Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries.
PID is a common condition, although it's not clear how many women are affected in the UK.
It mostly affects sexually active women aged 15 to 24.
PID often does not cause any obvious symptoms.
Most women have mild symptoms that may include 1 or more of the following:
- pain around the pelvis or lower tummy
- discomfort or pain during sex that's felt deep inside the pelvis
- pain when peeing
- bleeding between periods and after sex
- heavy periods
- painful periods
- unusual vaginal discharge, especially if it's yellow or green
A few women become very ill with:
- severe pain in the tummy
- a high temperature
- feeling and being sick
When to seek medical advice
It's important to visit a GP or a sexual health clinic if you experience any of the above symptoms.
If you have severe pain, you should seek urgent medical attention from your GP or local A&E department.
Delaying treatment for PID or having repeated episodes of PID can increase your risk of serious and long-term complications.
There's no simple test to diagnose PID. Diagnosis is based on your symptoms and the finding of tenderness on a vaginal (internal) examination.
Swabs will be taken from your vagina and the neck of the womb (cervix), but negative swabs do not rule out PID.
Most cases of PID are caused by a bacterial infection that's spread from the vagina or the cervix to the reproductive organs higher up.
Another type of STI called mycoplasma genitalium is thought to be increasingly responsible for cases of PID.
In many other cases, it's caused by bacteria that normally live in the vagina.
If diagnosed at an early stage, PID can be treated with a course of antibiotics, which usually lasts for 14 days.
You'll be given a mixture of antibiotics to cover the most likely infections, and often an injection as well as tablets.
It's important to complete the whole course and avoid having sexual intercourse during this time to help ensure the infection clears.
Your recent sexual partners also need to be tested and treated to stop the infection coming back or being spread to others.
The fallopian tubes can become scarred and narrowed if they're affected by PID. This can make it difficult for eggs to pass from the ovaries into the womb.
It's estimated around 1 in 10 women with PID become infertile as a result of the condition. Women who have delayed treatment or had repeated episodes of PID are most at risk.
But most women treated for PID are still able to get pregnant without any problems.
You can reduce your risk of PID by always using condoms with a new sexual partner until they have had a sexual health check.
Chlamydia is very common in young men and most do not have any symptoms.
If you're worried you may have an STI, visit your local genitourinary medicine (GUM) or sexual health clinic for advice.