Pelvic inflammatory disease (PID) is an infection of the female reproductive organs that can damage parts of the female reproductive system (uterus, ovaries, fallopian tubes, etc). Usually, patients may not realize that they have PID because symptoms may be mild, or they may not experience any symptoms. However, below are some common symptoms noticed by patients with PID.
- An unusual discharge from the vagina
- Bad vaginal odor
- Fever (100.4° F or higher)
- Burning sensation during urination
- Pain in the lower abdomen
- Pain and/or bleeding during sex
- Bleeding between periods
- Nausea and vomiting
- Lower backache
- Generalized weakness
- Swollen lymph nodes
- Rarely patients may experience pain in the upper right side of the stomach
What are the common causes of PID?
PID is a swelling of the pelvic organs caused by an infection spreading from the vagina and cervix to the uterus (womb), fallopian tubes, ovaries, and pelvic area. If severe, it may cause an abscess (collection of pus) inside the pelvis. PID is more common in young, sexually active women. The common causes of PID include:
- Untreated sexually transmitted infections (STIs), such as chlamydia, gonorrhea, are the most likely causes of PID.
- PID may also be caused by several less common infections that may or may not be sexually transmitted.
- Having more than one sex partner or having a sex partner who has multiple sex partners.
- Recurrent vaginal douching (Washing the vagina with water or a mixture of fluids to eliminate odors and clean the vagina. This can push bacteria into the reproductive organs and cause PID. Douching may also hide the signs of PID).
- Rarely PID may develop after a miscarriage or termination of pregnancy, after having a baby, or after a procedure such as insertion of an intrauterine device (IUD) or coil.
- Women who have already had PID are at higher risk for another episode.
How is PID diagnosed?
The doctor may suspect PID based on patient symptoms or during a pelvic exam. The patient may have pain or tenderness when the doctor examines the cervix or uterus. Below are some other ways to diagnose or confirm PID:
- Blood test
- Microscopic examination of samples from the vagina and cervix
- Pap test: This test involves microscopic examination of cells collected from the cervix that is used to detect changes that may be cancer or may lead to cancer and show noncancerous conditions, such as infection or inflammation.
- Ultrasound: A diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs.
- Laparoscopy: A minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic area, the physician can determine the locations and extent of infection.
- Culdocentesis: A procedure in which a needle is inserted into the pelvic cavity through the vaginal wall to obtain a sample of the pus, which is later examined to confirm PID.
How is PID treated?
Treatment may include painkillers and antibiotics used to treat gonorrhea, chlamydia, streptococci, and other gram-negative bacteria. Due to the difficulty in identifying organisms infecting the internal reproductive organs and more than one organism may be responsible for an episode of PID, PID is usually treated with at least two antibiotics that are effective against a wide range of infectious agents. These antibiotics can be given by mouth or by injection. The symptoms may go away before the infection is cured. Even if symptoms go away, the woman should finish taking all of the prescribed medicine. This will help prevent the infection from returning. Severe cases of PID or pregnant women may need to stay in the hospital and get antibiotics through a vein (intravenous). Sometimes, surgery may be needed to drain a pocket of infection or an abscess. Aggressive treatment of PID is recommended for women with HIV, who may be more likely to require surgical intervention.