Pelvic Inflammatory disease (PID)
PID is caused by infection of the upper female genital tract, including the womb, fallopian tubes, ovaries and nearby pelvic structures.
The importance of diagnosing and treating PID early is related to its complications which can have major detrimental effects on a woman’s fertility and health.
What causes PID?
PID is caused by infection that moves upward from the vagina and cervix into the upper genital tract. Commonly the infection is sexually transmitted and the woman may or may not have any symptoms suggestive of an infection. The most common sexually transmitted organisms associated with PID is chlamydia trachomatis and neisseria gonorrhoea.
Other organisms that is linked to PID include gardnerella vaginalis, mycoplasma hominis, ureaplasma urealyticum, herpes simplex virus 2, trichomonas vaginalis, haemophilus influenza, cytomegalovirus, etc.
PID can be caused by both sexually transmitted and non sexually transmitted infections.
Studies have shown that up to one third of PID cases is caused by >1 organism.
Multiple sexual partners
History of sexually transmitted infections (STI)
Current untreated sexually transmitted infections (STI)
Previous history of PID
Previous gynaecological surgical procedures – eg: endometrial biopsy, curettage, etc
Having an intrauterine device (IUD) – risk is highest during the first 6 months after insertion
With PID, the severity of symptoms may vary in each individual and may take weeks or months for symptoms to present after being infected. Symptoms include:
Pelvic/lower abdominal pain (ranges from mild to severe) –usually bilateral dull, aching or crampy pain. Pain is worse with movement, exercise or sex.
Abnormal vaginal discharge – up to 75% of cases
Abnormal vaginal bleeding – usually after sex or in between menstrual period – up to 40% of cases
PID can be treated with antibiotics if diagnosed early. However, treatment would not reverse any damage that has already occurred to your reproductive system. Hence, it is important to seek treatment early as the longer you wait, the more likely you will develop complications from PID.
While being treated for PID, it is advisable to abstain from sexual activity until your symptoms have fully resolved and you have completed your antibiotic regimen. It is important for your sexual partner to be tested and treated for STI if necessary so that you do not re-infect each other.
Even after treatment, you can still contract PID again if you get infected again.
If you have had PID before, the chances of getting it again increases.
Chronic pelvic pain
Affects up to 25% of patients with a history of PID. Could be linked to cyclic menstrual changes, pelvic adhesions (due to scarring causing internal organs to be stuck together) or fallopian tube blockage.
Approximately 1 in every 10 women with PID becomes infertile, with the highest risk in women who have had delayed treatment or repeated episodes of PID.
Infertility is due to infection and inflammation causing scarring and adhesions outside and within the fallopian tubes, which can lead to tube blockage.
Ectopic pregnancy (pregnancy outside the womb)
Risk of ectopic pregnancy is increased from 10% to up to 50% in women who has a history of PID.
Complications during pregnancy
In pregnant women with untreated PID, complications such as miscarriage, premature birth and stillbirth increases.
Include abscess formation in the fallopian tubes, ovaries which can also extend and spread to the rest of the abdomen (peritonitis) including structures around the liver (Fitz-Hugh-Curtis syndrome).
If you think you have symptoms suggestive of PID or you could be at risk of having PID or a sexually transmitted infection (STI), please see your doctor early or visit our clinics as the earlier you diagnose and treat PID, the lower the chances of developing complications which can be detrimental to your health and fertility. You can also help reduce the risk of getting PID or STI by using condoms with a new sexual partner until they have had a sexual health screen.Click here for our full range of Women’s Health Services
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