PELVIC INFLAMMATORY DISEASE (PID)

  • Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It most often occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries

  • 1 in 8 women with a history of PID have difficulty getting pregnant. 

Factors causing PID

The causes which can lead to PID are:

  • Chlamydia or Gonorrhoea infections contribute to one third of reported PID cases

  • PID also can be caused by infections that are not sexually transmitted, such as bacterial vaginosis (BV)

  • The pathogen Mycoplasma Genitalium (a sexually transmittable bacteria) also causes PID

  • PIDs can be polymicrobial (infection due to more than one type of microbe)

Pelvic inflammatory disease (PID)
Pelvic inflammatory disease (PID) symptoms, treatment and prevention

Symptoms of PID

The symptoms range from mild to moderate to severe. The patient may not recognise any symptoms if they are mildPID symptoms do not just affect the genital system, they also affect the digestive system and the urinary system. Common symptoms are as follows:

  • Lower abdominal pain

  • Mild pelvic pain

  • Increased vaginal discharge

  • Discharge from the vagina, sometimes bloody 

  • Irregular menstrual bleeding

  • Fever with temperature>38 degree centigrade 

  • Painful sexual intercourse

  • Painful and frequent urination

  • Redness and burning sensation in the genital area

  • Pelvic, Abdominal organ tenderness (observed by medical professional)

  • Uterine, cervical motion tenderness (observed by medical professional)

Complications of PID

If untreated, PIDs can lead to severe complications like

  • Infertility—One in 10 women with PID becomes infertile. PID can cause scarring of the fallopian tubes. This scarring can block the tubes and prevent an egg from being fertilised 

  • Ectopic pregnancy—Scarring from PID also can prevent a fertilised egg from moving into the uterus. Instead, it can begin to grow in the fallopian tube. The tube may rupture (break) and cause life-threatening bleeding into the abdomen and pelvis. Emergency surgery may be needed if the ectopic pregnancy is not diagnosed early

  • Collection of fluid in the ovary and the fallopian tube (Tubo-Ovarian Abscess)

  • Chronic pelvic pain—PID may lead to long-lasting pelvic pain

Diagnosis of PID

A pelvic examination will reveal whether your reproductive organs are tender or swollen. This helps to identify the specific site of infection. The diagnosis of pelvic inflammatory disease is not always easy because the site of infection cannot be examined easily. During the pelvic examination, your doctor may swab the inside of your cervix with a sterile, cotton-tipped swab. A laboratory will test the sample for gonorrhoea and chlamydia. Your doctor may order a blood test to see if your white blood cell count is high, which may indicate that the pelvic inflammatory disease is more severe. 

Prevention of PID

  • Do not engage in unprotected sexual intercourse, especially with multiple partners, which poses the risk of Chlamydia and Gonorrhoea or transfer of other bacterial agents causing STIs

  • If any of the above mentioned symptoms occur, or if there is any suspicion of transmission of STIs causing PID, visit a health professional (gynaecologist preferably)

  • Pregnant women should get tested for STIs and PID to avoid complications

Treatment of PID

  • PID can be treated. However, treatment of PID cannot reverse the scarring caused by the infection. The longer the infection goes untreated, the greater the risk for long-term problems, such as infertility

  • Antibiotics are prescribed to the diagnosed woman and the patient should ensure that the antibiotic regime is completed, even after the symptoms disappear

  • Most cases of pelvic inflammatory disease clear up after 10 to 14 days of antibiotic treatment. More severe cases may need to be treated in a hospital 

  • A woman’s sexual partners must be treated as well. Women with PID may have partners who have gonorrhoea or chlamydia. A person can have these STIs even if there are no signs of illness

  • Men can be silent carriers of PID, hence getting the partner tested is very critical for women