Pelvic Inflammatory Disease

When to Seek Medical Care

If you are experiencing the following symptoms, you should see your health care provider:

• Abdominal pain  that does not go away
• Irregular vaginal bleeding
• Foul-smelling vaginal discharge
• Unusual vaginal discharge
• Fever, nausea, vomiting

Given the long-term complications PID can cause, such as infertility  and ectopic pregnancy, it is recommended that you seek immediate medical attention if you have any of these symptoms:

• Lower abdominal pain or tenderness
• Fever greater than 101°F (38.3°C)
• Abnormal or foul-smelling vaginal discharge

Adult women with PID are either closely monitored or admitted to the hospital. More aggressive treatment may take place in the hospital for adolescents, who are at a much higher risk of not following treatment plans and of having complications.

You may be admitted to the hospital if any of the following are true:

• The diagnosis is unclear.
• Ectopic pregnancy or appendicitis cannot be ruled out.
• You are pregnant.
• An abscess (an infection) is suspected.
• You are acutely ill or cannot manage your illness at home.

Follow-up

Take all medications your health care provider prescribes. Your symptoms may go away before the infection is cured and you may feel much better, but finish taking all the antibiotics prescribed for you. Follow up with your doctor or in a clinic within 3 days to monitor improvement. Whether on oral or IV therapy, you usually improve within 72 hours.

• If you are being treated and your symptoms get worse prior to the 72-hour follow-up appointment, you should return to the doctor's office or hospital. If you do not improve, you may require additional testing and maybe surgery.
• You should not have sexual activity until the infection is cured. Any sexual partners you have had within 2 months of getting PID should also be treated.

Outlook

If you are diagnosed and treated early, your outcome is good. The outcome may not be as good if you wait too long before treatment and/or engage in unsafe sexual practices. Complications can occur:

• Tubal damage and scarring can result in infertility. PID is the most common cause of infertility in women. Following a single episode of PID, 8% of women were infertile; after 2 episodes, 19.5% of women were infertile; and after 3 or more episodes, 40% of women were infertile.
• Ectopic pregnancy is 6 times more common in women who have had PID at least once. In the United States, half of all women with such pregnancies have had a prior episode of PID.
• Chronic pelvic pain is present in up to 18% of women with PID.
• Ovarian abscesses can occur after an episode of PID. Untreated PID also puts you at risk for a tubo-ovarian abscess (TOA). A TOA is a collection of bacteria, pus, and fluid that occurs in the fallopian tube. It is most often seen in teens. A TOA is also more likely to occur in teens or adult women who use intrauterine devices (IUDs) as birth control. A teen girl with a TOA often looks sick and has a fever and pain that makes it difficult to walk. The abscess will be treated in the hospital with antibiotics, and surgery may be needed to remove it.

If you have PID, you are at increased risk of getting PID again. As many as one third of women who have had PID will have the disease at least one more time. With each case, your risk of becoming infertile is increased.