Pelvic Inflammatory Diseases (PID)

This is a broad term encompassing infections of the female reproductive organs, including the ovary, fallopian tubes, uterus, cervix or the vagina.

The infection is in the pelvic region of the female, hence the term.

Most infections are transferred upwards during sexual activities via the vaginal canal. Therefore, many STDs are covered under the broader class, PID.

Common Modes of Catching a PID

  • Most infection are encountered during unprotected sex from an infected partner.
  • During procedures like IUD insertion.
  • During surgical abortions or child birth.
  • Douching, which may push the bacteria upwards into the vaginal tract
  • Poor hygiene in the groin area

Common culprits of pelvic infection include chlamydia and gonorrhea, there are many other organisms associated with it.


  • Pain in lower abdominal area. The pain is usually dull and constant. It may be tender to touch. Sometimes, the pain is an the upper abdomen, typically on the right side.
  • Pain or burning while urinating
  • Painful intercourse
  • Fever. This may be accompanied with shivering
  • Foul smelling discharge form the vagina. The discharge may be altered in its smell, color and consistency.
  • Low back ache
  • Sometimes, there are no overt signs or symptoms of the condition. The couple may report infertility.


PID is a common cause of infertility now a days. Due to infection in the tubes, inflammation occurs, occluding the fallopian tubes with products of inflammation. Sometimes, thick fibrous bands are formed, which may block the tube for ever.

In a normal course, the egg released from the ovary, travels through the fallopian tube to reach the uterus. When tubes are occluded, the egg is not able to complete its journey.

Also, occluded tubes prevent the sperm from traveling upwards to fertilize with the egg.

PID are culprits in several cases of abortions. They do not let the fetus grow in a healthy way.

Many cases of low back pain are actually due to chronic PID.


Diagnosis is made on the basis of symptoms. Vaginal discharge may be analyzed. A swab may be taken from the vagina or the cervix and send for culture.

In some cases, ultrasound pelvis is required. Endometrial biopsy may be taken.


  • Cleaner sex practices are recommended.
  • Avoid multiple sexual partners.
  • Using clean condoms would prevent most of the infections of that area.
  • A course of appropriate antibiotics is given. PID is usually a mixed infection. So a combination regimen of antibiotics may be recommended.

Commonly used medications include doxycycline, ceftriaxone or cefoxitin. Metronidazole may be given to cover the anaerobic bacteria.

Medical Advice (Q&As) on “Pelvic Inflammatory Diseases (PID)

    1. Buddy M.D. Post author

      Fluid in pouch of Douglas needs to be investigated further. This may be an indication of some infection, PID or even malignancy.

      What are your symptoms? Do you have any pain, fever etc.?

  1. Janet

    I have had 4 miscarriage and I am 30 yrs. My scan said my endometrial plate is thin and there is much fluid in my pod. I am afraid can I still be pregnant again.

    1. Buddy M.D. Post author

      It’s not normal to be having fluid in the pouch of douglas. This may be due to some pelvic infection or hidden malignancy.

      Before conceiving again, you need to get evaluated by a doctor and investigate the cause of having excess fluid in the POD.

  2. Janet

    Thank you for your answer sir. I will go and see my Doctor right now. My endometrial plate is thin what is the meaning and is there an problem with me?

    1. Buddy M.D. Post author

      Yes, endometriosis may cause infertility, though it’s temporary. You recover after treatment.

      Pelvic infections may be due to sexual indulgence with an infected partner. This is the commonest cause.

  3. fynna

    Hi. Plz, I have delay in my menses for days now, abdominal pain which is on right side of my abdomen. Fever, diarrhea today, went and had a pregnancy test. It was negative. Also had a scan and every time seemed normal but saw a little accumulation of fluid in the cul-de-sac. Have been scheduled to see a gynecologist but want to know what’s wrong with me. Will I be able to have kids in future? I am 23 yrs.

  4. Name

    I had a scan today and was diagnosed with hemorrhagic right ovarian cyst.
    Minimal POD FLUID – To R/O P.I.D

    1. Buddy M.D. Post author

      Management would depend upon your clinical symptoms. If the hemorrhage is substantial, surgical drainage is usually done. For smaller amounts, pills may be given and it resolves on its own.

