Pelvic Inflammatory Disease (PID)

What is PID?

Pelvic inflammatory disease is a condition where there is inflammation of the female reproductive organs such as the uterus, fallopian tubes and the ovaries following infection. It can lead to the formation of adhesions among the affected organs and adjacent abdominal organs. Pain and heavy vaginal discharge are the most common presenting symptoms of pelvic inflammatory disease.

About 750,000 women in the United States suffer from pelvic inflammatory disease every year and more than 100,000 of these women become infertile. Having unprotected sex with more than one partner is the most common risk factor for suffering from pelvic inflammatory diseases (PID). The most serious complication of pelvic inflammatory disease is failure to conceive (infertility). Antibiotics are the cornerstone of treatment.

PID Symptoms

In many women there is often no symptoms of pelvic inflammatory disease. The disease is then diagnosed when the patient suffers from infertility or chronic lower abdominal pain and pelvic pain. Common presenting symptoms of pelvic inflammatory disease includes :

  • Severe pain in the lower abdominal and pelvic region.
  • Profuse discharge from the vagina with foul smell.
  • Menstrual cycle becomes irregular.
  • Painful sexual intercourse.
  • Pain in the lower back area.
  • High fever, tiredness, diarrhea and vomiting.
  • Burning sensation or pain during urination.

Untreated pelvic inflammatory disease may lead to a number of complications in the future such as :

  • Appearance of scar tissue involving the pelvic organs along with accumulation of fluid in the adjacent area or within the reproductive organs.
  • Ectopic pregnancy characterized by inability of the fertilized egg to reach the uterine cavity from the fallopian tubes for implantation. The passage of the egg is blocked by adhesive bands causing the fertilized egg to implant within the fallopian tube. Ectopic pregnancy when ruptured leads to heavy bleeding which can be fatal for the mother. Pelvic inflammatory disease is the most common cause for ectopic pregnancy.
  • Chronic pelvic pain characterized by pain in the lower abdominal region after exercise, intercourse or ovulation. This pain lasts for years even though there is no underlying active pelvic inflammatory disease. Scarring of the fallopian tubes and adjacent reproductive organs may be responsible for this chronic pain.
  • Failure to conceive (infertility) months or years after pelvic inflammatory disease is one of the most common complications of pelvic inflammatory disease (PID).

Causes of PID

Practicing unsafe sex is the most common cause leading to sexually transmitted infections which can result in pelvic inflammatory disease. Other common causes may include :

  • Using an intrauterine device (IUD) for contraceptive purposes. However, other barrier methods of contraception like condom use reduces the risk of developing pelvic inflammatory disease.
  • Childbirth, miscarriage, abortion or endometrial biopsy may also increase the risk of suffering from pelvic inflammatory disease.
  • Infection causing pelvic inflammatory disease may spread through blood stream or lymphatic route from another site elsewhere in the body.

Risk factors

Common risk factors include :

  • Sexually active young women commonly below 25 years of age.
  • Multiple sexual partners.
  • Having sexual intercourse with a partner who has multiple partners.
  • Using intrauterine device for contraception.
  • Regular vaginal douching leads to damage of the normal protective bacteria within the vagina.
  • Prior history of pelvic inflammatory disease.

PID Treatment

Ideally pelvic inflammatory disease should be prevented. When it does arise, antibiotics are the cornerstone of treatment. Sexual partner smay also require treatment. Surgery is rarely done to drain the fluid from the pelvic region. Patients need to be educated about the dangers of risky sexual behavior and other risk factors that can increase the risk of PID and how it can affect their fertility in the future.

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