), such as chlamydia or gonorrhea, can introduce bacteria into the genital tract. Douching may also flush bacteria higher into the genital tract.

Diagnosis and treatment

To diagnose PID, your doctor analyzes vaginal or cervical discharge for evidence of an STD. He or she may also feel your abdomen and pelvic area for tenderness and possible masses.

Your doctor may also order a sonogram, an endometrial biopsy or a minimally invasive surgical procedure called laparoscopy. Laparoscopy is often performed on an outpatient basis.

Because several bacteria are responsible for PID, doctors usually prescribe two antibiotics to cure the infection. It is important to take the medication even after symptoms disappear. Some women with PID, including those who are pregnant, may be hospitalized for treatment.

Intercourse and tampon use should be avoided during treatment.

Untreated PID

If left untreated, PID may lead to pain and scarring. Scarred fallopian tubes may prevent a fertilized egg from passing into the uterus to grow. The egg is then forced to implant on the narrow walls of the fallopian tube. As the embryo gets bigger, the tube ruptures and causes internal bleeding. This condition, called a tubal or ectopic pregnancy, can be life threatening. Women who have had PID increase their risk for a tubal pregnancy by six- to tenfold.


If you think you may have an STD, get treatment immediately to prevent it from spreading throughout the genital tract.

Women who have had PID may suffer repeat episodes because the initial infection damages the body’s disease-fighting defenses. Unfortunately, reinfection increases the risk of infertility.

Infection-causing bacteria can also enter the vagina when the cervix is partially open, such as after childbirth or miscarriage. During these times, women who have had PID should refrain from intercourse, douching or using tampons until the cervix is fully closed. Not only can douching promote PID, but it may also ease the discharge caused by the infection, thereby masking a symptom that might prompt a woman to seek care. Ask your doctor for more information.