What is PID or Pelvic Inflammatory Disease?

Pelvic inflammatory disease (PID) is a bacterial infection of the female reproductive organs. PID is often transmitted sexually, but not always. While chlamydia or gonorrhea infections are the most common, PID can also be caused by many types of bacteria. Usually, these bacteria are contracted during unprotected sex. These bacteria spread from your vagina to your fallopian tubes, uterus, and ovaries when the normal barrier created by the cervix gets disturbed. This can occur during menstruation and after childbirth, abortion, or miscarriage.

Although rarely, bacteria may also enter the reproductive tract during the insertion of an IUD (intrauterine device), a type of long-term birth control, or any medical procedure that involves inserting instruments into the uterus. Pelvic pain by PID can be so mild that it goes unnoticed, or it can be so severe that the person is unable to stand.

According to the U.S. Department of Health and Human Services, this condition affects about 5 percent of women in the United States.

PID can become extremely dangerous, even life-threatening, if the infection spreads to your blood. If you suspect that you have an infection, see your doctor as soon as possible.

How Common is Pelvic Inflammatory Disease?

Every year, more than 1 million women in the U.S. get PID. And more than 100,000 women become infertile because of it, meaning they cannot have a baby. Many cases of ectopic pregnancies are also the result of PID. An ectopic pregnancy occurs when the baby starts to develop outside of the uterus, most commonly in the fallopian tube. An untreated ectopic pregnancy needs immediate medical attention.

Cases of PID have dropped in recent years. The reason may be that more women get tested regularly for chlamydia and gonorrhea, the main infections that lead to PID.

What are the symptoms of PID?

Some women do not always show signs of PID until there are difficulties during pregnancy. The symptoms of the pelvic inflammatory disease include the following –

• The pain intensity ranges from moderate to severe, primarily in the lower abdominal area and pelvis.
• Vaginal discharge – It can be an abnormal and heavy discharge with a bad smell.
• Uterine bleeding – It is abnormal and between periods or after sexual intercourse.
• Intercourse accompanied by frequent pain.
• You might have difficulty urinating due to pain and increased frequency.
• You may have a fever with chills.

When to Consult a Doctor?

Consult your doctor immediately if you experience extreme abdominal pain and fever (more than 38.3 °C or 101 °F) accompanied by nausea and vomiting.

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What is the method of diagnosis for PID?

They are as follows –

● The doctor will perform a pelvic examination to evaluate the extent of tenderness and swelling in the pelvic region. Some fluid samples are taken from the vagina and cervix to detect the signs of any sexually transmitted infection like gonorrhea and chlamydia.

● Blood and urine tests are conducted to look for infections.

● Your doctor may also order an ultrasound study to picture the reproductive organs.

In very few cases, the diagnosis would require:

● Laparoscopy. A thin, lighted instrument is inserted through a small incision in your abdomen to view the pelvic organs.

● Endometrial biopsy. A thin tube is inserted into the uterus to remove a small sample of endometrial tissue. The tissue is tested for signs of infection and inflammation.

What are the complications of PID?

Uterine infection is common in PID. Untreated diseases can lead to permanent damage and difficulties during pregnancy.

• Ectopic pregnancy – The development of infected scar tissue in the fallopian tubes can prevent the fertilized egg from reaching the uterus for implantation. This leads to ectopic pregnancy when the egg is left behind in the uterine (fallopian) tube. It can cause heavy bleeding and is life-threatening. The condition requires immediate medical care.
• Infertility – PID causes damage to a woman’s reproductive organs and can take away her ability to get pregnant. A delay in the treatment of pelvic inflammatory disease increases the risks of becoming infertile.
• Chronic pelvic pain – The pain due to PID can last for a long period. You might experience pain during ovulation and intercourse too.Abscess formation – An abscess is the accumulation of pus that might form in your reproductive region due to pelvic inflammatory disease. It usually affects the ovaries and uterine tubes and is known as a tubo-ovarian abscess.

Test for Pelvic Inflammatory Disease

Diagnosing PID

Your doctor may be able to diagnose PID after noting your symptoms. In most cases, your doctor will run tests to confirm the diagnosis.

Tests may include:

• A pelvic exam to check your pelvic organs and lower abdominal area.
• A cervical culture to check your cervix for infections.
• A urine test to check your urine for signs of blood, cancer, and other diseases.

After collecting samples, your doctor sends these samples to a laboratory.

Assessing damage

If your doctor determines that you have pelvic inflammatory disease, they may run more tests and check your pelvic area for damage. PID can cause scarring on your fallopian tubes and permanent damage to your reproductive organs.

Additional imaging tests include:

• Pelvic ultrasound: This is an imaging test that uses sound waves to create pictures of your internal organs.
• Endometrial biopsy: In this outpatient procedure, a doctor removes and examines a small sample from the lining of your uterus.
• Laparoscopy: A laparoscopy is an outpatient procedure where a doctor inserts a flexible instrument through an incision in your abdomen and takes pictures of your pelvic organs.

What are the risk factors of PID?

The risk factors associated with PID are:

● If you are less than 25 years old and are sexually active.

● If you have multiple sexual partners.

● If you have intercourse without the use of contraceptive barriers like condoms.

● Frequent douching upsets the balance of beneficial and harmful bacteria.

● If you have a medical history of PID or STI (sexually transmitted infection).

What is the treatment for patients with PID?

PID is commonly caused by gonorrhea or chlamydia infections. The treatment for patients with PID includes –

● Antibiotics – Your doctor is likely to prescribe antibiotics initially. The prescribed course should be completed religiously, even if you start recovering or have recovered.

● You and your sexual partner will need to get checked and treated for the sexually transmitted infection. Doing this prevents any reinfection .

● Temporary abstinence – This method focuses on avoiding any sexual intercourse until the treatment is completed;

What are the precautions to PID?

Follow these precautionary and preventive measures to reduce the risk of Pelvic Inflammatory Disease:

● Avoid unprotected sex and practice safe sex. You should use condoms or other protective barrier methods during intercourse. Be aware of the partner’s sexual history and limit the number of partners.

● Consult your doctor immediately in case of any sexually transmitted infection. Early treatment can prevent the risk of developing Pelvic Inflammatory Disease.

● If you are affected by PID or any STI, ensure that your partner also gets tested and treated . This is done to prevent the recurrence of Pelvic Inflammatory Disease.

● Avoid Douching – Douching is the process of washing and cleaning the vagina from inside with the use of water or any other fluids. This procedure affects the balance of bacteria and can cause complications.

Frequently Asked Questions (FAQs)

1. Can PID go away on its own?

Pelvic Inflammatory Disease should not be left untreated, and it rarely goes away on its own. It can cause scarring and abscess in the fallopian tubes resulting in permanent damage. It can cause ectopic pregnancy as a long term complication. In very few women, PID will show no symptoms, and the inflammation due to it can go away without any medical treatment.

2. What does PID discharge look like?

Discharge due to Pelvic Inflammatory Disease occurs through the vagina. It is an abnormal and heavy vaginal discharge, which is yellowish-green in colour, having an unpleasant odour.

3. What happens if PID is left untreated?

If Pelvic Inflammatory Disease is left untreated, it can cause permanent damage. It can cause serious complications like ectopic pregnancy, infertility, and chronic pelvic pain that do not go away easily. In some cases, it leads to the accumulation of pus that might form in your reproductive area affect the ovaries and uterine tubes.

4. Will PID show up in a urine test?

Your doctor is likely to perform a pelvic examination and take blood and urine samples to detect the presence of chlamydia, gonorrhoea, and other infections.