by Kimberly Allen R.N.
Pelvic inflammatory disease, referred to as PID, is an infection of the organs of a womans pelvis, including the uterus and cervix as well as the ovaries and fallopian tubes. Over 750,000 women in the US are affected by PID every year. Also, over 100,00 women in the US will become infertile due to PID every year. Teens and first time mothers have the highest rate of PID.
PID is most commonly caused by a sexually transmitted infection, however, in some cases PID can be caused by bacteria that are considered normal vaginal flora and some cases are caused by a co-infection of one or more bacteria. There are many ways bacteria can get into your reproductive system including insertion of an IUD, childbirth, abortion, or miscarriage as well as through a procedure called an endometrial biopsy. In 40-60% of the women diagnosed with PID the causative bacteria is gonorrhea. Chlamydia is also responsible for a large number of cases of PID. Young women that are sexually active with multiple partners have the highest risk of developing PID. Other factors that can significantly increase your chances of developing PID include unprotected sexual contact, and douching on a regular basis. Douching disrupts the balance between the good bacteria and the bad bacteria in the vagina. Douching can also mask the symptoms of infection.
Many women with PID have no symptoms especially when the infection is caused by chlamydia which can lead to complications. Of the women that do experience symptoms the most common is pain in their lower abdomen. Other symptoms that you may experience are fever, a vaginal discharge that tends to have a foul odor, irregular menstrual bleeding, pain with intercourse, and pain or difficulty with urination.
PID can cause serious damage to your reproductive system if left untreated. Scar tissue can develop in any of the organs but it most commonly affects the fallopian tubes. The scar tissue can interrupt or competely block the tubes preventing the sperm from fertilizing the egg making the woman infertile. At least 15% of women with PID become infertile. If the fallopian tube is damaged but not completely blocked the egg frequently doesn’t travel down to the uterus after fertilization and begins to attach and grow in the fallopian tube. This is called an ectopic pregnancy and can lead to rupture of the fallopian tube causing severe bleeding as well as internal bleeding and in some cases death.
If you or your Dr suspect you have PID the Dr will do a pelvic exam and take samples of vaginal and cervical tissue for analysis in the laboratory to determine the organism responsible for the infection. If you are having severe symptoms the Dr may also do a pelvic ultrasound to determine the extent and severity of the infection.
The standard treatment for PID is antibiotic therapy. Usually the Dr will use a combination of at least two different antibiotics known as broad spectrum antibiotics because they are effective against many different bacteria. Most women with PID are able to tolerate oral antibiotics and do not require hospitalization. However, there are times when the Dr will hospitalize women with PID, especially if you’re severely ill, have a chronic illness like HIV or are pregnant. Occasionally some women do not respond to oral antibiotics and may require intravenous antibiotics. In these cases the woman would be hospitalized for 24-48 hours to start the intravenous therapy and assess for side effects then be allowed to receive the remainder of the intravenous antibiotics at home with a home nursing service administering the treatments.
Preventing any type of infection is always better than treating, but in infections like PID it is even more important because it can cause so much irreversible damage before it’s discovered. The single most important thing you can do to prevent PID is practice safe sex. Use a condom every time you have sex and limit your number of partners. If you are a high risk candidate get tested for sexually transmitted infections regularly. This will give you the best chance for early detection and treatment hopefully limiting the damage. Do Not Douche. Douching changes the balance of bacteria in your vagina. practicing good hygiene habits will also help you reduce the potential for infection.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.