How Is Pelvic Inflammatory Disease Treated?

Pelvic inflammatory disease (PID) is an infection of the reproductive tract typically caused by an untreated sexually transmitted infection (STI), bacterial vaginosis (BV) or, less commonly, recent implantation of an intrauterine device (IUD).

The symptoms of PID are wide-ranging and can include pelvic pain, fever, nausea or vomiting, painful sexual intercourse, changes in menstruation (including more severe cramping or a heavier flow), burning with urination and unusual vaginal discharge.

Receiving treatment for PID is essential. Left untreated, the condition can lead to severe complications such as infertility, risk of ectopic pregnancy, chronic pelvic pain and an abscess.

A healthcare provider will make a diagnosis using a wide variety of criteria before PID can be treated.

"A provider would consider the symptoms that the patient manifests and accordingly order a urine test, blood test, perform a pelvic exam and, if needed, a sonogram," said Anna Cabeca, D.O., an OB-GYN in Dallas. "If those results are still inconclusive, a laparoscopy or, in some cases, an endometrial biopsy may be required.

"There is no specific test out there that can directly determine if someone has PID; therefore, the provider must take into consideration a variety of factors before making the diagnosis."

You can receive testing for PID from your primary care provider, a gynecologist or a sexual health clinic.

How is pelvic inflammatory disease treated?

PID is not a condition you can self-diagnose or treat at home, because it requires antibiotics, follow-up care and potentially further treatment for any complications. If detected early, PID is easily treatable. However, when someone receives treatment too late, their risk of developing complications increases.

Certain complications can be irreversible, such as scarring in the fallopian tubes.

"Since we are dealing with a bacterial infection, antibiotic treatment is essential," Cabeca said.

Determining the cause of PID is critical to enlisting proper treatment. Several kinds of antibiotics may be used.

"If the origin is an STI or if it is stress-related, it may determine which antibiotic and for how long of a period you will need to take it," Cabeca said. "Since some bacteria are resistant to certain antibiotics, finding the appropriate one is key."

Because untreated chlamydia and gonorrhea are common causes of PID, finding an antibiotic regimen that treats them concurrently is essential.

Be sure you finish the entire course of antibiotic treatment, even if PID symptoms clear early. It’s essential to abstain from sex until you’ve completed the prescribed course of treatment for PID, too. Ensure your partner receives testing and treatment, as you could pass the infection back and forth to each other if someone remains infected.

While someone is undergoing treatment for PID, recommendations to alleviate discomfort include rest, a heating pad, over-the-counter pain relief and no tampon use.

Follow-up care is vital. You need to schedule an appointment after your course of antibiotics to ensure the infection is cleared before you start having sex again. If any of your symptoms remain or return, it’s best to schedule an appointment with your doctor.

Once you've had PID, your chances of developing it again in the future increase. Repeat testing for chlamydia or gonorrhea is recommended three to six months after treatment completion.

Lifestyle changes can aid in immunity alongside the prescribed antibiotic treatment.

"There are natural ways you can reduce the risk of catching PID, or in case of an infection, aid the antibiotic treatment by reinforcing your body’s immune system from within," Cabeca said. "Our body is a wonderfully well-oiled machine; following a healthy lifestyle and providing it with the right nutrients and ingredients can really do wonders to our overall health."

What happens if you don't treat PID?

"Untreated PID can lead to serious consequences," Cabeca said. "Recurring infections can increase the risk of infertility to 50 percent or more."

A common complication of PID is chronic pelvic pain, which Cabeca said could lead to a dependency on painkillers and spawn further issues. Sometimes, chronic pelvic pain can lead to depression and difficulty sleeping.

For severe symptoms such as vomiting, intense pelvic pain, faintness or an abscess, hospitalization may be required for treatment. In the case of an abscess, the recommended treatment may include antibiotics, a minimally invasive drainage procedure or surgery.

Sometimes, a combination of interventions is used. If someone does not see an improvement in their symptoms from antibiotic treatment, hospitalization may be suggested.

While PID can make it more challenging to get pregnant because of scarring, pregnancy is still possible. A fertility doctor may recommend the assistance of in vitro fertilization (IVF) to bypass potential issues from fallopian tube scarring.

The risk of ectopic pregnancy increases when someone with PID becomes pregnant; immediate care for ectopic pregnancy is essential. Ectopic pregnancies can cause the fallopian tubes to rupture, which is a life-threatening development.

How can you prevent PID?

"Prevention is just as important as treatment," Cabeca said.

One of the most effective ways to prevent PID is to prevent STIs by correctly using a barrier contraceptive method such as condoms and dental dams each time. You can get PID from vaginal sex, oral sex, sharing sex toys and anal sex.

Frequent STI testing is pivotal, especially for younger people of reproductive age. If you get another STI, you can develop PID again, according to the Centers for Disease Control and Prevention (CDC). Early detection and treatment of STIs can help prevent PID; chlamydia is present in 30 percent of all PID cases.

If someone has PID, it’s important their partners also get tested. Women who douche have a higher risk of developing PID, so abstaining from douching can help prevent the condition.

If you notice any symptoms of PID, get a diagnosis and treatment quickly. The longer someone waits to receive treatment for PID, the higher their chances of developing a serious complication. When detected early, PID can be effectively treated with antibiotics.