Pelvic inflammatory disease (PID)

Pelvic Inflammatory Disease (PID): Understanding, Diagnosing, and Treating Pelvic Infections

Don’t ignore pelvic pain, abnormal discharge or bleeding – especially if it comes with a fever or feeling unwell. These could be signs of Pelvic Inflammatory Disease (PID), a condition that if left untreated can cause long term health problems including fertility issues.

At Happiher we approach PID diagnosis and treatment with urgency, care and sensitivity. Looking for a private gynaecologist in London for pelvic infection management? Help is here.

What is Pelvic Inflammatory Disease (PID)?

Pelvic Inflammatory Disease (PID) is an infection of the upper female reproductive tract – the uterus (womb), fallopian tubes and ovaries. It usually starts with a bacterial infection that spreads up from the vagina or cervix.

Bacterial vaginosis can cause PID. Mycoplasma genitalium has also been identified as a potential cause of PID.

Most cases are caused by sexually transmitted infections (STIs) like chlamydia or gonorrhoea, Chlamydia trachomatis is one of the main bacterial agents that cause PID. About 10-15% of women with endocervical Neisseria gonorrhoeae or Chlamydia trachomatis will go on to develop PID. PID can also result from:

• Normal vaginal bacteria becoming unbalanced

• Bacteria introduced during childbirth, miscarriage, abortion or pelvic procedures like coil (IUD) insertion

PID is mainly caused by sexually transmitted bacteria that can spread from the lower genital tract to the upper reproductive organs like the uterus and fallopian tubes.

Introduction to PID - Causes and Risk Factors of PID

Pelvic inflammatory disease (PID) is a complex condition that can be caused by many factors. Bacterial infections especially those caused by gonorrhea and chlamydia account for a big percentage of PID cases. The main cause of PID is a bacterial infection, usually a sexually transmitted infection (STI) like chlamydia or gonorrhea that spreads from the lower genital tract to the upper genital tract including the fallopian tubes, uterus and ovaries. This infection can cause inflammation and potentially damage the reproductive organs permanently. Risk factors for PID include having multiple sexual partners, history of STIs, unprotected sex and using an intrauterine device (IUD). Women who have had pelvic surgery, abortion or childbirth are also at higher risk. Understanding these causes and risk factors is key to preventing PID and reducing the likelihood of long term complications like chronic pelvic pain, ectopic pregnancy and infertility.

Symptoms of PID

PID symptoms can vary – from mild and easy to miss to sudden and severe.

Common signs include:

• Lower abdominal pain or pelvic pain

• Unusual vaginal discharge (especially with an unpleasant smell)

• Pain during sex

• Painful urination

• Bleeding between periods or after sex

• Heavy or painful periods

• Fever, chills or feeling unwell

• Adnexal tenderness

• Cervical motion tenderness

Women with PID may also experience pain during sexual intercourse (dyspareunia) which can be a big indicator of the condition.

Sometimes PID causes very subtle symptoms – or none at all – but still causes damage inside the reproductive organs over time. This lack of obvious symptoms can make early detection tricky, that’s why regular health checks are important.

Why Early Diagnosis of PID Matters

Untreated PID can cause:

• Permanent damage to the fallopian tubes

• Chronic pelvic pain

• Increased risk of ectopic pregnancy (pregnancy outside the womb)

• Infertility

About 10-50% of women with a history of PID will experience infertility, that’s why early diagnosis and treatment is important.The sooner PID is treated the better. Quick diagnosis and antibiotics can prevent long term complications. Delayed treatment can cause chronic pain, infertility and other serious complications. So don’t delay treatment to avoid these health issues. Early diagnosis and treatment is key to preventing PID and its complications.

When to See a Gynaecologist?

You should seek urgent advice if you have:

• Persistent or worsening pelvic pain

• New abnormal vaginal discharge

• Fever with pelvic pain

• Bleeding between periods or after sex

• Painful sex or urination

• Concerns after a positive STI test

At Happiher we offer fast and discreet appointments to get you diagnosed and treated quickly.

How is PID Diagnosed?

There is no single test for PID — diagnosis is based on a combination of symptoms, examination findings and investigations. Diagnosis often includes assessing tenderness during a vaginal examination which can give important clues to the presence of PID. There is no straightforward test to diagnose PID; diagnosis relies on a combination of symptoms and physical examinations.

Bacteria can enter and affect the upper reproductive tract including the uterus and fallopian tubes and cause PID and potentially serious complications like scarring and infertility.

At Happiher diagnosis includes:

• Detailed consultation about symptoms, sexual health and medical history

• Pelvic examination (if appropriate and you’re comfortable)

• Vaginal and cervical swabs to test for infections

• Nucleic acid amplification tests (NAATs) to identify specific pathogens like Chlamydia trachomatis and Neisseria gonorrhoeae

• Pelvic ultrasound scan to look for signs of inflammation, abscesses or hydrosalpinx (fluid in the fallopian tubes)

• Blood tests to check for signs of infection

STI testing is often done as part of the diagnostic process for PID.

