Pelvic Inflammatory Disease Does Not Occur in Males
No, males cannot develop Pelvic Inflammatory Disease (PID) because they lack the anatomical structures—uterus, fallopian tubes, and ovaries—that define this condition. 1, 2
Why PID is Female-Specific
PID is explicitly defined as infection and inflammation of the upper female genital tract, including the uterus, fallopian tubes, ovaries, peritoneal surfaces, and contiguous structures. 1, 2 The pathogenesis involves ascending spread of microorganisms from the vagina and endocervix to these upper-genital sites—anatomical structures that males do not possess. 1, 2
The Male Equivalent: Urethritis and Epididymitis
While males cannot develop PID, they can develop infections with the same causative organisms (Chlamydia trachomatis and Neisseria gonorrhoeae) that cause PID in women. 3 In males, these pathogens cause:
These conditions can remain asymptomatic or minimally symptomatic, allowing unknowing transmission to female sexual partners. 3
Critical Role of Males in PID Prevention
Males play an essential role in the PID prevention chain, even though they cannot develop the disease themselves. 1, 4
Partner Treatment is Mandatory
- Male partners of women with PID must be examined and treated if they had sexual contact within 60 days preceding symptom onset. 4
- Treatment is imperative because untreated male partners are the primary source of reinfection in women, with many reinfections traced directly to the original source partner. 1, 4
- Male partners should receive empiric treatment with ceftriaxone 500 mg IM plus azithromycin 1 g orally in a single dose, covering both gonorrhea and chlamydia, regardless of whether pathogens were isolated from the female partner. 4
Prevention Strategy
- Prevention of lower-genital-tract infection with C. trachomatis and N. gonorrhoeae in both men and women is the primary strategy for preventing PID. 1
- Sexually active males should be encouraged to undergo STD testing. 1
- Identifying and treating asymptomatic male carriers prevents PID development in female partners. 1, 3
Common Clinical Pitfall
A critical error is failing to treat male partners empirically even when the female partner's tests are negative or when the male partner is asymptomatic. 4 The pattern of recurrent PID in women strongly suggests ongoing transmission from an untreated partner, and false-negative test results are possible. 4