Pelvic inflammatory disease symptoms and treatment

What is pelvic inflammatory disease and how do you get it?

Pelvic inflammatory disease is a condition that occurs when untreated sexually transmitted diseases such as chlamydia and gonorrhoea remain untreated and they spread to the reproductive organs, the uterus, fallopian tubes and ovaries; other infections that are not sexually transmitted may also result in PID developing.

The risk of developing PID is increased if you:

  • Do not seek treatment for STIs
  • Have more than one sexual partner
  • Have a sexual partner that has multiple partners
  • Are sexually active and under 25
  • Douche regularly
  • Have an IUD inserted? However, this small risk tends to be limited to the first three weeks after the IUD has been inserted

PID is a common condition that largely affects women who are sexually active and are aged between 15 and 24 years

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Symptoms of PID

Symptoms of PID may be mild and some women do not experience any signs or symptoms, however, if a woman does experience symptoms they are likely to be one or more of the following:

  • Pain around the lower abdomen
  • Discomfort during sex that is felt deep into the pelvis
  • Pain during urination
  • Frequent or difficult urination
  • Bleeding after sex
  • Bleeding between periods
  • Heavy periods
  • Painful periods
  • Unusual vaginal discharge that may be yellow or green

Some women may experience severe symptoms and become very unwell with:

  • Severe abdominal pain
  • High temperature
  • Nausea and vomiting

It is important that if you experience any of the symptoms above that you seek the help of your GP.  If the symptoms are severe it may be advisable to visit your nearest hospital emergency department

 

Causes of PID

As discussed above, pelvic inflammatory disease can develop as a result of infections in the uterus or cervix spreading to the upper reproductive tract and causing infection of the uterus, ovaries and fallopian tubes.  Infections that can spread are sexually transmitted infections although other types of bacteria such as those found normally living in the vagina can also spread and result in PID

 

Diagnosis of PID

There are no specific tests for PID and diagnosis is therefore based on a number of physical observations and a pelvic examination alongside your medical history.  

The pelvic examination is likely to be uncomfortable if you have contracted PID; swabs will be taken from the vagina and cervix which will be sent away and tested for infection.  The infection will be identified so that it can be treated specifically.  Many women have swabs that are tested as negative but this does not rule out a diagnosis of PID

Other tests may be considered to establish if there is an infection or inflammation present.  These would include:

  • Urine test
  • Pregnancy test
  • Ultrasound scan
  • Laparoscopy

You may not be aware that you have PID if you do not experience any symptoms but if you do have at least one of the symptoms it is advisable to seek the advice of a medical professional

 

Treatment for pelvic inflammatory disease

If found in its early stages, PID can be treated with a course of antibiotics.  The antibiotics you will be given will likely be a mixture to cover the infections that are most likely to be causing the disease;  often an injection, as well as tablets, will be given

It is important that sexual contact is avoided during your treatment and that your sexual partner is tested and treated for any STI that may be present

 

Complications that may be caused by PID

If the presence of PID is recognised and treated early enough then complications will not necessarily arise.  The longer it is left untreated however the more likely it is for complications to occur.

Complications can include:

  • Scarring and narrowing of the fallopian tubes which can in turn make it more difficult to conceive as when eggs travel from the ovaries to the uterus their passage will be impeded.  This also increases the risk of an ectopic pregnancy occurring as the fertilised egg would be more likely to implant in the wall of the fallopian tube.
  • In the long term, it may render the woman infertile and the risk of this happening increases if initial treatment has been delayed or if there have been multiple occurrences of PID
  • Pelvic inflammatory disease can result in chronic pelvic pain that may last for months or even years
  • Scarring in the fallopian tubes and other organs in the pelvis may cause pain  during intercourse and whilst ovulating
  • PID can cause a tubo-ovarian abscess which is a collection of pus that forms in the reproductive tract.  It is most common to find abscesses in the fallopian tubes and ovaries but they may also form in the uterus or elsewhere in the pelvis.  If an abscess goes untreated and it ruptures it can cause sepsis which can be fatal

 

Sources

  1. Overview - Pelvic inflammatory disease https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/
  2. Causes https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/causes/
  3. Diagnosis https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/diagnosis/
  4. Treatment https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/treatment/
  5. Complications https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/complications/
  6. Pelvic Inflammatory Disease (PID) https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
  7. Pelvic inflammatory disease (PID) - CDC fact sheet https://www.cdc.gov/std/pid/stdfact-pid-detailed.htm

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