Pelvic Inflammatory Disease (PID) is a common pelvic infection of the genitals, uterus, ovaries and fallopian tubes. It can be sexually transmitted and is most frequent in sexually active women but it can also occur due to changes in the bacterial flora of the vagina brought on by illness and as a side-effect of medications. Rarely, an IUD may cause PID. It is important that any woman with symptoms of infection seek medical advice promptly because undiagnosed, untreated PID can scar the pelvic organs and cause infertility, particularly in cases where the PID was sexually transmitted.
Symptoms of PID are:
A diagnosis of PID is made after a pelvic examination. Swabs will be taken for analysis to identify the type of bacteria present. If the patient has had intercourse without using a condom or with more than one partner, she will be offered a test for sexually transmitted diseases like gonorrhoea to rule these out as a possibility. Some women with PID have an STI and so this will help in the diagnosis, but as there are other causes, this isn’t a fail-safe method of diagnosis.
A urine sample will also be tested.
If diagnosis is uncertain from these measures, a trans-vaginal ultrasound can be done. This involves inserting a probe into the vagina and doing an internal scan of the pelvic organs.
Treatment for PID is antibiotics. The woman will be given a course of antibiotics. If the infection is severe, they may also be given by injection or by IV in a hospital setting. If she has a partner, he should also receive treatment. In-patient treatment may be suggested if she has PID and she is also pregnant or another condition is suspected, such as appendicitis.
Painkillers and anti-inflammatories can also be taken to ease the discomfort and these can be taken in combination with the antibiotics.
Remember, PID can cause infertility because the inflammation and scarring can cause a build up of scar tissue on the pelvic organs that can block the fallopian tubes or prevent a fertilised egg from implanting into the uterus. This occurs in one in 10 women who get PID. Having the infection also makes an ectopic (tubal) pregnancy more likely if conception were to occur. Tubal pregnancies are dangerous because they can lead to the rupturing of the fallopian tube and result in heavy bleeding that is life threatening to the woman.
If left untreated, PID can result in long-term chronic pelvic pain and affect a woman’s future enjoyment of intimacy and her self-esteem, so it’s always best to get a gynaecological check up when any changes are noticed, even if they seem minor.