  5. bee

    My scan says: bulky uterus, minimal fluid seen in cul-de-sac and in endometrial cavity. PID suggested, both ovaries are normal in size. ( 8 months after normal delivery) treatment?

  6. Remi

    The result of my pelvic scan shows a retroverted uterus. Is it possible to give birth? I am also experiencing sperm leakage. How can I overcome that? Thank you doctor.

    1. Buddy M.D. Post author

      You may conceive, there should be no problem due to the retroverted position.

      How much is the sperm leakage? This needs to be assessed. If it’s too much, your cervix needs to be tightened.

  7. Andy

    I did scan I was told I have pid for fluid in the pouch of Douglas and I have not seen my period for this month and am having pain in my lower abdomen

    1. Buddy M.D. Post author

      Kindly elaborate your symptoms. Since when do you have pain lower abdomen, any evident swelling there, fever or fatigue, irregularity of menses, backache, discharge from vagina, if yes, smell and color of the discharge?

    1. Buddy M.D. Post author

      You need to check up with your gyne. Your doctor would correlate this finding with clinical symptoms. He would check if you have any pain in lower abdomen, fever, problem urination or any other symptoms suggesting PID.

      Furthermore, there can be other causes, besides PID, for getting fluid there. They need to be ruled out at the earliest.

    1. Buddy M.D. Post author

      Pouch of douglas is a sort of pocket or groove between your urinary bladder and the uterus. It is formed by folding of internal covering layers of skin over these organs.

      In healthy conditions, it doesn’t have any fluid. Fluid collected in it is usually indicative that some nearby organ is sick and is oozing out fluid.

      In most cases, it is the uterus, which is either infected or has some other cause of inflammation, and is oozing fluid.

      You need to be checked up by a gyne to know your cause.

    1. Buddy M.D. Post author

      Infection in the uterus are commonly transmitted via sexual intercourse. However, there are other causes too.

      You may get it via infected commodes, bath tubs or swimming pools. You are also likely to develop an infection there if there’s poor hygiene down there, easpecially after defecation or when you don’t change tampons for long hours.

  8. Joan

    I had a surgical abortion in December and in January 15th 2018 I had my period which seemed normal and February it was 5 days past 15th with no periods but mild cramps, I went to the doctor who ordered for an ultrasound which showed free fluid in the posterior cul de sac measuring 14.4mm deep suggesting pid, I was given antibiotics which Iam taking now. Will I be able to get pregnant in the future? And could this pid have come from the surgical procedure I did? Iam scared.
    Note. I wasn’t diagnosed with any STI
    Thank you Doc

    1. Buddy M.D. Post author

      You just need to treat this infection completely. Only incompletely managed infections may make it difficult to conceive in future.

      It may have come through the surgical procedure, or else, may be from infected commode or baths used after the procedure.

  9. Lady boun

    Am a lady of 27 yrs old. Was diagnosed with fluid in pod oct 2016 ..not much drug was taken ..Xmas 2016 i started having severe pelvic pain..forward to now .i have barely 2days menstrual flow which comes out slippery..weight loss..and back ache..
    Am scared that i might have a serious problem..what is my fate. Forgot to mention i have aborted thrice in my life before the ultrasound test

    1. Buddy M.D. Post author

      You are likely to be carrying some infection in your pelvic area. Antibiotic treatment required at the earliest. If not treatment well, you may have difficulty conceiving later on.

  10. Mounika

    Iam 21yr old,i used to have vaginal discharge without smell,i was diagnosed as free fluid in pod as related to pld.i used cefoxiten,doxycyclin,metrodinozoal tables,and now am suffering from lower abdominal pain what’s the reason for the abdominal pain?.and my doctor suggested the same treatment again can I use the same tables again?

    1. Buddy M.D. Post author

      Was a follow up ultrasound done to see fluid in POD? Any burning, itching or redness down there? Do you have fever or weakness?

  11. simah

    i did untrasound and there is mild free fluid in POD? What does it mean? will i be able to concieve in the future am 25 yrs

    1. Buddy M.D. Post author

      There can be many reasons for POD having fluid collected in it. Most of these causes are treatable.

      Commonest reason is having a pelvic infection. You need appropriate treatment for the underlying cause. Once treated, conception should not be a problem.


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