Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is a bacterial infection of the female reproductive organs. The bacteria found in PID is the same bacteria that is found in gonorrhea and chlamydia, but PID can also result from infections that are not sexually transmitted. PID spreads from the vagina to the uterus, ovaries and fallopian tubes and can lead to infertility or complications during pregnancy. It is estimated that one in eight women diagnosed with PID have issues when trying to become pregnant.

Risk Factors for PID

To completely avoid the risk of pelvic inflammatory disease, an individual must be completely sexually abstinent, an unworkable solution for most people. There are measures, however, that can be taken to lower the risk of developing this disorder. Risk factors for PID include the following:

  • Having unprotected sex, especially with multiple partners
  • Being younger than 25 years of age
  • Having a sexual partner who has other sexual partners
  • Have had PID previously
  • Have an STD that is not promptly treated
  • Douching
  • Using an intrauterine device (IUD) for birth control

The risk of getting PID are greatly diminished by being in a long-term monogamous relationship with an individual who has tested negatively for sexually transmitted disease, using latex condoms during every sexual encounter, and not using IUDs are birth control. There are, however, instances in which bacteria can enter the vagina and result in PID through other means than sexual intercourse. These include IUD insertion, childbirth, miscarriage, or abortion.

Symptoms of PID

Patients with PID may be asymptomatic. In patients who do experience symptoms, the symptoms may range from mild to severe. Symptoms of PID may include:

  • Malaise or fatigue
  • Fever
  • Genital sores
  • Lower abdominal pain
  • Malodorous vaginal discharge
  • Pain or bleeding during or after sexual activity
  • Pain during urination
  • Irregular menstrual bleeding

If a patient is experiencing these symptoms, tests may be performed to rule out other conditions before diagnosing PID. Most cases of PID can be treated with antibiotics. More severe cases may require hospitalization or even surgery.

Diagnosis of PID

Gynecologists can diagnose the condition based on medical history, physical examination, and certain other diagnostic tests. Because PID may not be suspected when the patient is asymptomatic, and because the disorder can be dangerous if left untreated, women, particularly young women who are sexually active, should be checked annually for chlamydia, and, in some cases, for other sexual diseases. They should be aware of the signs of potential disease and promptly consult their gynecologists if they suspect they have, or have been exposed to, any STDs.

If PID is suspected, the gynecologist may perform or administer the following tests:

  • Microscopic evaluation of vaginal fluid or discharge
  • Blood Count to indicate elevated white blood cell count
  • Endometrial biopsy
  • Transvaginal sonogram
  • Pelvic MRI scan
  • Laparoscopy
  • Urinalysis

These diagnostic tests may indicate the present of other infections often found in combination with pelvic inflammatory disease.

Treatment for PID

When PID is diagnosed, prompt treatment is necessary since the longer the delay in treatment, the more likely the patient will suffer reproductive damage. Antibiotics are normally prescribed to treat PID and it is important that patients and their partners take the full course of treatment, even if the symptoms abate quickly. When PID is diagnosed, any other sexual partners must be notified so that, if infected, they, too, can receive prompt medical treatment.

Sometimes, hospitalization may be necessary, particularly if the patient develops an tubo-ovarian abscess, is pregnant, has another medical condition that requires surgery, or cannot tolerate the oral antibiotics. She may also have to be treated as an inpatient if the oral antibiotics are ineffective and medications must be administered intravenously.

Complications of PID

Although PID can usually be treated and cured with antibiotics, left untreated, it may result in the following complications:

  • Fallopian tube scar tissue formation
  • Ectopic pregnancy (pregnancy outside the uterus)
  • Infertility
  • Long-term pelvic or abdominal pain.
In some cases, surgery may be necessary to treat complications of PID if abscess drainage is required, an ectopic pregnancy has to be dealt with, or excessive scar tissue has to be removed to reduce pelvic pain.

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