Infections of the Vagina, Cervix and Uterus – Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) happens when bacteria pass from your vagina or cervix into the uterus, fallopian tubes, ovaries, or pelvis. PID is a condition that is generally caused by having unprotected sex with someone who has a sexually transmitted infection. It is caused by the same bacteria that causes sexually transmitted infections (STIs) or diseases such as Chlamydia and Gonorrhea.

However, bacteria can also enter the body during certain surgical procedures, such as Childbirth, Endometrial biopsy, Insertion of an intrauterine device (IUD), Miscarriage and Therapeutic or elective abortion

According to estimates, approximately 1 million women develop PID each year in the U.S. Recurrent episodes of PID can often result in scarring of the fallopian tubes, which can further lead to infertility, ectopic pregnancy, or chronic pelvic pain. Infertility commonly occurs in women who have PID.

Causes for Pelvic Inflammatory Disease

  • A male sexual partner who is suffering from Gonorrhea or Chlamydia
  • Multiple sexual partners
  • Past medical history of sexually transmitted infection
  • Past medical history of PID
  • Insertion of an IUD
  • Sexual activity during teenage or adolescence

Symptoms of Pelvic Inflammatory Disease

  • Intermittent fever
  • Pain or tenderness in the pelvis, lower abdomen, or sometimes in the lower back region
  • Vaginal discharge which has abnormal color, texture, or smell
  • Painful sexual intercourse
  • Bleeding after sexual intercourse
  • Chills and fatigue
  • Frequent or painful urination
  • Severe menstrual cramping
  • Irregular menstruation or spotting
  • Lack of appetite
  • Nausea, accompanied with or without vomiting
  • No menstruation
  • Diagnosis

First of all, the doctor will evaluate your complete medical and sexual history. He will then perform a thorough pelvic exam to check the overall health of your reproductive organs, and to identify whether you have gonorrhea and chlamydia infection.

If your doctor suspects that you have PID, he may recommend other tests, including Blood tests and Ultrasound (sonogram), Endometrial biopsy ( a process in which a small sample of tissue present in the lining of the uterus or endometrium is extracted for evaluation and testing) and Laparoscopy.

Treatment for Pelvic Inflammatory Disease

Antibiotics: The primary treatment for mild cases of PID generally comprises the oral intake of antibiotic medications. In severe cases, a combination of intravenous and oral antibiotics can be used. In case you are diagnosed with PID, your sexual partner(s) must also undergo treatment even if they do not exhibit any symptoms. Otherwise, the infection would most probably recur when you have sex again.

Surgery: If PID causes an abscess, surgery is often required. The abscesses have to be immediately removed to prevent it from rupturing and causing widespread infection, especially throughout the pelvis and abdomen. This may be performed using laparoscopy or laparatomy (a procedure in which the doctor cuts opens the abdomen to view the internal organs).

If abscesses are present on the uterus or ovaries, the doctor may recommend hysterectomy (Surgical removal of the uterus) or Oophorectomy (Surgical removal of the ovaries).

How to prevent PID?

Some of the steps you can take to prevent PID are:

Avoiding multiple sexual partners.
Use condoms and/or a diaphragm and spermicides, even if you are using birth control pills.
Avoid the insertion of IUDs if you have multiple sexual partners.
Consult a doctor immediately if you notice symptoms of PID or any other sexually transmitted disease, including abnormal vaginal discharge, pelvic pain, or bleeding between periods.
Perform regular gynecologic check-ups as most of the cervical infections can be identified and treated before they start spreading to the internal reproductive organs