What is Pelvic Inflammatory Disease?
Pelvic inflammatory disease (PID) is a bacterial infection of the reproductive organs which is spread by sexual contact, poor hygiene habits or other methods in which bacteria are introduced into the reproductive tract. Pelvic inflammatory disease symptoms can range from mild to none at all. More severe symptoms may not be present until the PID has become worse.
Untreated PID can cause infertility, ectopic pregnancy and chronic pain. Ectopic pregnancy, in which a fertilized egg begins to grow in the fallopian tube instead of the uterus, can cause life-threatening internal bleeding and death. PID can be hard to detect because symptoms can be mistaken for urinary tract infection, appendicitis, or ovarian cysts. Women with HIV should be treated aggressively as they may require surgical intervention.
How is PID Transmitted?
Sexual contact is not the only way to develop PID. Anything that causes bacteria to move upwards from the vagina to the cervix can trigger PID. IUD placement, douching, childbirth, abortion, miscarriage, or endometrial biopsy potentially exposes the reproductive organs to the bacteria that causes PID. According to Planned Parenthood, more than one million women in the U.S. get PID every year. The bacteria that cause gonorrhea and chlamydia cause most cases of PID.
Early stages of PID may have no symptoms or symptoms which can be mistaken for many other common conditions. Pain in the lower stomach is the most common symptom. Fever, unusual vaginal discharge, painful urination, painful sex, and irregular periods may indicate PID. Periods may also become unusually long or painful. If caused by gonorrhea, PID can cause severe pain and fever. Left untreated, chills, nausea, vomiting, low back pain, and fainting may occur.
Who’s at Risk?
PID is most common in sexually active women age 15 to 25, and the risk increases with the number of sexual partners. Women who have had an STD or previous PID in the past are at higher risk for repeated infections. Another important risk factor is having sex without using a latex condom consistently for each sexual encounter. While non-barrier methods such as spermicide protect against pregnancy, they offer no protection from STDs.
In addition to the above symptoms, PID may require more invasive tests to confirm the diagnosis. Ultrasound of the pelvic area shows whether the fallopian tubes are enlarged or if an abscess is present. Laparoscopy, in which a tiny lighted tube is passed through the abdomen, allows the doctor to see the pelvic organs and take specimens. Endometrial biopsy consists of removing a small piece of the lining of the uterus and testing for abnormalities.
Treatment usually consists of a course of at least two antibiotics to cover the bacteria responsible. If hospital treatment is required, IV antibiotics may be given. It is important to take the full course of antibiotics, even if the infection appears to be gone, in order to avoid a recurrence and developing antibiotic resistance. As with any STD, do not engage in sex until you and your partner(s) have been treated.
Always use condoms when engaging in sex to reduce (not eliminate) the risk of contracting an STD. The CDC recommends that all sexually active women age 25 or younger, all pregnant women, and older women with risk factors for chlamydia be tested every year for chlamydia. The physician should always have full and complete sexual history information to most effectively treat any STD and avoid the spread.
American Social Health Association-https://www.ashastd.org/learn/learn_pid.cfm
Centers for Disease Control-https://www.cdc.gov/std/PID/STDFact-PID.htm
U.S. Dept. of Health and Human Services, Office on Women’s Health-https://www.womenshealth.gov/faq/pelvic-inflammatory-disease.cfm