A pelvic inflammatory disease is an infection within the reproductive organs of women. The lower part of the abdomen is the pelvic region and it comprises the Fallopian tubes, uterus, cervix, and ovaries. As per the US department of health and human service, this condition impacts about one million women every year in the United States. Varied bacterial types cause PID. This includes the bacteria causing sexually transmitted infections/STI such as chlamydia and gonorrhea. The bacteria first enter the vagina and leads to an infection. As time elapses, the infection moves into the pelvic organs. PID can be life-threatening and extremely tough to cope with. This is more so if the infection spreads to the rest of the body. If one suspects an infection, seeing the doctor as quickly as possible is advisable.
Specifically, the pelvic inflammatory disease is an inflammation and infection of the pelvic organs of women such as the uterus and the woman, the ovaries, cervix and Fallopian tubes. PID is common and impacts 1 million women each year in the US. The pelvic inflammatory disease develops as a result of STD. Most cases of PID are caused by chlamydia and gonorrhea. Several different bacteria types also impact the body. Women with multiple partners are at a greater risk for PID. Douching and a history of PID are other risk factors. The pelvic inflammatory disease is also not associated with any symptoms or signs in some cases when it is said to be asymptomatic. In many cases, symptoms can range across the pan in discharge, urination or physical intercourse. There can also be abdominal or pelvic pain and fever.
PID generally occurs when sexually infected bacteria reaches the uterus, ovaries or Fallopian tube from the vagina. The pelvic inflammatory disease is often associated with no initial symptoms and as such, the condition may not be detected, unless you later develop infertility or chronic pelvic pain. PID can initiate serious issues if it is not treated in time. For example, there may be a problem in pregnancy. If pelvic inflammatory disease triggers serious symptoms, one will need to go to the ER. Getting medical help is essential if there is severe lower belly pain, signs of shock like fainting and vomiting or even fever higher than 101 degrees F. Other serious medical conditions also have similar symptoms. PID can also lead to scar formations with fibrous bands forming between the organs and the tissues. Complications include pelvic pain, chronic persistent pain, infertility, and ectopic pregnancy. According to the CDC, one in 8 women have PID and may experience difficulty in becoming pregnant. Most of these cases are associated with a vagina or cervical infection that spreads. STIs can be a cause, but PID can also develop due to infections from other causes.
The survey of the National Health and Nutrition Examination conducted from 2013 to 2014 discovered that of 1171 sexually active women in the US, about 4.4% reported a PID. Close to 80 thousand women receive a diagnosis of PID each year in the US. PID stems from untreated STIs or gynecological infections. Symptoms, though not noticeable, can lead to pain and fever, and untreated PID can even cause fertility problems, an abscess or scarring. Treatment generally involved antibiotics, but surgery may also be required. Prevention strategies include safe sex intercourse.
Causes
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The risk of PID rises if there is gonorrhea or chlamydia. PID can also develop without an STI. Other factors that lead to pelvic inflammatory disease include young age at which sexual intercourse was initiated, unsafe sex practices, multiple partners, using an intrauterine device for the prevention of pregnancy and douching or even have a history of PID. This disease is an infection of the reproductive organs of women. It is caused by bacteria from sexually transmitted infections. PID is also triggered by normal vaginal bacteria at times. If it is left untreated, it can cause pregnancy problems as well as long-term pelvic pain. More than 1 million women in the US have PID and more than 100 thousand become infertile because of it. Along with this, many ectopic pregnancies also take place due to PID problems.
Risk Factors
Your chances of contracting the pelvic inflammatory disease are high if you have had PID or another STI before, are younger than 25 and sexually active. Statistics show those aged 15-24 years are most prone to PID. Having more than one sex partner or a partner with multiple sexual partners can also trigger this disease. Additionally, insertion of douching or IUDs can also trigger PID by pushing bacteria into the reproductive organs.
PID generally starts with an infection beginning in the vagina and spreading to the cervical region. It then moves to the Fallopian tubes and ovaries. The causes of infection can be parasitic, bacterial or fungal and involve one or additional bacteria types.
