Pelvic Inflammatory Disease

Overview

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs, which includes the uterus, fallopian tubes, and ovaries. It is usually caused by sexually transmitted bacteria that spread from the vagina to other parts of the reproductive tract. The signs and symptoms of PID may be subtle or mild and can include pain in the lower abdomen and pelvis, unusual vaginal discharge with a foul odor, and unusual bleeding between periods. If left untreated, PID can lead to serious complications such as tubo-ovarian abscesses, chronic pelvic pain, and difficulty getting pregnant. To reduce the risk of PID, it is important to practice safe sex, use contraception, and seek prompt medical care if symptoms arise.

Understanding the disease

Symptoms

Symptoms of pelvic inflammatory disease (PID) can be subtle or mild and may include:

1. Pain in the lower abdomen and pelvis, ranging from mild to severe
2. Unusual or heavy vaginal discharge with an unpleasant odor
3. Unusual bleeding from the vagina, especially during or after sex, or between periods
4. Pain during sex
5. Fever, sometimes with chills
6. Painful, frequent, or difficult urination It's important to see a healthcare provider if you experience severe pain low in your abdomen, nausea and vomiting, a fever higher than 101 F (38.3 C), foul vaginal discharge, or any other concerning symptoms. Prompt treatment of a sexually transmitted infection (STI) can help prevent PID.

Risk Factors

The risk factors for developing pelvic inflammatory disease (PID) include being sexually active, especially for women under 25 years old, having multiple sex partners, having a partner with multiple partners, and having a history of sexually transmitted infections such as gonorrhea. Other risk factors include having had an intrauterine device (IUD) inserted, having a tubo-ovarian abscess, and having had previous episodes of PID.

Development

Pelvic inflammatory disease (PID) can develop when sexually transmitted bacteria spread from the vagina to the uterus, fallopian tubes, or ovaries. The most common cause of PID is infection with gonorrhea or chlamydia, which are typically acquired during unprotected sex. However, other bacteria can enter the reproductive tract if the normal barrier created by the cervix is disturbed, such as during menstruation, after childbirth, miscarriage, or abortion, or during the insertion of an intrauterine device (IUD) or other medical procedures involving the uterus.

Assessment and Diagnosis

Triage

You should see a doctor if you experience severe pain low in your abdomen, nausea and vomiting with an inability to keep anything down, fever with a temperature higher than 101 F (38.3 C), foul vaginal discharge, or painful, frequent, or difficult urination, as these may be signs of pelvic inflammatory disease (PID). It's important to seek urgent medical care if you have these symptoms. If you have milder signs or symptoms, such as vaginal discharge with an odor, painful urination, or bleeding between periods, it's still important to see your health care provider as soon as possible.

Diagnosis

To diagnose pelvic inflammatory disease (PID), a healthcare provider will typically rely on a combination of factors, including a medical history, a pelvic exam, and laboratory test results. There is no single test that can accurately diagnose PID. During the appointment, it's important to discuss any symptoms you're experiencing, provide information about your sexual habits and history, and share any medications or supplements you're taking. Depending on the situation, additional tests like blood and urine tests, ultrasound, laparoscopy, or endometrial biopsy may be necessary to help confirm the diagnosis.

Management and Treatment

Complications

Potential complications of pelvic inflammatory disease (PID) include:

1. Tubo-ovarian abscess: PID can cause an abscess, a collection of pus, to form in the fallopian tubes, ovaries, uterus, or other pelvic organs. If left untreated, this can lead to a life-threatening infection.
2. Infertility: Untreated PID can cause scar tissue to develop in the reproductive tract, leading to permanent damage and blocking of fallopian tubes, which can result in infertility.
3. Ectopic pregnancy: PID-related damage to the fallopian tubes can increase the risk of ectopic pregnancy, where the fertilized egg implants outside the uterus, often in a fallopian tube. This can be life-threatening if not diagnosed and treated promptly.
4. Chronic pelvic pain: PID can cause ongoing pelvic pain and discomfort, even after treatment.
5. Adhesions: Scar tissue formation in the reproductive organs can lead to adhesions, which are fibrous bands that can cause pain, infertility, and other complications. It is essential to seek medical attention promptly if you suspect PID or experience any related symptoms, as early treatment can help prevent these potential complications.

Prevention

Pelvic inflammatory disease (PID) can be prevented by practicing safe sex, using contraception, and avoiding douching. To reduce your risk of PID, it's important to:

1. Practice safe sex: Use condoms every time you have sex, limit your number of partners, and ask about a potential partner's sexual history. Using barrier methods, such as a condom, helps to reduce your risk.
2. Talk to your health care provider about contraception: Many forms of contraception do not protect against the development of PID. Using barrier methods, such as a condom, helps to reduce your risk. Even if you take birth control pills, use a condom every time you have sex with a new partner to protect against STIs.
3. Avoid douching: Douching upsets the balance of bacteria in your vagina, which can increase your risk of PID. By following these precautions, you can significantly reduce your risk of developing PID.

Home Remedies

It is important to consult with a healthcare professional for proper diagnosis and treatment of pelvic inflammatory disease.

Treatment

Treatment for pelvic inflammatory disease (PID) typically involves antibiotics to combat the bacterial infection. The specific antibiotic used will depend on the type of bacteria causing the infection. It's important to follow your healthcare provider's instructions and complete the full course of antibiotics, even if you start feeling better before finishing the medication. In addition to antibiotics, your healthcare provider may recommend pain relief medications to help manage any discomfort or pain associated with PID. In case of severe complications, such as an abscess or ectopic pregnancy, further medical interventions may be required. Surgery might be necessary to drain the abscess or remove damaged tissue. Prompt diagnosis and treatment of PID are crucial to prevent potential long-term complications, including infertility. If you suspect you have PID or experience signs and symptoms, consult your healthcare provider as soon as possible.

Preparing for medical consultation

To prepare for an appointment for pelvic inflammatory disease, make sure to:

1. Be aware of any pre-appointment restrictions, such as not eating solid food on the day before your appointment.
2. Write down your symptoms, including any that seem unrelated to the reason for the appointment.
3. Write down your key medical information, including other conditions.
4. Make a list of all your medicines, vitamins, or supplements.
5. Bring a relative or friend with you for support.
6. Prepare a list of questions to ask your healthcare provider. Remember to avoid using tampons or vaginal sprays, douching, or having sex for 24 hours before your appointment, and schedule the appointment on a day when you don't have your period to make it easier for the doctor to examine you.