Pelvic Inflammatory Disease - Treatment Overview

Treatment Overview

Untreated pelvic inflammatory disease (PID) can produce scar tissue (adhesions) that can cause ongoing (chronic) pelvic pain, ectopic pregnancy, and infertility. This is why PID must be treated right away, even if you have only one or two signs of PID.¹ This means that you may be given antibiotic treatment before lab results have come back, based on your medical history and a physical exam. This is because waiting several days to treat you could raise your risks of fallopian tube damage and infertility.⁴

Initial treatment

Antibiotic treatment for pelvic inflammatory disease (PID) takes 14 days. Your partner will also need treatment. Although you may feel better before the 2 weeks are up, be sure to finish taking the medication. If you don't, the infection may return. You may also be able to use a nonsteroidal anti-inflammatory drug (NSAID) to relieve PID pain or discomfort.

Follow-up evaluations are important for making sure that treatment is working. Close monitoring may be able to prevent complications, such as chronic pelvic pain and infertility. Your health professional will want to check you 2 to 3 days after you've started treatment, then 7 to 10 days later. You will also have a checkup 4 to 6 weeks after treatment has ended, to monitor your recovery.

What to think about

If you have an intrauterine device (IUD) for birth control in place and you develop PID, the IUD may need to be removed, depending on how severe the infection is.¹

Your health professional will recommend hospitalization if you are pregnant, are very ill, are vomiting, may need surgery for a tubo-ovarian abscess or ectopic pregnancy (which can result from PID), or aren't able to treat yourself at home.

Anyone with whom you have had sexual contact in the last 60 days should be evaluated and treated for sexually transmitted diseases (STDs) to prevent reinfection and passing infection on to someone else. Treatment for gonorrhea or chlamydia is not the same as treatment for PID. Different antibiotics are sometimes prescribed for PID, and they are taken for a longer period of time. Your partner will need to take antibiotics only for an STD, not for PID.

To prevent reinfection, do not have sex until both you and your sex partner(s) have completed antibiotic treatment (at least 14 days).

Ongoing treatment

If initial antibiotic treatment cures the infection that caused pelvic inflammatory disease (PID), you will not need ongoing treatment. However, it is important to make sure the infection is cured by following up with your health professional.

Avoiding a recurrent pelvic infection, particularly involving a sexually transmitted disease (STD), is the key to preventing another episode of PID. Regular condom use has been proven to reduce the risk of recurrent PID.⁵ (Having repeat episodes of PID increases your risks of tubal infertility, chronic pelvic pain, and ectopic pregnancy. For more information, see the Prevention section of this topic.)

Treatment if the condition gets worse

Most cases of PID are cured with antibiotic therapy. Surgery is not usually necessary to treat PID. However, surgery may be needed to:

• Drain or remove a pocket of infection (abscess).
• Cut scar tissue (adhesions) that is causing pain. (Surgery to remove adhesions from pelvic inflammatory disease has not been proven to relieve pain unless adhesions are severe.⁶)

Exploratory surgery is occasionally used when a diagnosis is still unclear after other tests are done or when antibiotic treatment is not working; diagnostic laparoscopy (which involves using a small lighted viewing instrument) is usually used.

What to think about

To avoid reinfection, it is critically important that you and your sex partner(s) be treated.

After having PID, it's important that you have any further pelvic symptoms checked promptly. Your health professional will want to examine you for signs of another infection, possible pelvic organ damage (adhesions), and other possible causes of your symptoms.