Updated August 2025

Definition

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs, specifically the uterus, fallopian tubes and ovaries.

Signs and Symptoms

A person with PID may have some of the following signs and symptoms:

  • pain in the pelvic area or lower abdomen
  • unusual and/or increased vaginal discharge
  • pain during or after vaginal intercourse
  • bleeding from the vagina when it is not a menstrual period
  • fever

Sometimes the symptoms go unnoticed because they are mild. Some individuals do not have any signs until PID has caused damage.

Causes

PID occurs when bacteria spread from the vagina to the uterus and fallopian tubes. Infection can be caused by many types of bacteria including some that are sexually transmitted like chlamydia and gonorrhea. It is common to not know exactly which bacteria caused the infection.

Diagnosis

Your health care provider will ask you some questions, do a physical examination including a pelvic exam and take some tests for sexually transmitted infections (STI) and vaginal infections.  If you are diagnosed with PID, you will be treated with antibiotics. You may be asked to return to the clinic to be re-examined in 2 or 3 days. This is very important. You may have to go to the hospital for further tests and treatment if your symptoms aren’t getting better.

Complications (that may arise)

The longer PID is left untreated, the greater the chance of serious damage. The infection can damage the fallopian tubes. If this happens, it may be more difficult to get pregnant in the future. It also increases the risk of an ectopic pregnancy (pregnancy outside the uterus, usually in the fallopian tubes). An ectopic pregnancy is a medical emergency that requires treatment to stop the pregnancy.

Ongoing (chronic) pelvic pain, abscesses and/or scarring may also result from having PID.

Risk Factors

People are at risk for getting PID if they have:

  • unprotected vaginal sex
  • an untreated STI such as chlamydia or gonorrhea
  • an untreated STI or vaginal infection at the time of an abortion or rarely, within the first month of an IUD insertion

Treatment

Treatment for PID aims to control the infection and prevent any long-term complications. Treatment usually includes more than one type of antibiotic and is effective against both chlamydia and gonorrhea. The antibiotics are usually a combination of pills and an injection. Intravenous (IV) medication is used for serious PID infections requiring hospitalization.

Prevention

Use latex condoms every time you have sexual intercourse.

Getting tested regularly for STIs is an important part of maintaining your overall sexual health. Encourage your partner(s) to get tested regularly too.

Self-care

Here are a few important points to remember:

  • Take all medication as prescribed by your health care provider or clinic.
  • Return to your health care provider or clinic for follow up if you have been told to do so.
  • Avoid sex for 7 days after you and your sexual partner(s) have completed treatment. You can get re-infected every time you have sex with an untreated partner.
  • If you have an untreated STI like chlamydia or gonorrhea, it is easier to get HIV from a person who has it.
  • It is possible to have more than one infection at a time; get tested for other STIs and HIV.

Public Health Role

Chlamydia and gonorrhea infection, both of which can cause PID, are reportable to your local health department. Your health information will be kept confidential. A public health nurse will work closely with your health care provider to ensure you are aware of your infection, receive the correct treatment, answer any questions you have and discuss notifying your partners. If you do not want to tell your partner(s), a public health nurse can notify them for you. Your name will be kept confidential.

Transmission/Spread

Chlamydia and gonorrhea are spread through unprotected oral, anal, or vaginal sex or sharing sex toys. PID occurs when these or other bacteria move up from the vagina into the uterus and fallopian tubes.

Information for Sexual Partners (for STIs)

PID is only possible in individuals who have female reproductive organs, but any sexual partner can get an infection from the STIs that can cause PID, such as chlamydia and gonorrhea.

When someone has PID, even if they tested negative for an infection, their partner(s) within the past two months must be notified and treated for chlamydia and gonorrhea. This is because sometimes the bacteria that cause these infections can travel so far up in the reproductive organs that it cannot be reached by a test. If these bacteria are not treated, they can be passed back and forth the next time they have sex without a condom.

If you have not had sex in the past two months, your last sexual partner should be tested and treated. Tell your partner(s) that having no symptoms does not mean there is no infection.

For More Information

Call the Sexual Health Infoline Ontario at 416-392-2437 (1-800-668-2437) or visit toronto.ca/health

Safer sex: To reduce your risk of getting a sexually transmitted infection (STI), use a condom every time you have vaginal, anal or oral sex.