Pelvic Inflammatory Disease (PID): Symptoms & Treatment

Pelvic Inflammatory Disease (PID) is a reproductive infection that affects the fallopian tubes, ovaries, and uterus of women. This inflammatory disease is often spread vagina to different parts of the female reproductive organs in the form of bacteria. Pelvic Inflammatory Disease (PID) is a progressive infection that spreads from the lower genital tract and keeps on increasing (worsening) with time. The damage this infection causes to the female reproductive system is often irreversible; however, there are treatments to get rid of the infection and its further outbreak. 

Pelvic Inflammatory Disease (PID) is not new and has been recognized for quite some time now. The infection is predominantly effective amongst sexually active women, especially those under the age of 25 years; however, any female can be at risk.

Although the exact number of women infected with Pelvic Inflammatory Disease (PID) often goes undiagnosed, there are an estimated over 1 million cases every year in the United States of America. PID is a relatively common health concern and is curable through early diagnosis and treatment. 

Symptoms of Pelvic Inflammatory Disease (PID)

Although Pelvic Inflammatory Disease (PID) may not have many noticeable symptoms, infected females can observe certain signs:

• Pelvic Pain is a hallmark sign of PID, with pain ranging from dull to intense towards the lower abdomen or pelvis.
• Excessive pain in the lower back or rectum.
• Unusual vaginal discharge in green/ yellow color with an unpleasant odor.
• Irregular menstrual bleeding with spotting or heavy menstrual flow.
• Painful and discomforting sexual intercourse.
• Nausea and Vomiting.
• Fever and chills.
• Discomfort and pain during urination (similar experiences to UTI).
• Pain during walking

Causes of Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) is caused by bacterial spread from the vagina and cervix towards the uterus, ovaries, and fallopian tubes (the upper reproductive organs). Some of the causes of PID include:

Sexually Transmitted Infections (STIs), especially Chlamydia trachomatis, are the primary reason behind Pelvic Inflammatory Disease (PID). However, most of the women suffering from  Chlamydia trachomatis bacterial infection may not experience any PID symptoms, thus resulting in untreated infection. Besides that, Neisseria Gonorrhoea is another bacterial infection that, if left untreated, can lead to PID. Just like Chlamydia trachomatis, Neisseria Gonorrhoea may also not have symptoms in many.

Non- Sexually Transmitted Bacteria present in the vagina as well sometimes move to the upper reproductive tract leading to Pelvic Inflammatory Disease (PID). Such types of infections are prevalent during IUD insertion, childbirth, and abortion. Or even an imbalance in normal vaginal bacteria (good bacteria) can sometimes create a favourable environment for the development of PID.

In addition, some other factors responsible for  Pelvic Inflammatory Disease (PID) involve:

• Having multiple sexual partners or having a sexual partner with multiple sexual encounters.
• A previous history of PID can often result in the reoccurrence of PID again.
• Age, especially women under 25 years, are at higher risk.
• Women with bowel infections such as gastroenteritis.

PID: Diagnosis and Treatment

The diagnosis of Pelvic Inflammatory Disease (PID) includes:

1. Evaluation of Medical History: Your gynecologist or obstetrician-gynecologist may enquire about your sexual life, medical history, and existing symptoms.
2. Physical Examination: A pelvic diagnosis to determine the tenderness of the pelvic area or a cotton swab for taking fluid samples from the vagina.
3. Lab Tests: A Complete Blood Count (CBC) and other blood tests for checking other signs of infections. Along with blood tests for diagnosing Sexually Transmitted Infections (STIs), including  Chlamydia trachomatis and Neisseria Gonorrhoea.
4. Ultrasound: Imaging studies to visualize the female reproductive organs and identify any abnormalities.
5. Laparoscopy: A minor surgical procedure to visualize the internal regions of reproductive organs and pelvic organs to identify any abnormalities and confirm the diagnosis.

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After the above evaluation, the gynecologist or obstetrician-gynecologist in charge may use the following treatment methods:

1. Medication: Broad-spectrum antibiotics may be prescribed depending on the severity of the underlying bacterial infection. Typically, a combination of antibiotics follows up for an entire course to altogether remove the infection (even after the symptoms improve).
2. Pain Relivers: Pain relievers like ibuprofen for alleviating pain and discomfort. 
3. Rest and No-Sexual Activities: Rest is often advised to support healing. Along with that, the doctors may also advise avoiding sexual activities until the infection is completely treated and cured.
4. Partner Treatment: If the cause of Pelvic Inflammatory Disease (PID) is STIs, doctors may advise diagnosis and treatment for the sexual partner as well. 

Once done, the concerned doctor will plan follow-ups for further monitoring of the response of medication/ treatment and check if the infection is fully treated or not.

For treating PID prompt diagnosis and treatment right after observing symptoms is necessary. If left untreated, the infection can lead to severe consequences. 

Does Pelvic Inflammatory Disease (PID) have any effects on Pregnancy?

Yes, Pelvic Inflammatory Disease (PID) may have significant impacts on pregnancy, especially if the condition is left untreated. Some of its potential side effects involve:

• Infertility (the most severe consequence) due to damage to the Fallopian tube that can make it difficult for eggs to travel from the ovaries to the uterus.
• Increased risk of Ectopic Pregnancy with life-threatening consequences.
• Chronic Pelvic Pain even after successful treatment.
• Preterm Birth and complications during preterm labor.

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Conclusion

Overall, Pelvic Inflammatory Disease (PID) is a severe bacterial infection affecting young women, especially the ones who are highly sexually active. Recognizing the symptoms and getting immediate treatment may help stop the infection, however, the damage (which is already done) can’t be reversed.

To decrease the risk of PID it is essential to practice safe sex along with regular medical diagnosis. Regular screening not only helps in keeping such conditions away but also in preventing reinfection.

References

• Witkin SS, Minis E, Athanasiou A, Leizer J, Linhares IM. Chlamydia trachomatis: the Persistent Pathogen. Clin Vaccine Immunol. 2017 Oct;24(10) [PMC free article]
• Park ST, Lee SW, Kim MJ, Kang YM, Moon HM, Rhim CC. Clinical characteristics of genital chlamydia infection in pelvic inflammatory disease. BMC Womens Health. 2017 Jan 13;17(1):5. [PubMed]