Pelvic inflammatory disease (PID)

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

Pelvic pain, abnormal discharge, or unusual bleeding shouldn’t be ignored — especially if they come with fever or general unwellness. These could be signs of Pelvic Inflammatory Disease (PID), a condition that, if left untreated, can lead to serious long-term health issues, including fertility problems.

At Happiher, we approach PID diagnosis and treatment with urgency, care, and sensitivity. If you’re looking for a private gynaecologist in London for pelvic infection management, expert help is available.

What Is Pelvic Inflammatory Disease (PID)?

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

Bacterial vaginosis can contribute to PID. Additionally, infections caused by Mycoplasma genitalium have also been identified as potential contributors to the development of PID.

Most cases are caused by sexually transmitted infections (STIs) like chlamydia or gonorrhoea, with Chlamydia trachomatis being one of the primary bacterial agents responsible for PID. About 10 to 15 percent 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 predominantly arises from infections caused by sexually transmitted bacteria, which can spread from the lower genital tract to the upper reproductive organs such as the uterus and fallopian tubes.

Introduction to PID

Causes and Risk Factors of PID

Pelvic inflammatory disease (PID) is a complex condition that can arise from various causes and risk factors. Various bacterial infections, especially those caused by gonorrhea and chlamydia, account for a significant percentage of PID cases. The primary cause of PID is a bacterial infection, typically a sexually transmitted infection (STI) such as chlamydia or gonorrhea, which spreads from the lower genital tract to the upper genital tract, including the fallopian tubes, uterus, and ovaries. This infection can lead to inflammation and potentially cause permanent damage to the reproductive organs. Risk factors for developing PID include having multiple sexual partners, a history of STIs, unprotected sex, and the use of an intrauterine device (IUD). Additionally, women who have had pelvic surgery, abortion, or childbirth are at a higher risk. Understanding these causes and risk factors is crucial for preventing PID and reducing the likelihood of long-term complications such as chronic pelvic pain, ectopic pregnancy, and infertility.

Symptoms of PID

PID symptoms can vary — from mild and easily overlooked 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 generally unwell

• Adnexal tenderness

• Cervical motion tenderness

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

Sometimes, PID causes very subtle symptoms — or none at all — but still leads to damage inside the reproductive organs over time. This lack of obvious symptoms can make early detection challenging, underscoring the importance of regular health check-ups.

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

Approximately 10-50% of women with a history of PID may experience infertility, highlighting the importance of early diagnosis and treatment.

The sooner PID is treated, the better the outcomes. Quick diagnosis and effective antibiotics can prevent long-term complications. Delayed treatment can lead to chronic pain, infertility, and other severe complications. Therefore, it is crucial not to delay treatment to avoid these serious health issues. Early diagnosis and treatment are essential to prevent PID and its associated complications.

When Should You See a Gynaecologist?

You should seek urgent advice if you experience:

• 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, discreet appointments to ensure early diagnosis and immediate treatment.

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 provide critical 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, leading to pelvic inflammatory disease (PID) and potentially causing serious complications such as scarring and infertility.

At Happiher, diagnosis typically 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

Testing for sexually transmitted infections (STIs) is often conducted as part of the diagnostic process for PID.

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

Treatment Options for PID

Prompt and empiric treatments are essential to prevent complications and typically involve: Treatment for PID should begin immediately even before confirmation of the infection to avoid complications.

Untreated PID can lead to complications such as 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

It is important to complete the entire course of antibiotics and avoid sexual intercourse during treatment to ensure the infection clears.

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

Surgery for Complications

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

Dr Kaur specialises in:

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

• Robotic-assisted surgery for complex cases, offering precision and quicker recovery

Our aim is always to preserve fertility wherever possible and minimise long-term impact. It is crucial to preserve the reproductive system during surgery to prevent long-term complications such as infertility and chronic pain.

Complications and Consequences

If left untreated, PID can lead to severe complications, including the formation of 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, such as the abdomen, and cause pelvic abscesses. Delaying treatment or receiving inadequate treatment can lead to long-term complications, including 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 developing other gynaecological conditions, such as endometriosis. It is essential to seek medical attention promptly if symptoms of PID occur, and to receive prompt treatment to prevent these complications.

Fertility Concerns Related to PID

PID can significantly affect fertility due to the potential for scarring and damage to the reproductive organs, particularly the fallopian tubes. Sexual activity is a major risk factor for developing PID, as it is most commonly linked to infections stemming from sexual activity, particularly among young women. When the fallopian tubes are scarred or blocked, it can prevent the fertilized egg from traveling to the uterus, leading to difficulties in conceiving. Furthermore, PID can increase the risk of ectopic pregnancies, where the fertilized egg implants outside the uterus, often in a fallopian tube. The rate of ectopic pregnancy following PID is significantly higher than in women without PID. This condition is life-threatening and requires immediate medical attention. Early diagnosis and prompt treatment of PID are essential to minimise the risk of fertility concerns. Women who have had PID should discuss their reproductive health and potential fertility issues with a healthcare provider to understand their options and the best course of action for their individual situation.

Living with PID

Living with PID requires a comprehensive approach to manage symptoms, prevent long-term complications, and maintain reproductive health. It is essential for individuals with PID to practice safe sex, use barrier methods, and limit their number of sexual partners to reduce the risk of reinfection and the transmission of STIs to their sexual partners. Using barrier contraception with a new sexual partner is particularly important to reduce the risk of PID. Regular check-ups with a healthcare provider are crucial for monitoring the condition and addressing any concerns or complications that may arise. Additionally, maintaining a healthy lifestyle, including a balanced diet and regular exercise, can help in managing symptoms such as pelvic pain and improving overall well-being. In cases where PID has caused significant damage or led to complications like chronic pelvic pain or infertility, seeking support from a consultant gynaecologist or a fertility specialist can provide guidance on available 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

• Avoiding douching, as it may increase the risk of pelvic inflammatory disease (PID).

PID occurs most frequently in women ages 15 to 25 years, emphasising the clinical significance of understanding its occurrence and diagnosis in sexually active young women presenting with specific symptoms.

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

Why Choose Happiher for PID Care?

If you’re seeking private care for pelvic infections in London, Happiher provides:

• Same-week private consultations

• Rapid access to diagnostic testing and ultrasound

• Immediate antibiotic treatment when needed

• Specialist minimally invasive surgical care

• Follow-up and fertility support if required

Happiher is dedicated to women's health, offering comprehensive care and expert insights to address serious health conditions and wellness.

You deserve swift, expert care delivered with kindness, privacy, and respect. Pelvic inflammatory disease (PID) affects approximately 1.5% of young women each year, particularly those aged 15 to 25, making it crucial to understand the risk factors and seek timely treatment.

Final Thoughts

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

If you’re concerned about pelvic infection symptoms, reach out today. We’re here to listen, diagnose with precision, and treat with the highest standard of care.