[Question #3630] PID from Chlamydia and Subsequent Questions

88 months ago

Hi Doctors,

Thank you for taking the time to answer my questions. I was recently diagnosed with Chlamydia. I did not know I was infected and likely gave it to my girlfriend. I was treated on February 16^th bur we weren’t both treated together until March 9^th(her choice) We had been having sex (unprotected) since sometime in mid/late January. I am worried she may have gotten PID from the incidence and have a few questions:

How long does Chlamydia take to cause PID? How likely is it that she has PID?

I have read that bacterial PID is when a bacteria moves up through the uterus. I am not sure if PID means the pelvis has become enflamed because of Chlamydia that is no longer there, or that the Chlamydia is alive and well in her pelvis and she can reinfect herself with Chlamydia. If my girlfriend was cured of Chlamydia but had PID, would she still be able to give me Chlamydia/become reinfected with Chlamydia? Would I need to get retested?

My girlfriend already has endometritis and experiences pain during sex, sometimes severely. She is also infertile. I have read that endometritis is a form of PID, although I believe this is incorrect. Does endometritis prevent her from acquiring PID in any way?

I was diagnosed and treated for Chlamydia on February 16^th. My girlfriend was at first in denial that she had anything, but we finally got treated together on March 9^th, as stated above. During the time after I was treated but she wasn’t, we definitely had sex, maybe 7-10 days after the 16^th and several other days before the 9^th. She was never actually tested for Chlamydia but took the treatment on the 9^th with me as a precaution. I was tested myself on the 9^th and the test yielded a negative result. We only had sex several times from mid/late January to February 16^th, maybe less than 10. Is it possible I never actually gave her chlamydia, since I should have shown a positive test (from reinfection) if I did?

We think the antibiotics she was given may have caused bacterial vaginosis or a yeast infection, as there was discharge seven days after she took them. If a doctor was to examine and treat her for PID, could he determine whether it was caused by chlamydia? Is the treatment different for chlamydial PID?

Edward W. Hook M.D.

87 months ago

Welcome to the Forum. I'll try to help. PID occurs when bacteria, including chlamydia present in the lower female genital tract get up into the uterus and adjoining fallopian tubes. The symptoms of PID are lower abdominal pain, lower abdominal tenderness and pain with sexual intercourse. Endometritis has many causes and can be a manifestation of PID but, if she had endometritis before your chlamydia it will be difficult to determine whether she has chlamydial PID/endometritis or not without a test. Sex with infected partners does not always result in transmission of infection so, as noted above, without testing there is no way to know if she was infected or not. The important thing however is that you were both treated at about the same time and as I understand it, you have been re-tested since treatment and found not to be infected. If that is the case, things are probably OK.

The antibiotics she took could have caused a yeast infection. If she has a vaginal discharge at this time, it is worthwhile for her to be checked out. At that time, the doctor could easily also test her from chlamydia to determine if infection is present. If chlamydial PID is present, she would likely be treated with similar medications to before but might be treated for a longer time.

I hope these comments are helpful. The situation you describe is a bit complex. If anything I have said is unclear or raises new questions, we will take up to 2 follow-up questions. EWH

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87 months ago

Hi Doctor,

Everything you said makes sense so thanks for taking the time to reply.

My outstanding question is still:

Is chalmydial PID a separate condition then chalmydia? Meaning if my girlfriend was treated for chalmydia but now has PID, could I catch chalmydia from her?

Say the doctor examines her and discovers she has PID, will he know whether it is chlamydial PID or not? It is paramount to her that she knows the type of PID she has and whether chalmydia causes it. Thanks!

Edward W. Hook M.D.

87 months ago

Chlamydia infections can cause a variety of clinical conditions all they way from asymptomatic infections to PID with the symptoms I describe above. If your GF was successfully treated (it sounds like she was) and you were treated at the same time, you are not at risk for infection. Your recent negative test supports this statement.

If a doctor examines her and tests for chlamydia he/she will also know if she has PID. hope this helps. EWH

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