Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs, including the uterus, fallopian tubes, and ovaries. If left untreated, it can cause long-term complications, such as chronic pelvic pain, infertility, and ectopic pregnancy.

Common causes

PID occurs when bacteria from the vagina or cervix travel upward into the reproductive organs. While many types of bacteria can be responsible, the most common causes are sexually transmitted infections (STIs):

  • Chlamydia and gonorrhea: These are the primary culprits behind most PID cases and can cause the infection to develop quickly if left untreated.

  • Bacterial vaginosis (BV): This is another vaginal infection that can disrupt the natural balance of bacteria and increase the risk of PID.

  • Douching: Regular douching can upset the balance of bacteria in the vagina and push harmful bacteria up into the reproductive tract.

  • Certain medical procedures: Bacteria can sometimes enter the reproductive tract after medical procedures like an abortion, miscarriage, or the insertion of an intrauterine device (IUD).

Signs and symptoms

The symptoms of PID can be subtle or even absent, which is why many cases go undiagnosed. When symptoms do appear, they can range from mild to severe.

  • Pain: The most common symptom is pain or tenderness in the lower abdomen or pelvis. This pain may worsen during sexual intercourse.

  • Abnormal vaginal discharge: A change in vaginal discharge, such as a different color, odor, or amount, is a common sign.

  • Irregular bleeding: This can include spotting between periods or heavier-than-usual menstrual bleeding.

  • Fever and chills: A fever may develop, and it may be accompanied by chills.

  • Painful urination: Some women may experience a burning sensation while urinating.

  • Nausea and vomiting: In more severe cases, PID can cause nausea or vomiting.

Diagnosis

There is no single test for diagnosing PID. A healthcare provider will evaluate a patient by:

  • Reviewing medical history: The provider will ask about the patient's symptoms, sexual history, and general health.

  • Performing a pelvic exam: This involves checking the reproductive organs for tenderness or inflammation. Tenderness during this exam is a key indicator of PID.

  • Collecting fluid samples: Swabs may be taken from the cervix or vagina to test for gonorrhea, chlamydia, and other bacteria.

  • Ordering additional tests: To rule out other conditions like a urinary tract infection or ectopic pregnancy, a provider might order blood tests, urine tests, or an ultrasound.

Treatment

Treatment for PID is essential to prevent long-term health problems and typically involves antibiotics.

  • Antibiotics: A combination of antibiotics is prescribed to fight the infection. It is important to complete the full course of medication, even if symptoms improve, to ensure the infection is completely cleared.

  • Treatment for sexual partners: All recent sexual partners must also be treated to prevent reinfection.

  • Hospitalization: In severe cases, a patient may need to be admitted to the hospital to receive antibiotics intravenously.

  • Surgery: If an abscess has formed and does not respond to antibiotics, surgery may be necessary.

  • Temporary abstinence: Patients should avoid sexual intercourse until treatment is complete and symptoms have resolved.

Important: Prompt medical attention is crucial if you suspect you have PID. Early treatment can help prevent permanent damage to your reproductive organs.

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