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Understanding Pelvic Inflammatory Disease: Symptoms, causes and treatments

Dr. Ajay KohliSept 14, 2023

Pelvic inflammatory Disease (PID) can cause long-term effects on women's reproductive potential. As a serious complication of some sexually transmitted diseases caused by bacteria, the infection is marked by mild to severe lower abdominal pain and vaginal discharge. When diagnosed early, prompt, and appropriate treatment can help prevent complications of PID. Read ahead to know more about this disease.

Contents

What is Pelvic Inflammatory Disease?
Signs and symptoms of Pelvic Inflammatory Diseases
What causes Pelvic Inflammatory Disease (PID)?
Treatment of Pelvic Inflammatory Disease
Diagnosis of Pelvic Inflammatory Disease
How can I prevent Pelvic Inflammatory Disease?
Risk factors for Pelvic Inflammatory Diseases
Frequently Asked Questions (FAQs)

What is Pelvic Inflammatory Disease?

Pelvic inflammatory Disease is an infection of the female reproductive system involving the uterus, fallopian tubes, and/or ovaries. In most cases, PID occurs due to sexually transmitted infections (STIs) associated with gonorrhoea and chlamydia. Repeated episodes of untreated PID can lead to infertility, chronic pelvic pain, and ectopic pregnancy (pregnancy outside the uterus).

Signs and symptoms of Pelvic Inflammatory Diseases

Symptoms of PID resemble other health problems and can vary from none to severe. In most patients infected with chlamydia, the symptoms are either mild or none, while the damage is silently done to their reproductive organs. However, those who have milder symptoms may go on to experience the following.

Lower abdominal pain (the most common symptom)
Fever
Pelvic discomfort
Foul-smelling vaginal discharge
Painful urination (burning sensation)
Abnormal bleeding pattern
Lower back pain
Tiredness
Nausea and vomiting
Pain during sex
Pain in the right upper abdomen(rare)

In a small fraction of patients, especially those infected with gonorrhoea, the PID symptoms are often severe, with patients experiencing a high-grade fever and severe pain.

What causes Pelvic Inflammatory Disease (PID)?

Often, Pelvic Inflammatory Disease occurs due to the bacteria that also cause STIs. But the disease can also arise when the normal bacteria present in the woman's vagina or cervix move upward into other reproductive organs coupled with additional causes such as the following.

Childbirth
Miscarriage or Abortion
Placement of an intrauterine device (IUD) (risk of infection highest in first few weeks)

Treatment of Pelvic Inflammatory Disease

Antibiotics are a fast and effective way to prevent complications of PID. But treatment might not be able to undo the damage the long-standing PID has caused your reproductive organs. For this reason, see your doctor right away to get the necessary help you need. Depending on your general health, your medical history, and the anticipated duration of the infection, you will be given a combination of antibiotics, which you must take as instructed, even if you feel better. This will ensure that your infection is cleared completely.

A woman may also be advised to get treated in the hospital, if:

She is pregnant
She is seriously ill
Her symptoms do not improve with oral antibiotics even after a few days, and you need antibiotics intravenously
She has a suspected abscess in a fallopian tube or ovary
She needs surgery (in rare situations)

Furthermore, it is also essential that your sex partner must undergo treatment, despite not having symptoms. Or else, you may get PID again when you resume sex.

Diagnosis of Pelvic Inflammatory Disease

To diagnose PID, your doctor will take a medical history related to your general health, symptoms, and sexual activity. They will also do a pelvic examination to look for the signs of infection and conduct some laboratory tests to confirm the diagnosis. These include:

Blood tests, particularly vaginal culture, to identify the offending agent
Urine test to check for the signs of urinary tract infection and cancer
Ultrasound to get more clear-cut images of the reproductive system

Sometimes, when your diagnosis is not precise, your doctor may opt for added tests such as laparoscopy and endometrial biopsy to identify the cause of PID.

How can I prevent Pelvic Inflammatory Disease?

Currently, there are no effective means to prevent PID. Even though STIs are the primary cause of PID, normal bacteria in your vagina can also cause this condition. So, if you want to lower your risk of PID, the surest way is to abstain from unprotected sex or be in a long-term, mutually monogamous relationship with an uninfected partner. Regardless, if you still want to get engaged, here are some things to keep in mind.

Get tested for sexually transmitted diseases if you notice any PID-related symptoms to know for sure if it is caused by chlamydia or gonorrhoea infections. Treating STIs early is the best way to prevent PID.
Practice safe sex by using condoms or dental dams every time you have sex.
Limit sex partners, for your risk of catching STI increases with the growing number of sexual partners.
Avoid washing your vagina (douching) as it raises your risk for PID by pushing bacteria deeper into other parts of your reproductive system, like your uterus, ovaries, and fallopian tubes.

Risk factors for Pelvic Inflammatory Diseases

PID majorly associates with gonorrhoea and chlamydia infection. But here’s a list of other risk factors that may contribute to establishing the disease.

Having multiple sexual partners
Age 25 or below
Pregnancy
Repeated episodes of PID
Having sex without a condom
Excess douching
Use of an intrauterine device

Frequently Asked Questions (FAQs)

Here are some common questions and answers related to Pelvic Inflammatory Disease.

What happens if I do not get treated for Pelvic Inflammatory Disease?

If you delay PID treatment, the possibility of repeated infection increases, which can lead to infertility, ectopic pregnancy, and continuous pain in your lower belly in the long term.

How long does it take to clear pelvic inflammatory disease?

A 14-day course of at least two antibiotics can effectively cure PID. However, the treatment will not be able to undo the damage to reproductive organs caused by the disease.

Can I get pregnant if I had Pelvic Inflammatory Disease before?

Having had Pelvic Inflammatory Disease before does not mean you cannot conceive. But, with every episode of PID, your fallopian tubes become increasingly damaged, which will prevent your eggs from travelling to the uterus, leading to decreased fertility. In fact, about one in ten women with PID indeed becomes infertile.

Does Pelvic Inflammatory Disease increase the risk of cancer?

Evidence suggests that Pelvic Inflammatory Disease is associated with ovarian and cervical cancer in women, and that the risk is higher for cervical cancer.

Is it safe to resume sexual activity after pelvic inflammatory disease?

You and your partner can resume sexual activity safely after completing two weeks course of antibiotics. This will help ensure that reinfection is prevented.

References

https://www.womenshealth.gov/a-z-topics/pelvic-inflammatory-disease
https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
https://my.clevelandclinic.org/health/diseases/9129-pelvic-inflammatory-disease-pid
http://www.ncbi.nlm.nih.gov/books/NBK499959/
https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.13935
https://doi.org/10.1186/s12905-021-01413-2
https://doi.org/10.1016/j.ejogrb.2019.11.004

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