Pelvic Inflammatory Disease (PID)

February 8, 2017

Pelvic inflammatory disease (PID) is an infection induced inflammation of a woman’s pelvic organs. The pelvic organs include the uterus (womb), fallopian tubes, ovaries, and cervix. It is a complication often caused by some STDs, like Chlamydia and gonorrhea. Other infections that are not sexually transmitted can also cause PID. Other bacteria that normally live in the vagina can also cause it, especially after a termination of pregnancy, or having intra uterine device (IUD/coil) fitted.

In PID, inflammation spreads from the vagina or cervix to the upper genital tract, with endometritis as an intermediate stage in the pathogenesis of disease. The hallmark of the diagnosis is pelvic diagnosis combined with inflammation of the lower genital tract; women with PID often have a very subtle symptoms and signs.

Pelvic inflammatory disease is common. More than one million U.S. women get PID every year. As a result of PID, more than 100,000 women become infertile each year. In addition, a large proportion of the 100,000 ectopic (tubal) pregnancies that occur each year can be linked to PID. The rate of infection is highest among teenagers.

PID can lead to serious, long-term problems –

  • Infertility—One in ten women with PID becomes infertile. PID can cause scarring of the fallopian tubes. This scarring can block the tubes and prevent an egg from being fertilized.
  • Ectopic pregnancy—Scarring from PID also can prevent a fertilized egg from moving into the uterus. Instead, it can begin to grow in the fallopian tube. The tube may rupture (break) and cause life-threatening bleeding into the abdomen and pelvis. Emergency surgery may be needed if the ectopic pregnancy is not diagnosed early.
  • Chronic pelvic pain—PID may lead to long-lasting pelvic pain.


In most cases the PID is caused by an infection which starts in the vagina and then makes it way to the cervix, and can move onto the fallopian tubes and ovaries. Often more than one type of bacteria may be causing the infection.

  • Chlamydia and Gonorrhea – Chlamydia is the most common cause (50% to 65% of cases in the UK), followed by gonorrhea (14% of cases in the UK). Sometimes PID may be caused by a combined Chlamydia-gonorrhea infection.
  • Childbirth, abortion or miscarriage – bacteria can get into the vagina during/after childbirth, abortion or miscarriage; it then multiplies and spreads, causing PID. The infection can spread more easily because the cervix may not have fully closed.
  • IUD – the intrauterine device, also known as a coil can increase the risk of infection which may lead to PID.
  • Endometrial biopsy – this procedure, during which a sample of tissue is taken for analysis, has a risk of infection and subsequent PID.
  • Appendicitis – there is a slight risk of developing PID if a woman has appendicitis.
  • Women who are sexually active and less than 25 years of age, have several sexual partners, or do not use barrier contraceptives have a higher risk of developing PID.


Some women with PID have only mild symptoms or have no symptoms at all. Because the symptoms can be vague, many cases are not recognized by women or their gynecologists or other health care professionals. Listed are the most common signs and symptoms of PID:

  • Abnormal vaginal discharge
  • Pain in the lower abdomen (often a mild ache)
  • Pain in the upper right abdomen
  • Abnormal menstrual bleeding
  • Fever and chills
  • Painful urination
  • Nausea and vomiting
  • Painful sexual intercourse
  • Fatigue

Having one of these signs or symptoms does not mean that you have PID. It could be a sign of another serious problem, such as appendicitis or ectopic pregnancy. You should contact your gynecologist or other health care professional if you have any of these signs or symptoms.


PID can be treated. However, treatment of PID cannot reverse the scarring caused by the infection. The longer the infection goes untreated, the greater the risk for long-term problems, such as infertility.

  • Antibiotics – treatment for PID depends on the cause, but usually involves administering antibiotics. If the patient does not respond to antibiotic treatment within three days she should go back to her doctor or hospital, who may recommend intravenous antibiotic therapy or a change of medication.

As PID is frequently caused by more than just one type of bacteria at any one time, doctors tend to prescribe two antibiotics, which are taken together. As soon as the doctor knows which bacterium or bacteria are causing the disease, antibiotic therapy may become more targeted. Examples of antibiotics for PID include ofloxacin, metronidazole, ceftriaxone and doxycycline.

A course of antibiotics usually lasts 14 days. Patients with very severe symptoms will be hospitalized and receive their medication intravenously.

  • Surgery – the fallopian tubes may have scarring, or there may be abscesses that need to be drained. Surgery may be needed, either laparoscopy (keyhole surgery) or salpingectomy (removal of one or both fallopian tubes). Doctors are reluctant to remove both fallopian tubes, because the woman will not be able to get pregnant naturally.
  • Sexual partner – the doctor may advise the woman to have her sexual partner checked and if necessary, treated for an STD (sexually transmitted disease). If the partner has an STD there is a serious risk of recurrence.

Alternative Treatment

A comprehensive treatment plan for PID may include a range of alternative therapies.

  • Nutritional Supplement –
    • Multivitamin supplement – Intake of antioxidant vitamins A, C, and E, the B complex vitamins and trace minerals such as magnesium, calcium, zinc and selenium.
    • Omega 3 fatty acids – Intake of fish oil help reduce inflammation.
    • Probiotic – Probiotic yogurt that contains live cultures (good bacteria) is a great remedy to fight this bacterial infection. The good bacteria in this yogurt will help fight the bad bacteria and restore good bacteria in your vagina. It also helps maintain a healthy vaginal pH balance.
    • Vitamin C This vitamin is essential for the proper functioning of the immune system. It also helps with the formation of collagen, which is very important if you are suffering from a vaginal infection or PID. Collagen is a protein that is found in an abundant supply in the body. It maintains the integrity of skin, ligaments, tendons and bone. If the collagen matrix (which is the main component of connective tissue) is intact, infection is less likely to spread, and your organs are less likely to become scarred by the infection. The bacteria can spread through the connective tissue so having extra vitamin C at this time will help to strengthen the connective tissue, make it more resistant, and decrease the time it takes for your body to repair damaged tissue.

o   Beta-carotene – Beta-carotene is a type of vitamin A that is known to help your body produce collagen, and it also helps to keep your cartilage strong. It is important that you have adequate levels in your body to help stop the spread of infection. Beta-carotene is also a powerful antioxidant and is found in high concentrations in the ovaries. However, if there isn’t enough in the body, levels in the ovaries will be inadequate, and the ovaries will be less likely to be able to fight off attacking infectious agents. Studies show that adequate levels of beta-carotene can help to prevent excess cell damage. Beta-carotene is also vital for immune function and for the normal growth of the type of tissue found in the vagina.

  • Garlic – Often called ‘nature’s antibiotic’, garlic is very important while you are trying to fight off an infection because it has strong antibacterial properties. So not only can it help to deal with the present infection, but it can help to prevent a recurrence by making the body an inhospitable place for invaders
  • Herbs – Herbs are one way to strengthen and tone the body’s systems.
    • Green Tea
    • Cat’s claw
    • Bromelain
    • Reishi Mushroom
    • Olive Leaf
  • Acupuncture – Acupuncture may help enhance immune function and reduce pain and inflammation, especially in women with chronic PID. Acupuncturists often target their protocols to draining what they call “Damp Heat” from the area. This is done using both acupuncture and Chinese herbal preparations.



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