Pelvic inflammatory disease (PID) is an infection of the female reproductive organs (uterus, fallopian tubes and ovaries). In the United States alone, approximately 1 million women contract PID each year. Women who have already had an STD, are under 25 and sexually active, douche, have recently been fitted for an intrauterine device (IUD) for birth control, or any sexually active woman of childbearing age who has more than one sex partner are at greatest risk for PID.
How do I know if I have PID?
The most common way to get pelvic inflammatory disease is through sexual contact with someone who has gonorrhea or chlamydia, which are bacterial STDs. Germs spread up the vagina and infect the cervix, then the bacteria travels to other reproductive organs. Bacteria can also move up into a woman’s reproductive tract through douching. In rare cases, PID develops without any STD contact; how normal bacteria causes PID is unknown.
PID can develop quickly or over a few weeks or months. Some women suffer severe symptoms, while others have hardly any. This can be especially dangerous, since internal damage can occur without a woman even knowing she has PID. Among the warning signs to look out for are lower abdominal pain (the most common symptom), fever, smelly yellow or green vaginal discharge or bleeding, and painful intercourse, pain in the upper right abdomen, urination and/or bowel movements. If a woman experiences any of these, particularly at the end of a menstrual period, she should see her health care provider right away.
PID Diagnosis and Treatment
Pelvic inflammatory disease can be difficult to diagnose when the symptoms are mild, which is sometimes the case when a woman is infected through exposure to chlamydia. PID caused by gonorrhea can come on fast and often be accompanied by acute pain and fever. There is no specific test for PID, so a health care provider will conduct a general and pelvic examination and test for STDs and infections. A pelvic ultrasound, laparoscopy or uterine biopsy may be performed to check on internal organs.
PID must be treated as soon as possible to prevent serious complications. Antibiotic treatment can cure most cases, and more than one antibiotic is often prescribed, to combat a range of infections. However, even with successful treatment, reproductive organs can be permanently damaged. (If a woman is being treated for PID, her partner should be treated as well, even if asymptomatic, to lessen the risk of re-infection. Don’t engage in sexual activity until both have completed the course of medication.) In severe cases of PID, a woman might be hospitalized to treat extreme symptoms or complications. A pregnant woman or a woman who is HIV-positive who contracts PID will also probably be hospitalized.
Serious Complications of PID
PID can result in serious complications if treatment is delayed and is the most common cause of infertility in women. Women with untreated pelvic inflammatory disease are at risk for permanent fallopian tube damage. Scar tissue develops and blocks the tubes and/or ovaries, which can lead to infertility (eggs don’t develop properly or cannot travel from the ovaries to be fertilized) or ectopic pregnancy. Other potential problems associated with PID include chronic pelvic pain, ovarian abscess and scarring; these can sometimes be successfully treated with surgery. Once a woman has had PID, she can get it again (about a third do), and each occurrence increases the risk of infertility.
The only certain way to prevent PID is sexual abstinence. If you are sexually active, limit the number of partners, practice safe sex and be tested regularly for STDs. Using latex condoms during sex can reduce the risk of gonorrhea and chlamydia, the most common causes of PID. Don’t douche, as this can move bad bacteria into the upper reproductive organs. If you contract an STD or experience any suspicious symptoms, see your health care provider immediately.