Pelvic Inflammatory Diseases (PID): Causes, Symptoms & Treatment

The female reproductive organs such as the ovaries, fallopian tubes, uterus, cervix, vagina, and vulva are susceptible to certain disorders which can even lead to infertility. Infections, physical damage or hormonal fluctuations can lead to the onset of certain conditions. Getting an early diagnosis and seeking treatment can be immensely helpful and prevent long-term consequences. One such problem is pelvic inflammatory disease (PID).

What is PID?

PID is an infection that occurs in the uterus, ovaries, and fallopian tubes. If the infection is left untreated for a long time, it can lead to blockage in the affected area. Also known as adhesions, these blocks can occur in the fallopian tubes resulting in infertility. PID can be caused by a number of different bacteria.

Causes of Pelvic Inflammatory Disease

A sexually transmitted infection (STI) is quite often the cause of PID. The infection tends to travel up the cervix to the uterus, the fallopian tubes, and the ovaries. This can take weeks or months before you start feeling sick or experience symptoms. Thus, PID can develop a long time after you have sex with an affected partner. Chlamydia and gonorrhoea are some of the common STIs that can lead to PID. In some instances, PID is not caused by an STI. It might be completely different bacteria which appear harmless and go on to cause PID. This happens after childbirth or procedures like inserting a contraceptive coil.

Who Are More Likely To Get PID?

This is a fairly common condition, but those who have chlamydia or gonorrhoea are more likely to develop PID eventually. But STIs are not the only way a PID occurs. Chances of contracting PID are more if you have one or more of these risk factors:

• Not using a condom when having sex
• Being under the age of 25, as chlamydia is seen more in young people
• Have been sexually active since a young age
• Having multiple sex partners
• A history of STIs or your partner has a history of these
• Getting an intrauterine contraceptive device fitted or having been subjected to an intrauterine investigation
• An unsafe abortion
• After childbirth
• Douching
• A history of PID

What Are the Signs and Symptoms of PID?

The infection causing bacteria can be present in your body for a long time before any signs or symptoms show up.

• Pain in the stomach region or the pelvis
• Fever and chills
• Presence of vaginal fluid with unusual smell, texture, or colour
• Bleeding after intercourse
• Being fatigued or tired
• Frequent urination
• Lack of appetite
• Missed period
• Nausea and vomiting
• Abnormal vaginal bleeding that can be during periods or between periods

If PID goes untreated, it can lead to serious problems such as difficulty getting pregnant and signs of shock such as fainting. These symptoms can also mean an ectopic pregnancy or appendicitis.

How is the Diagnosis Done?

If you have any of the symptoms of PID or there are other reasons that lead you to suspect that you might have PID, convey your concerns to your doctor, and seek an appointment. If symptoms are mild, it might take longer to diagnose PID. The following may help your doctor arrive at a definitive diagnosis:

• A pregnancy test might be done first to rule out the possibility of an ectopic pregnancy.
• A swab may be taken from the cervix and the urethra to check for any bacteria.
• Blood and urine tests will also be likely prescribed to look for any indication of bacterial infections.
• If these results do not offer any evidence for a confirmed diagnosis of PID, your doctor may recommend an ultrasound scan since this can help detect inflammation of the fallopian tubes.
• In the event your doctor needs to get a closer look inside your abdominal cavity, a laparoscopy might be necessary.

Analysing Damage

Once a diagnosis of PID has been arrived at, your doctor might recommend more tests to determine the extent of damage to your pelvic area. The fallopian tubes are prone to scarring while your other reproductive organs might have permanent damage. A pelvic ultrasound, endometrial biopsy, and laparoscopy are some of the additional tests and procedures that might have to be carried out.

PID Treatment for Women

Antibiotics are the usual course of treatment for PID, especially since this is a safe option even when no clear diagnosis has been arrived at. A combination of antibiotics is likely to be prescribed in order to ensure that all bacterial infections that cause PID are targeted. Painkillers may also have to be taken simultaneously. Your doctor will suggest you refrain from the intercourse of any kind to prevent the infection from recurring till the course of medication is completed. Follow-up visits to the doctor might be required to determine that the infection has resolved fully.

Be sure to finish the medication even if you start feeling better halfway through the recommended course. In a few cases, PID treatment might involve surgery. This becomes necessary only when an abscess ruptures in your pelvic region or your doctor has reason to believe that there might be an abscess that is about to rupture. In this case, you might have to stay at the hospital for a short while.

How PID Can Be Prevented?

The only way to completely avoid PID is through abstinence, but this is easier said than done. Since sexual intercourse can transmit infections, taking adequate precautions can mitigate the risk to some extent. Using a condom is one means of doing this while limiting the number of sexual partners is also highly effective. Be sure to get tested for STIs on a regular basis especially if you have multiple sexual partners. Avoid douching and do not wipe from back to front after using the bathroom.

Possible Complications That May Occur in PID

There are no complications if PID is detected early and treatment follows immediately. In severe cases of PID or untreated cases, the following complications are possible:

• Difficulty in getting pregnant as a result of scarring or other damage to the fallopian tubes caused by PID. For those who become pregnant after having been treated for PID, the chances of an ectopic pregnancy are as high as 1 in 10.
• Greater risk of ectopic pregnancies, again due to damage to the fallopian tubes.
• Higher probability of pregnancy complications such as miscarriage, premature birth, and stillbirth.
• Pain that persists and also pain during intercourse.
• More chances of contracting Reiter’s Syndrome which causes arthritis and eye inflammation.
• An abscess near the uterus in severe cases of PID.

When to Contact a Medical Professional?

The pain can be anywhere between mild and moderate and if the infection spreads to the bloodstream or other parts of the body, it can turn into a life-threatening situation very fast. On noticing severe symptoms, you should call your doctor immediately or rush to the emergency room of the nearest hospital. You should also go to a doctor for a check-up if you feel you have contracted an STI or if the treatment you are undergoing for an STI seems ineffective.

Does Your Partner Need to be Treated

Yes, your partner or partners over the past six months with whom you’ve had sexual relationships will all have to be tested for infection and treated. A course of antibiotics is recommended for your partner even if they test negative for infection. This is because Chlamydia is the cause of PID in most cases and it gets passed on during intercourse. Also, men do not show any symptoms of Chlamydia but can pass on the infection. Since the test for Chlamydia is not 100% accurate, a course of antibiotics can target any infection that the tests have missed out on. Last, but not the least, if your sexual partner has the infection, he might pass it on to you again, after you have been treated.

Can it Happen Again?

It has been seen that around one in five women will contract PID again within two years of the first. There are some reasons this can happen, including the failure to get your partner treated, failure to practice safe sex by using condoms, your failure in completing the course of the medication which has led to the infection staying within your body resulting in a flare-up. The PID damage can make some women more vulnerable to re-infection.

PID is a common condition with many women having experienced it and nearly all recovering fully. It is also a fact that around 10% to 15% women with PID might find it difficult to get pregnant while others might have ectopic pregnancies and develop chronic pelvic pain as a result of this infection. But leaving the infection untreated can turn dangerous and even become life-threatening if it spreads to your blood.

Disclaimer:

This information is just a guide and not a substitute for medical advice from a qualified professional.

Also read: Blocked Fallopian Tubes – A Major Cause Of Female Infertitlity