STIs
STIs and resulting bacterial contamination is the most common cause of PID. Another common cause is chlamydia and yet another is gonorrhea. AFP estimates that anywhere between 80 to 90 percent of women with chlamydia and 10 percent of those with gonorrhea lack symptoms. Close to 10 to 15% of women with gonorrhea or chlamydia develop PID as a secondary infection.
Entry of Bacteria
Another reason for the development of the pelvic inflammatory disease is the entry of bacteria into the vagina. This can be caused on account of abortion, miscarriage or even childbirth. An IUD or intrauterine device is another form of birth control placed into the uterus. This can increase the chances of an infection like PID. Another medical procedure that increases the risk is endometrial biopsy where a tissue sample is taken for analysis. It also causes an increase in the risk of infection and consequent PID. Appendicitis also slightly raises the chances of PID, if infection moves from the appendix to the pelvic region.
Symptoms of Pelvic Inflammatory Disease
Photo by: OpenStax/ CC BYUntreated PID can lead to scar tissue. Collections of infected fluid or abscesses also develop within the Fallopian tube organs in the reproductive system.
Some of the other complications of PID include ectopic pregnancy, infertility, chronic pelvic pain, tubal ovarian abscess.
PID is a major cause of tubal or ectopic pregnancy. In this type of pregnancy, the scar tissue from the PID prevents a fertilized egg from moving down the Fallopian tube to be implanted in the uterus. Ectopic pregnancies lead to massive, life-harming and potentially fatal bleeding and need medical attention.
PID may also damage the reproductive system and lead to infertility and difficulty in becoming pregnant. The more times there is PID, the greater are the chances of infertility. The risk of infertility is dramatically increased by delaying treatment for this condition.
PID can also cause chronic pelvic pain that lasts for months or years. Scarring in pelvic organs like the Fallopian tube can cause pain at the time of intercourse as well as ovulation.
PID might also lead to an abscess. This is a collection of pus formed in the uterine tube and the ovaries. In case this is left untreated, it can trigger a fatal infection.
But for many PID patients, there are no symptoms. For women with symptoms, the signs can range across the following:
Pain in the Abs
The most common type of symptom for PID is a pain in the lower abs. Pain in the upper abdomen may also be noted. PID can lead to mild or even moderate pain. Some women may report severe pain along with other symptoms like fainting, vomiting and high fever greater than 101 degrees F.
If symptoms are severe, the doctor needs to be called immediately or one should visit the ER. The infection can spread to different parts of the body such as the bloodstream.
Pain in Urination/Intercourse
Another symptom of PID is pain during intercourse or origination. Pain may also be accompanied by a foul-smelling vaginal discharge. If there is PID, seeing a nurse or doctor as soon as possible is critical. Irregular bleeding and tiredness are other symptoms.
Diagnosis
Physicians will ask about symptoms and carry out pelvic examinations to check for signs. They may also test for STI like chlamydia and gonorrhea. A swab may be taken from the cervix or the urethra. The urethra’s a tube from a bladder for transporting urine. Blood and urine tests may also be carried out. Further, an ultrasound scan may be used to check for inflammation within the Fallopian tubes. A laparoscopy can also be used for viewing the area. If needed, tissue samples can be taken via this.
The doctor may also diagnose the disease after clarifying the symptoms. Tests will be run to confirm the diagnosis. These include a pelvic exam to check pelvic organs, cervical culture to check the cervix for infections and urine test to check for signs of blood or other diseases.
If a pelvic inflammatory disease is suspected, more tests may be run and the pelvic area checked for damage. PID can lead to scarring on the Fallopian tubes and permanent damage to reproductive organs. Additional tests range across pelvic ultrasound and imaging tests that use sound waves to create images of internal organs. Biopsies from the lining of the uterus may also be collected. Finally, outpatient processes like laparoscopy may also be undertaken.
Treatment
Photo By: OpenStax/ CC BYAntibiotics may be given to treat PID. As the doctor may not know the kind of bacteria causing the infection, two different types of antibiotic medicines are used to treat a variety of bacterial infections. Within just a few days of treatment, symptoms may get better or go away. However, the medication must be finished if one is to feel better. Stopping medicines early may even cause the infection to return.
