What are the Causes of Pelvic Inflammatory Disease?

“Severe PID can cause permanent damage to your reproductive organs and prevent you from getting pregnant” [1]. Getting an accurate diagnosis from a Vulva Doctor who will give you a Personalised Treatment Plan to treat your PID right away, is the best course of action. After all, prompt treatment will help you avoid a number of complications, including infertility

The Low-Down
As a Vulva Specialist will tell you: Pelvic inflammatory disease (also known as PID), refers to an infection that is found in the ovaries, fallopian tubes, or uterus. Generally speaking, it is caused by a sexually transmitted infection. PID can affect females, and those who are assigned female at birth. It comes about when specific types of bacteria expand from the vagina to the reproductive organs [1].

“Bacteria from untreated sexually transmitted infections (STIs) are the most common cause of PID. However, bacteria normally found in the vagina, can also cause PID” [1]

Where Do People Feel PID Pain the Most?

In general, pain generated by pelvic inflammatory disease, is experienced in the pelvic region or lower abdomen. Vulva consultants find that most patients describe it as sore and tender, on a par with a dull ache. In addition to this, if you are having sex, you may sense pain deep in to your pelvis [1].

PID Signs & Symptoms to Look Out For

Symptoms can start suddenly, and include:

• Stomach pain or tenderness
• Lower abdominal (belly) pain or tenderness
• Pelvis pain, and
• Abnormal vaginal discharge (this is usually green or yellow, and has an unusual odour)
• Fever or chills
• Vomiting or nausea
• Painful sex
• A feeling of burning when passing water
• Irregular periods, or cramping or spotting throughout the month [1]

Did You Know?

“Many types of bacteria can cause PID, but the two most common infections are gonorrhoea & chlamydia caused by unprotected sex. These two STIs cause about 90% of all cases. Less commonly, PID happens when normal bacteria get into your reproductive organs. This can happen after childbirth, pelvic surgery & miscarriage. or getting an IUD” [1]

Because pelvic inflammatory disease can be mild or not noticeable, you may not know that you have it [1]. To that end, if you feel that you may have PID, it is important to consult a Vulva Doctor, to find out one way or the other, and then arrange treatment if needed.

Who is at the Most Risk of Getting PID?

People are at higher risk if they:
• Are under 25 years of age
• Are sexually active
• Have a sexually transmitted infection (particularly chlamydia or gonorrhoea)
• Have had a large number of sexual partners
• Have had a partner who has had multiple sexual partners
• Have previously suffered from pelvic inflammatory disease
• Have undergone pelvic surgery such as tubal ligation [1]

How Bacteria Causes PID

When bacteria enters the reproductive tract, it generates PID. The bacteria passes from the vagina through the cervix, and then up into the uterus, fallopian tubes and ovaries. In most cases, when the bacteria enter the vagina, the cervix prevents it from extending deeper into other reproductive organs. However, the cervix can be disrupted by any form of infection, and thus prevent it from carrying out its regular functions [1].

Complications Caused By PID

Vulva Specialists often explain to patients that the longer they have had pelvic inflammatory disease, the more serious their situation could be. This is because their infection can generate scar tissue in the fallopian tubes, and this can result in:
• Long-term pelvic pain
• Ectopic pregnancy
• Infertility
• Tubo-ovarian abscess [1]


[1]. Cleveland Clinic (2023). “Pelvic Inflammatory Disease.”