Patient Basics: Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection of the womb (uterus) and fallopian tubes, and sometimes the ovaries. It usually starts with a sexually transmitted infection (STI), such as chlamydia or gonorrhea, that spreads upward from the vagina and cervix. Early antibiotic treatment matters, because PID can scar the fallopian tubes and make it harder to get pregnant later.

Key points

• The most common symptom is pain low in the belly or pelvis. Some people have only mild symptoms, or none.
• Untreated chlamydia and gonorrhea are the main causes.
• Treatment is a combination of antibiotics, usually for 14 days. Sex partners need testing and treatment too.
• About 1 in 8 women who have had PID have trouble getting pregnant, according to the CDC.
• Regular STI testing and condoms lower the risk.

What causes pelvic inflammatory disease

The cervix, the narrow opening at the bottom of the uterus, normally keeps most germs out of the upper reproductive organs. Some infections can get past it. Bacteria then travel into the uterus and fallopian tubes and sometimes reach the ovaries and the lining of the belly.

• Chlamydia and gonorrhea cause many cases.
• Other bacteria that normally live in the vagina, including those involved in bacterial vaginosis, and an STI called Mycoplasma genitalium can also cause PID.

PID itself doesn’t pass between partners, but the infections that cause it do. Rarely, PID follows childbirth, a miscarriage, an abortion or a procedure on the uterus.

Who is at higher risk

• Being sexually active and under 25
• Having a new partner, more than one partner, or a partner who has other partners
• Not using condoms
• Having had PID or an STI before
• Douching, which can push bacteria upward

An intrauterine device (IUD) slightly raises the risk only in the first few weeks after it’s placed.

PID symptoms

• Pain or tenderness in the lower belly, often on both sides
• Pain during sex
• Unusual vaginal discharge, sometimes with a bad smell
• Bleeding between periods or after sex
• Burning when you urinate
• Fever, chills, nausea or vomiting in more severe cases
• Pain in the upper right belly, if the infection has spread to the lining around the liver

Symptoms can be mild enough to ignore, but damage to the tubes can still happen. That’s why any new pelvic pain in a sexually active person deserves a checkup.

How it’s diagnosed

No single test proves PID. Doctors diagnose it from your symptoms and a pelvic exam. Pain when the doctor gently moves the cervix, uterus or ovaries points to PID. You’ll likely have:

• Swabs or a urine test for chlamydia and gonorrhea
• A pregnancy test, to rule out an ectopic pregnancy (a pregnancy growing outside the uterus)
• Tests for HIV and syphilis
• Blood tests for signs of infection, in some cases
• An ultrasound if you are very ill, to look for a pocket of pus (abscess)

Because waiting can lead to scarring, doctors usually start treatment the same day, before test results come back.

How pelvic inflammatory disease is treated

Antibiotics

Most people are treated as outpatients. A common plan is one shot of ceftriaxone, then doxycycline and metronidazole pills for 14 days. The shot treats gonorrhea, doxycycline treats chlamydia, and metronidazole covers other vaginal bacteria. Take every dose, even after you feel better. You should start to improve within about three days. Your doctor will usually want to see you again then.

Hospital care

You may need antibiotics through a vein in the hospital if you:

• Are pregnant
• Are very ill, with high fever or vomiting
• Can’t keep pills down
• Have an abscess
• Don’t improve with pills

An abscess may need to be drained with a needle guided by ultrasound, or by surgery.

Partners

Anyone you’ve had sex with in the 60 days before your symptoms started should be tested and treated, even if they feel fine. Don’t have sex until you’ve both finished treatment and your symptoms are gone. Some health departments let your doctor give you medicine to pass to your partner.

If you have an IUD, it can usually stay in during treatment.

Possible complications

• Trouble getting pregnant. Scarring can block the fallopian tubes. The risk rises with each bout of PID.
• Ectopic pregnancy. A damaged tube can trap a fertilized egg. This is an emergency.
• Long-term pelvic pain that lasts months or years
• Tubo-ovarian abscess, a collection of pus around a tube and ovary

If you’ve had PID and are trying to get pregnant, tell your doctor. Early checks can spot an ectopic pregnancy.

Lowering your risk

• Use condoms every time with new or non-monogamous partners.
• Get tested for chlamydia and gonorrhea every year if you are sexually active and under 25, or older with a new or more than one partner.
• Get retested about three months after treatment for chlamydia or gonorrhea.
• Make sure partners are treated, so the infection doesn’t come back.
• Don’t douche.

When to see a doctor

• New pain in the lower belly or during sex
• Unusual discharge or bleeding
• A partner tells you they have an STI
• You’re not better within three days of starting treatment

Get emergency care for severe belly pain, fever above 101°F with vomiting, fainting, or belly pain with a positive pregnancy test.

Common questions about PID

What does PID mean in medical terms?

In women’s health, PID stands for pelvic inflammatory disease, an infection of the uterus, fallopian tubes or ovaries. The same letters can mean other things elsewhere in medicine. For example, a spine doctor may use PID for prolapsed intervertebral disc, a slipped disc in the back. Ask if you see it on a report and aren’t sure.

Is PID curable?

Yes. Antibiotics cure the infection in most people, especially when started early. PID doesn’t reliably go away on its own, and the longer it lasts, the more it can scar the tubes. Treatment can’t undo scarring that has already formed. PID can come back if a partner isn’t treated or you get a new STI.

Can PID kill you?

Rarely. Deaths from PID are uncommon in the US today, but a burst abscess can cause a life-threatening infection of the belly lining or blood (sepsis). An ectopic pregnancy after PID can also cause dangerous internal bleeding. Get emergency care for severe belly pain, high fever with vomiting, or fainting.

Can amoxicillin treat pelvic inflammatory disease?

Amoxicillin on its own is not a recommended treatment for PID. Several kinds of bacteria are usually involved, so doctors use a combination of antibiotics, most often a ceftriaxone shot plus doxycycline and metronidazole pills. If you’re allergic to any of these, your doctor can choose others that work.

How long does PID last after treatment?

Most people feel better within three days of starting antibiotics, and symptoms usually clear by the end of the 14-day course. Some tiredness or mild soreness can linger a little longer. Pelvic pain that lasts for months is a known complication, so tell your doctor if it doesn’t go away.

Questions to ask your doctor

• Which infection caused my PID?
• How soon should I feel better, and when should I come back?
• How can my partner get treated?
• Has this affected my chances of getting pregnant?
• How often should I be tested for STIs?

Learn more

• About pelvic inflammatory disease (CDC)
• Pelvic inflammatory disease (MedlinePlus, U.S. National Library of Medicine)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.