If women are sick, expecting or can’t swallow pills or have developed an abscess, the doctor may send them to the hospital for treatment. PID may also require surgery. This is a rare occurrence and only needed if the abscess has either ruptured or is about to. It is also needed if the infection does not react to treatment.
Bacteria causing PID spread through intercourse. For those who are diagnosed with this disease, the partner is infected too. Many could also be silent disease carriers, causing pelvic inflammatory disease. PID can recur if intercourse is resumed with such a partner. Lower the chances of developing PID by getting tested for STIs, avoiding douches, wiping from the front to the back after using the bathroom to prevent bacterial entry into the vagina and ensuring safe sex practices.
If you have PID, going to a doctor is essential. Other conditions such as UTI can also feel like PID. The doctor should be able to test for PID and rule out other conditions. If PID is not treated, the problem and symptoms can worsen. Infertility or ectopic pregnancies, chronic pain in the pelvic area and spreading of infection to other body parts are some of the dangers. PID can be life-threatening if it spreads to the blood.
Prognosis
Photo by: Henry Gray/ Bartleby/ CC BYPID is a treatable condition. Most women make complete recovery post a pelvic inflammatory disease. However, as per the CDC close to 10 to 15% of women having PID face problems in pregnancy. Pregnancy is still possible for many women.
Early treatment reduces the chance of complications. Antibiotic treatment course lasts for about 14 days. PID involves different types of bacteria. If tests reveal the kind of bacteria implicated in the disease, targeting the therapy is possible. Antibiotics for PID include cefoxitin, ceftriaxone, doxycycline, and metronidazole.
When antibiotics do not make an impact within three days, patients should opt for further help. Intravenous antibiotic therapy or medication change may result. For women with PID who are pregnant or have severe symptoms, it may be required to treat the disease in a hospital where intravenous medication may be given.
Surgery may also be needed, especially if there is scarring on the Fallopian tubes or if an abscess is in the need of draining. There may be keyhole surgical processes. Additionally, it may involve the removal of a single Fallopian tube. Doctors do not remove both Fallopian tubes, because natural pregnancy will be impossible. The partner of the woman also needs to be treated. PID can be minimized by regularly screening for those with multiple partners. Sexual intercourse should also not resume till the cervix is properly closed.
Doctors carry out a diagnosis of pelvic inflammatory disease based on symptoms and signs, an exam of the pelvic region, analysis of vaginal discharge and urine tests for detecting cervical culture. At the time of the pelvic exam, the doctor will check the pelvic region for symptoms and signs. Samples will be analyzed at the lab to determine organisms that are causing the infection.
To assess how widespread the infection is, or confirm the diagnosis, other tests are also carried out for confirmation. Urine and blood tests will measure the white blood count, indicating infections and markers that suggest inflammation. Doctors may also recommend tests for HIV and STI detection.
Ultrasound uses sound waves to replicate the images of reproductive systems. Laparoscopy involves the insertion of a thin, lighted instrument through the abdomen’s incision to view pelvic organs.
Antibiotics combinations are started once lab tests are carried out. Then, a follow-up results after three days to ensure the treatment is working. Physical intercourse should be avoided at the time of treatment.
Women with PID generally need outpatient treatment. If seriously ill, not responding to oral medications or pregnant, hospitalization may be needed. Intravenous and oral medicine shall be given in such cases.
Coping and Support
Many women have diagnosed with PID post an STI diagnosis. Take the steps to prevent reinfection and manage PID effectively. If a woman has experienced more than one instance of PID episode, there is a greater chance of infertility. If becoming pregnant without success, making an appointment with the doctor for evaluation of infertility.
The reproductive health specialist or doctor might do tests to assess if the PID history is causing the problem. If you show symptoms or signs of PID, make an appointment to see the doctor or the healthcare provider. The doctor assesses the severity of symptoms, sexual practices, safety devices used during intercourse etc and prescribes the course of treatment so that you can be disease-free.