Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is disorder that involves infection of the uterus (a woman’s womb), the fallopian tubes which carry eggs from the ovaries to the uterus where they can be fertilized, and the other reproductive organs. It is quite common and quite serious complication of certain sexually transmitted diseases (STDs), particularly chlamydia and gonorrhea. This disease can damage the fallopian tubes and the other tissues in and near the uterus and ovaries and, if left untreated, PID can lead infertility, ectopic pregnancy which is a situation where a fertilized egg lodges and develops in the fallopian tube or elsewhere outside of the uterus, abscess formation, and severe, chronic pelvic pain. According to the Center for Disease Control (CDC), estimates are that over one million women experience an episode of serious pelvic inflammatory disease and more than 100,000 women become infertile every year as a result. Many of the potentially life-threatening ectopic pregnancies which occur each year are because of previous episodes and resultant scarring from of PID. In face, more than 150 women in America die each year from PID or associated complications. PID occurs when bacteria manage to move upward from the vagina or cervical opening of the uterus into a woman’s reproductive organs. There are a number of organisms can be to blame for PID, but a great many cases are consequences of gonorrhea and chlamydia, two bacterial-caused sexually transmitted diseases. A past attack of PID increases the risk that a woman will have another attack because her reproductive organs may have become damaged during the initial infection. Sexually active women during their childbearing years are at highest risk. It is more common for PID to occur in women under age 25 than those over 25 years of age because the cervix of teenagers and young women has not matured fully, increasing susceptibility to STDs which have been linked to PID. The more different sex partners a woman has, the higher her risk of developing PID. Plus, a woman who has a sexual partner that has more than one sex partner is at even greater risk because of the potential for more exposure to infectious agents. It is thought that women who douche may have a higher risk of developing PID compared with women who do not douche. Research indicates that douching changes the healthy bacteria living in the vagina in harmful ways and may force bacteria into the upper reproductive tract from the vagina. Women who use intrauterine devices (IUDs) as a mean of birth control may have an increased risk of PID around the time the device is inserted compared with women using other contraceptives or using no contraceptive at all. This risk is reduced if a woman is tested and, if STDs are found, treated before an IUD is inserted. Symptoms of PID can be none or they can be extremely severe. When PID is caused by chlamydia, a woman may experience very mild or even no symptoms even though serious damage is occurring in her reproductive organs. Because symptoms can be so vague, PID goes unrecognized by many women and even their health care providers – as often as two-thirds of the time. Women with symptoms of PID may experience lower abdominal pain, fever, unusual vaginal discharge which may have a foul odor, painful intercourse, pain upon urination, irregular monthly bleeding, and, more rarely, pain in the right upper abdomen. The symptoms may include only one, two or all of these signs. Treatment will not only relieve symptoms but can help prevent complications of PID. Without treatment, this disease can result in permanent damage to the woman’s reproductive system. Infection-causing bacteria can cause scar tissue in the fallopian tubes, blocking the ability of eggs to move normally into the uterus. This can result in infertility or pregnancy that lodges outside the uterus, which can be life-threatening if not found early. Scarring of the tubes can also cause chronic pain and the more episodes of PID a woman experiences, the more likely she is to experience consequences of the disease. PID is difficult to diagnose because the symptoms are so subtle and frequently rather mild. Many cases of PID go undetected because the woman or her health care provider doesn’t recognize the mild or nonspecific symptoms. There are no specific tests for PID; therefore, a diagnosis is usually based on clinical findings and ruling out other possible problems. A health care provider should perform a physical exam, check for fever, abnormal discharge in the vagina or cervix, and for evidence of any STD infection. A health care provider may require tests to identify the exact infection-causing organism or to distinguish between PID and other problems which have similar symptoms. An ultrasound of the pelvis may be used in diagnosing PID so the health care provider can view the pelvic region to see determine if the fallopian tubes are enlarged or an abscess is present. In some situations, a laparoscopy, a minor surgical procedure that allows the practitioner to use a flexible tube to see into the abdomen through a small incision, may be necessary to confirm a diagnosis. PID treated with the use of several types of antibiotics or a combination of two antibiotics. A health care provider must determine and prescribe the correct therapy. Be aware, however, that antibiotic treatment can not reverse damage if any has already occurred to the reproductive organs. When a woman experiences pelvic pain and other symptoms of PID, it is crucial she seek treatment immediately. Prompt treatment can prevent serious damage to reproductive organs. Women being treated for PID require re-evaluation by their health care provider two to three days after beginning treatment to ensure the medication is working to cure the infection. A woman’s sexual partner or partners must also be treated to prevent re-infection, even though the partner may have no symptoms. The sex partner may still be infected with the organisms that caused the onset of PID. Women should protect themselves from getting PID by using sound, safe sexual practices to prevent STDs and by seeking early treatment if they do get an STD. Of course, the only certain way to avoid getting an STDs is to abstain from sexual intercourse, or to be involved a long-term mutually-monogamous relationship with one partner who has been tested and is known to be STD-free. Use of latex condoms, if used consistently and correctly, can reduce the risk of PID and other STDs.