Although PID and endometriosis have similar symptoms, they are two different conditions.

Pelvic inflammatory disease (PID) is a bacterial infection of the reproductive organs.

Endometriosis is specifically caused by the tissue that lines the uterus — called endometrial tissue — forming outside of the uterus. This misplaced tissue can cause inflammation and pain.

PID and endometriosis share similar symptoms, but they’re two different conditions.

Pelvic inflammatory disease

Not everybody with PID experiences symptoms.

However, if you do have symptoms, you might experience the following:

In some cases, you might experience more extreme symptoms, including:

  • fainting
  • fever greater than 101°F (38.3°C)
  • sharp, severe pain in the abdomen
  • vomiting

If you experience one or more severe symptoms and suspect you have PID, seek emergency medical care.


The most common symptoms of endometriosis are:

However, as with PID, endometriosis might not always have symptoms.

Overlapping signs and symptoms

PID and endometriosis can both cause pain in the pelvic region. You might experience pain in your abdomen, especially your lower abdomen, with either condition. This pain can become worse during penetrative sexual activity.

Pelvic inflammatory disease

PID is caused by a bacterial infection. The bacteria that causes sexually transmitted infections (STIs) like gonorrhea and chlamydia can also cause PID.

Typically, the bacteria enter through the vagina and spread into the pelvic organs, including the fallopian tubes, ovaries, cervix, and uterus.

You’re at a higher risk for PID if you:


There’s no scientific consensus on what causes endometriosis. Although there are several theories on the cause, these are as yet unproven.

However, there are some known risk factors. You might be at higher risk of developing endometriosis if you:

Overlapping causes and risk factors

A 2018 study that looked at 141,460 people in Taiwan, found that people with PID were 3 times more likely to develop endometriosis.

The researchers note that people with PID “may have a greater chance of being diagnosed with endometriosis because they are more likely to receive medical investigation of the reproductive tract and pelvic cavity” than others. However, the authors also suggest that PID could cause endometriosis or that they have similar underlying causes.

The link between endometriosis and PID will need to be studied further before we understand if — and how —one condition may cause the other.

Pelvic inflammatory disease

To diagnose PID, a doctor will usually:

  • ask you to describe your symptoms and medical history
  • perform a pelvic exam to check your pelvic organs
  • take a cervical culture to check your cervix for infections
  • do a urine test to check for signs of infection

If they’ve confirmed that you have an infection, the doctor might want to determine which organs the infection has affected and assess the damage.

If necessary, your clinician might order:

  • a pelvic ultrasound, which takes pictures to help healthcare professionals assess your pelvic organs
  • an endometrial biopsy, where a doctor removes a small sample from the lining of your uterus to test it
  • a laparoscopy, which is where a doctor makes a small incision in your abdomen and inserts an instrument to take pictures of your pelvic organs

A general medical doctor or gynecologist can diagnose PID.


If a doctor suspects you have endometriosis, they might:

  • ask you to describe your symptoms and medical history
  • conduct a pelvic exam to assess your reproductive anatomy
  • use a transvaginal ultrasound or an abdominal ultrasound to look for endometriomas (ovarian cysts) or anatomic abnormalities
  • use laparoscopy to identify endometriotic implants and inspect your pelvic and abdominal organs

A laparoscopy is the only sure way to diagnose endometriosis.

Overlapping tools for diagnosis

If you suspect you have endometriosis, PID, or both, a doctor will likely take a detailed medical history and ask about your symptoms to help narrow down the cause of your symptoms. You’ll probably need a pelvic exam with either condition, which can also help identify other potential conditions.

Pelvic inflammatory disease

Because PID is caused by a bacterial infection, antibiotics are the most effective treatment.

When prescribed antibiotics, it’s important to finish your course of treatment, even if you start feeling better. If you stop your medication, the infection may return.

You may need to be hospitalized for treatment if:

  • you have an abscess in your pelvis
  • you’re pregnant
  • you’re sick

In rare cases, PID might require surgery. This is only necessary if:

  • an abscess in your pelvis ruptures
  • an abscess in your pelvis might rupture
  • the infection doesn’t respond to antibiotic treatment

If you’re sexually active, your partner(s) should also get tested and treated for PID, even if they don’t have any symptoms.


Although there’s no known cure for endometriosis, there are many options for treating the symptoms.

Depending on your situation, you can treat your endometriosis with the following:

  • hormonal therapy (like birth control pills), which can prevent the growth of endometrial tissue
  • gonadotropin-releasing hormone (GnRH) agonists and antagonists, which block the production of estrogen, reducing the growth of tissues and stopping menstruation
  • Danazol, a medication that reduces endometriosis symptoms
  • a laparoscopy, a minimally invasive surgery during which a surgeon can remove out-of-place endometrial tissue
  • a total hysterectomy, which is considered a last resort and only used if other treatments don’t help

Your treatment depends on the severity of your symptoms, your health, and whether you plan to have children.

Overlapping treatment options

There are no overlapping treatment options for PID and endometriosis. If you have both conditions, you’ll need two different treatment plans.

Pelvic inflammatory disease is a treatable condition. The earlier you get treatment, the better.

Endometriosis cannot be cured, but with the right support and medication, many people manage their symptoms well.

However, both conditions can affect fertility. The Centers for Disease Control and Prevention CDC) estimates that about 1 in 8 people who have had PID will have difficulty getting pregnant. Similarly, some people with endometriosis have difficulty becoming pregnant.

With that said, it’s possible for people with either or both conditions to become pregnant. If you’re looking for fertility support, speaking with a doctor is a good first step.

Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.