Introduction
Pelvic inflammatory disease (PID) is due to inflammation of a woman’s pelvic organs including the uterus, fallopian tubes, ovaries and other reproductive organs.
PID can cause damage to the fallopian tubes and tissues in and near the uterus and ovaries. If left untreated, PID can even cause serious consequences including infertility, ectopic pregnancy and constant pelvic pain.
Incidence and Prevalence
PID is recognized as the most frequent serious infection inflicting women and is known to affect more then 1 million women in the US each year. The risk of PID is highest amongst women who:
• are younger than 25 years old
• have more than one sexual partner
• begin having intercourse at an early age
• have had an STD or PID in the past
• douche several times a month
• use an IUD for contraception
Symptoms
Pelvic inflammatory disease is most likely to occur between the ages of 15 and 25, especially in sexually active women. Interestingly, some of the patients might not even suffer from any of the symptoms while some might have most of them. Here we list the most common symptoms of PID:
• Fever, chills
• Nausea
• Vaginal discharge that may have an odor
• Painful intercourse
• Painful urination
• Irregular menstrual bleeding
• Pain in the upper right abdomen
Causative factors
Almost 90 percent of PID cases reported are found to be associated with infection with gonorrhea or chlamydia.
These might have ascended in to the uterus, fallopian tubes or ovaries due to childbirth, intercourse or surgical procedures such as IUDs insertion or abortion. Here we list some of the other factors associated with pelvic inflammatory disease:
• Gardnerella vaginalis infection
• Bacteriodes infection
• Appendicitis
• Childbirth
• TOP (Termination of Pregnancy)
• Reproductive surgery
• Ruptured appendix
• Appendix surgery
• HIV
PID- Diagnosis and Treatment
PID is diagnosed using multiple criteria, which include symptoms, signs and results of a pelvic examination and lab tests. The main diagnostic criteria include:
• Abdominal tenderness
• Tenderness of the cervix, ovaries, and fallopian tubes during a pelvic exam
• Fever
• Abnormal cervical/vaginal discharge
• Lab tests showing positive on presence of chlamydia or gonorrhea
Treatment
PID is generally treated with a combination of antibiotics. In some cases, hospitalization and intravenous antibiotics are necessary. Surgical intervention is required in cases where the infection spreads beyond the reproductive tract and deeper in to the abdomens, or if an abscess forms.
Anti-inflammatory drugs such as steroids are also prescribed in order to reduce inflammation and scarring. Patients are normally advised to have their sex partner(s) also treated to prevent the spread of infection again. Besides, abstinence is also advised during the course of treatment and for at least 7 to 10 days after the medication has been over.
