PELVIC INFLAMMATORY DISEASE


 

PELVIC INFLAMMATORY DISEASE

Pelvic inflammatory disease is an infection of the uterus, fallopian tubes or ovaries. It is the most common serious infection among especially young women. It usually affects sexually active women during their childbearing years. About one in every seven women receives treatment for pelvic inflammatory disease at some point in her life.

Pelvic inflammatory disease is the most common preventable cause of infertility. The infection can cause tissue inside the fallopian tubes to become scarred, which can damage the fallopian tubes or block them completely. The more often a woman gets this infection, the greater her risk of becoming infertile, and the risk doubles with each bout of the disease.

PID is a major cause of hospitalization in young women. It leads to thousands of surgeries due to complications from the infection. A lot of researchers believe most cases develop from STDs (sexually transmitted diseases), infections that are spread through sexual contact. The two diseases that are most likely to lead to pelvic inflammatory disease are gonorrhea and chlamydia. If the disease is left without treatment, the same bacteria that cause these diseases also can cause pelvic inflammatory disease.

Pelvic inflammatory disease usually develops in a two-staged process. First, the organisms infect the opening of the uterus (the cervix). Then, in about ten out of a hundred women, the bacteria migrate up to the uterus, fallopian tubes or ovaries.

Less commonly, if bacteria get into the upper portions of the reproductive tract in times such as;

  • After childbirth
  • After inserting an intrauterine device (IUD)
  • After an induced abortion

Pelvic inflammatory disease can develop. All of these procedures carry some risk of infection, especially if the patient also has an STD.

Pelvic inflammatory disease is most commonly found in women who are younger than age 25 and who have more than one sex partner. Women who have had an STD have a higher risk of getting pelvic inflammatory disease, as do those who have already had a previous pelvic infection. Any woman whose sex partner also has more than one sex partner is also at increased risk of pelvic infection.

CAUSES

Pelvic inflammatory disease (PID) is caused by an infection that develops in the female upper genital tract.

In most of the cases, the condition is caused by a bacterial infection spreading from the vagina or the entrance to the womb (cervix) into the womb, the fallopian tubes and or the ovaries.

PID is often caused by more than one type of bacterium and it can sometimes make it difficult for doctors to pinpoint which are responsible.

This would mean that a combination of antibiotics will be prescribed so that a variety of bacteria can be treated.

Sexually transmitted infections (STIs)

In about a quarter of all cases, PID is caused by sexually transmitted infection (STI) such as chlamydia, gonorrhea or mycoplasma genitalium.

These bacteria usually only infect the cervix, where they can be easily treated with a single dose of an antibiotic.

However, there's a risk that the bacteria could travel into the upper genital tract if they're not treated.

Other causes

In many cases, the cause of the infection that leads to PID is not known.

Sometimes bacteria that are normally harmless, and found in the vagina can get past the cervix and into the reproductive organs.

Although harmless in the vagina, these types of bacteria can cause infection in other parts of the body.

This is most likely to happen if:

  • The woman had a procedure that involves opening the cervix (e.g. abortion, inspection of the womb, or insertion of an intrauterine contraceptive device)
  • The woman has had PID in the past
  • There's been damage to the cervix following childbirth or a miscarriage

SYMPTOMS

What are the signs and symptoms of pelvic inflammatory disease?

Many women do not know that they have PID, because they do not have any signs or symptoms. When symptoms do happen, they can be mild or more serious.

Signs and symptoms include:

  • Pain in the upper right abdomen
  • Pain in the lower abdomen
  • Fever (38° C or higher)
  • Foul smelling vaginal discharge
  • Painful sex
  • Painful urination
  • Irregular periods
RISK FACTORS

A number of factors might increase your risk of pelvic inflammatory disease, including:

  • Being a sexually active woman younger than 25 years old
  • Having multiple sexual partners
  • Having multiple sexual partners who may also have multiple sexual partners
  • Having sex without a condom
  • Regular douching, which upsets the balance of good versus harmful bacteria in the vagina and might cover up symptoms
  • Having a history of pelvic inflammatory disease or a sexually transmitted infection

There is a small increased risk of PID after the insertion of an intrauterine device (IUD). However, this risk is generally confined to the first three weeks after insertion.

REDUCING THE RISK OF GETTING PID

The only way to avoid STDs is to not have vaginal, anal, or oral sex. However, if one is sexually active, the following things can be done to lower the chances of getting PID;

  • Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results;
  • Using latex condoms the right way every time for sexual intercourse.

COMPLICATIONS

Untreated pelvic inflammatory disease might cause scar tissue and abscesses (pockets of infected fluid) to develop in the reproductive tract. These can cause permanent damage to the reproductive organs.

Complications from this damage might include: 

Ectopic pregnancy. PID is a major cause of ectopic (tubal) pregnancy. An ectopic pregnancy can occur if PID that is not treated causes scar tissue to develop in the fallopian tubes. The scar tissue prevents the fertilized egg from making its way through the fallopian tube to implant in the uterus. Instead, the egg implants in the fallopian tube. Ectopic pregnancies can cause massive, life-threatening bleeding and require emergency medical attention.

Infertility. Damage to the reproductive organs may cause infertility (i.e. The inability to become pregnant). The more times a woman has PID, the greater her risk of infertility. Delaying treatment for PID also dramatically increases the risk of infertility.

Chronic pelvic pain. Pelvic inflammatory disease can cause pelvic pain that might last for months or years. Scarring in the fallopian tubes and other pelvic organs can cause pain during intercourse and ovulation.

Tubo-ovarian abscess. PID might cause a collection of pus (an abscess) to form in the reproductive tract. Most commonly, abscesses affect the fallopian tubes and ovaries, but they can also develop in the uterus or in other pelvic organs. If an abscess is left untreated, a life-threatening infection could develop.

LONG-TERM COMPLICATIONS OF PELVIC INFLAMMATORY DISEASE

Make a doctor's appointment if you think that you have PID. Other conditions, such as a UTI, can feel like pelvic inflammatory disease. However, your doctor can test for PID and rule out other conditions.

If you don't treat your PID, your symptoms can worsen and lead to problems, such as:

  • Infertility, an inability to conceive a child
  • Ectopic pregnancy, a pregnancy that occurs outside the womb
  • Chronic pelvic pain, pain in the lower abdomen caused by scarring of the fallopian tubes and other pelvic organs

The infection can also spread to other parts of your body. If it spreads to your blood, it can become life-threatening


WHAT HAPPENS IF IT IS NOT TREATED

If diagnosed and treated early, the complications of PID can be prevented. Some of the complications of PID are

  • Long-term pelvic/abdominal pain.
  • The formation of scar tissue both outside and inside the fallopian tubes that can lead to tubal blockage
  • Ectopic pregnancies (pregnancy outside the womb)
  • Infertility (inability to get pregnant)

PREVENTION

The risks of PID can be lowered by:

  • The practice of safe sex
  • Getting tested for sexually transmitted infections
  • The avoidance of douches
  • Wiping from front to back after using the bathroom to stop bacteria from entering the vagina.

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