Pelvic Inflammatory Disease

What is it?

Pelvic Inflammatory Disease (PID) is a severe infection of the female reproductive organs that results from the spread of a previously existing infection. PID can be caused by a variety of infections, but it is most commonly a complication of untreated sexually transmitted infections (STIs). Because of this connection, PID is considered an STI, even though it is not directly transmitted through sexual contact.1 Pelvic Inflammatory Disease is very common; in the United States alone, more than one million American women are diagnosed with PID each year.2

Transmission

Pelvic Inflammatory Disease most commonly develops when infectious bacteria from the vagina spreads to the cervix, into the uterus, and up through the fallopian tubes and ovaries. PID is most often caused by untreated chlamydia and gonorrhea.2 The disease is most commonly found in sexually active women who are age 25 or younger. Women are especially susceptible to PID if they have an untreated STI, have more than one sexual partner or their partners have multiple partners, or use an Intra Uterine Device (IUD).1Douching may also increase the likelihood of contracting PID because it can spread an existing vaginal infection to the uterus.1

Symptoms

Usually symptoms of Pelvic Inflammatory Disease are very mild or do not occur at all, but become more severe as the infection worsens.2 Symptoms include pain in the lower abdomen or back, fever, chills, unusual discharge and odor from the vagina, pain or bleeding during intercourse, burning during urination, bleeding between periods, and unusually long or painful periods. It is important to see a doctor as soon as possible if any symptoms arise. You should also see a doctor if you suspect that you or your partner has contracted an STI, as these are the leading causes of PID.1

Complications

Untreated Pelvic Inflammatory Disease can cause very serious, potentially life threatening health complications. A severe infection may create dangerous ruptures in the fallopian tubes. When left untreated, infection in the reproductive system can also spread to other parts of the female’s body, and can ultimately lead to death.2 Even after PID is cured, scar tissue often forms in the uterus, fallopian tubes or ovaries. Formation of scar tissue in the reproductive organs can create tubal blockage, putting a female at risk for ectopic pregnancy or infertility. PID can also lead to chronic abdominal and pelvic pain.1 A female’s chance of becoming infertile increases with the severity of the infection and the number of times she contracts it.2

Diagnosis and Treatment

Pelvic Inflammatory Disease can be diagnosed by a doctor, clinician, or other healthcare provider by performing a physical exam and utilizing the patient’s medical history.1 Currently, there are no tests that can confirm the presence of PID, however a doctor may order blood tests or vaginal swab tests to check for gonorrhea and chlamydia, as these bacterial STIs are the leading causes of PID. Medical professionals may also diagnose or treat PID via laparoscopy, which involves making a small incision through the belly button and inserting a device called a laparoscope which allows a doctor to see the reproductive organs and perform minor surgeries on them if necessary.2  

Once a medical professional has determined that the infection is in fact PID, it is easily treated with antibiotics. Be honest with your doctor so that the infection can be cured in the easiest and quickest way possible. With every day that the condition is left untreated, the severity of the infection increases. Antibiotics will cure the body of infection but will not reverse any damage done to the reproductive organs before treatment was administered.1 Often times surgery is needed to repair or remove organs that have been damaged.2

While undergoing treatment for PID, it is important to follow your healthcare provider’s directions as closely as possible to ensure that the infection is completely cured. Be sure to take all of the medicine prescribed to you for the entire duration of treatment, and do not stop taking the antibiotics if your symptoms go away before the medication is finished. It is wise to notify any recent sexual partners of your diagnosis and encourage them so be tested as soon as possible for any infections that they may have contracted from you (or given to you). You should limit sexual activity and the use of tampons until you are finished taking the antibiotics to reduce your risk of transmitting or re-contracting the bacterial infections that cause PID.1 It is especially necessary to maintain a healthy lifestyle while being treated for an infection (i.e., drinking plenty of water, maintaining a healthy diet, and getting plenty of rest).2

Symptoms associated with Pelvic Inflammatory Disease are also characteristic of other infections such as Urinary Tract Infections (UTIs), ovarian cysts, endometriosis, and appendicitis.2 This makes the diagnosis of PID difficult, so it is important to consult a doctor before seeking self-treatment.

Prevention

Pelvic Inflammatory Disease is most often caused by the complication of sexually transmitted diseases. Therefore, the best way to prevent PID is to practice safer sex.1Condoms, when used consistently and correctly, are the only contraceptive method that aid in inhibiting the spread of sexually transmitted infections. Remember that the only 100% effective form of defense against STIs is to abstain from all oral, vaginal, and anal sex. If you are sexually active, there are still a number of things you can do to lower your risk for PID. Get tested regularly for chlamydia and other STIs—especially if you are age 25 or younger. Limit your number of sexual partners and make sure that both you and your partner have tested negative for STIs before engaging in sex.1  

If you do contract a sexually transmitted infection, or if you think you have been exposed to an STI, see a doctor for treatment right away. The risk for PID gets higher the longer an existing vaginal infection is left untreated, and it is possible for an STI to develop into PID without producing any symptoms. Therefore, treatment of STIs should not be taken lightly.1

Hormonal contraceptive methods such as the pill, the patch, and the vaginal ring can offer a small amount of protection against PID. These contraceptives thicken cervical mucous, which can make it more difficult for a vaginal infection to spread to the uterus and other reproductive organs.2 Remember that the intra uterine device (IUD) does not help prevent PID and may actually increase a woman’s risk by facilitating the spread of infection through the cervix.1

If you have been treated for Pelvic Inflammatory Disease or a related STI before, you are still at risk for contracting and transmitting the infection again. In fact, people who have had PID at least once before are at an even higher risk for PID than those who have never had it.

References

1."Pelvic Inflammatory Disease (PID) - CDC Fact Sheet." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 01 July 2014. Web. 26 Jan. 2015.

2."(PID), Symptoms and Treatment." Plannedparenthood.org. Planned Parenthood, n.d. Web. 27 Jan. 2015.

Last Updated 5 February 2015.

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