If needed laparoscopy (keyhole surgery) can give a definitive diagnosis especially in complicated or unclear cases.

Treatment for PID

Empiric treatment should start immediately even before confirmation of the infection to prevent complications.

Untreated PID can cause pelvic abscess which requires timely diagnosis and treatment.* Oral antibiotics for mild to moderate cases

• Intravenous antibiotics in hospital for severe infections

• Partner notification and treatment to prevent reinfection

• Pain management with anti-inflammatory medications

Make sure to complete the full course of antibiotics and avoid sex during treatment to ensure the infection clears.

Follow up is key to ensure symptoms resolve fully — and any complications are detected early.

Surgery for Complications

In rare cases where abscesses form or infection persists despite antibiotics surgery may be needed.

Dr Kaur specialises in:

• Minimally invasive (laparoscopic) surgery to drain abscesses and clear infection

• Robotic-assisted surgery for complex cases, faster recovery

We always aim to preserve fertility wherever possible and minimise long term impact. It’s crucial to preserve the reproductive system during surgery to prevent long term complications like infertility and chronic pain.

Complications and Consequences

If left untreated PID can cause severe complications including scar tissue in the fallopian tubes which can cause infertility and increase the risk of ectopic pregnancy. The infection can also spread to other parts of the body like the abdomen and cause pelvic abscesses. Delaying treatment or inadequate treatment can cause long term complications like chronic pelvic pain which can affect a woman’s quality of life and sex life. In some cases PID can also increase the risk of other gynaecological conditions like endometriosis. Seek medical attention promptly if symptoms of PID occur and get treated early to prevent these complications.

Fertility Concerns related to PIDPID can affect fertility due to scarring and damage to the reproductive organs especially the fallopian tubes. Sexual activity is a major risk factor for PID as it’s most commonly linked to infections from sexual activity especially among young women. When the fallopian tubes are scarred or blocked it can prevent the fertilized egg from travelling to the uterus and cause difficulty in getting pregnant. PID can also increase the risk of ectopic pregnancy where the fertilized egg implants outside the uterus often in a fallopian tube. The rate of ectopic pregnancy after PID is higher than in women without PID. This is life threatening and needs immediate medical attention. Early diagnosis and prompt treatment of PID is key to minimising fertility concerns. Women who have had PID should discuss their reproductive health and fertility issues with their healthcare provider to understand their options and what’s best for them.

Living with PID

Living with PID requires a holistic approach to manage symptoms, prevent long term complications and maintain reproductive health. Women with PID should practice safe sex, use barrier methods and limit their number of sexual partners to reduce the risk of reinfection and transmission of STIs to their sexual partners. Using barrier contraception with a new sexual partner is especially important to reduce the risk of PID. Regular check ups with a healthcare provider is crucial to monitor the condition and address any concerns or complications that may arise. Maintaining a healthy lifestyle including a balanced diet and regular exercise can help in managing symptoms like pelvic pain and overall well being. If PID has caused significant damage or led to complications like chronic pelvic pain or infertility seeking advice from a consultant gynaecologist or fertility specialist can guide on treatment options including robotic assisted surgery for conditions like tubo-ovarian abscess. By taking an active role in their healthcare and following the recommended treatment and prevention strategies women with PID can reduce their risk of long term complications and improve their quality of life.

How to Reduce the Risk of PID

While not all cases are preventable, risk can be lowered by:

• Regular STI screening if sexually active with new or multiple partners

• Using barrier contraception (e.g., condoms)

• Seeking prompt treatment for any infections

• Having coil (IUD) insertions performed in a sterile setting by a trained specialist* Not douching as it may increase the risk of PID.

PID occurs most commonly in women 15-25 years old so it’s important to understand its occurrence and diagnosis in sexually active young women presenting with symptoms.

At Happiher we can also offer sexual health screening and advice in a confidential and non-judgmental environment.

Why Happiher for PID Care?

If you’re looking for private care for pelvic infections in London, Happiher offers:

• Same week private consultations

• Rapid access to diagnostic testing and ultrasound

• Immediate antibiotic treatment if needed

• Specialist minimally invasive surgery

• Follow up and fertility support if required

Happiher is a women’s health clinic, we offer comprehensive care and expert advice on serious health conditions and wellness.

You deserve fast, expert care with kindness, privacy and respect. PID affects 1.5% of young women each year, most of whom are 15-25 years old so it’s important to understand the risk factors and get treated on time.

Conclusion

Pelvic pain, abnormal discharge or bleeding may be embarrassing to talk about — but at Happiher there’s no judgment only support. Quick action can protect your future health, your fertility and your peace of mind.

If you have pelvic infection symptoms get in touch today. We’ll listen, diagnose with precision and treat with the highest standard of care.