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Pelvic Inflammatory Disease: Causes and Treatment
Gainesville well-woman care physicians at All About Women discuss risk factors, signs, and treatment options for women with pelvic inflammatory disease (PID)
Pelvic inflammatory disease (PID) is a serious women's health issue, yet many women don’t really know what it is. That's because PID symptoms can often be vague or nonexistent, making PID difficult to recognize and diagnose.
PID can lead to serious complications, including infertility, so it’s crucial that all women educate themselves about the potential risk factors and signs of PID so they know when to contact their well-woman care provider for treatment.
What is pelvic inflammatory disease?
Pelvic inflammatory disease, or PID, occurs when one or more of a woman's reproductive organs become inflamed from harmful bacteria that have entered the reproductive tract. This inflammation can cause abscesses or scar tissue to form in places like the fallopian tubes.
If left untreated, the abscesses and tissue can cause several conditions, including:
- Infertility. If enough scar tissue forms in the fallopian tubes, it can prevent the ability of sperm to join with an egg.
- Ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg begins to grow somewhere other than the uterus, usually in the fallopian tubes. The Centers for Disease Control and Prevention (CDC) reports that PID is one of the main causes of ectopic pregnancy. Ectopic pregnancy can be deadly and must be treated immediately.
- Chronic pelvic pain. Untreated PID can cause severe pelvic pain for months or even years.
What causes PID?
Undetected chlamydia and gonorrhea are the two main causes of PID. Both of these sexually transmitted infections (STIs) are usually asymptomatic in women and often go unnoticed, which is why it’s important that all women have an annual well-woman care exam that includes STI screening.
Pelvic inflammatory disease is sometimes caused by bacteria that are not associated with gonorrhea and chlamydia. Other potential causes of PID include bacterial vaginosis and picking up bacteria through a surgical procedure, such as an endometrial biopsy, abortion, or IUD insertion, or as a result of douching.
Who's most at risk for PID?
Those at high risk for pelvic inflammatory disease include women who:
- Are under the age of 25
- Have more than one sex partner
- Have chlamydia or gonorrhea
- Have a history of PID or any STIs
Women who douche are also at a higher risk for PID. This may be because douching upsets the natural flora balance in the reproductive tract, allowing harmful bacteria to grow. It may also push harmful bacteria higher up the reproductive tract. Because of this, the American College of Obstetricians and Gynecologists (ACOG) does not recommend douching.
What are the signs of PID?
The most common signs of PID include:
- Spotting or irregular or heavy menstrual periods
- Foul-smelling or off-colored vaginal discharge
- A fever that comes and goes
- Painful, frequent urination
- Pain during sex
- Tenderness or pain in the pelvic region, abdomen, or back (especially the upper right abdomen)
- Nausea or vomiting
If you have any of these symptoms, you should call your well-woman care provider immediately. You may have a case of PID that needs to be treated, or you may have another serious condition like appendicitis or ectopic pregnancy.
Some women who have PID will have no symptoms. These are the most dangerous cases of PID because they are less likely to be detected and more likely to cause significant damage to a woman's reproductive organs.
Because of the wide array of possible symptoms or the lack of symptoms altogether, PID can be difficult to diagnose. Having an annual exam that includes screening for STIs and being honest about your sexual history with your health care provider can help protect your reproductive health.
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How is PID diagnosed and treated?
PID is diagnosed through a pelvic exam that can reveal any tenderness of the uterus or ovaries. Women may have a tender cervix that bleeds easily. If so, your doctor will test you for certain bacteria, including chlamydia and gonorrhea. Your doctor may also perform an ultrasound or laparoscopy to investigate the amount of damage done by PID.
Antibiotics, either oral or by shot, are used to treat PID. The course of treatment is usually 10 to 14 days. Even if symptoms are relieved before the end of an antibiotic round, you should always complete the antibiotic to ensure the bacteria will not begin to grow back.
You should not have sex while you are being treated for PID, and you should ensure your sexual partner is free of STIs before having sex again to prevent reinfection.
While antibiotics will kill the bacteria causing PID, they are unable to undo any damage done by the disease.
Have questions about pelvic inflammatory disease? We can help!
Pelvic inflammatory disease, while easily treated, can be difficult to recognize and diagnose. Untreated PID can have serious complications. That's why it's important for all women to receive an annual exam from a gynecologist who they have an ongoing relationship with.
The well-woman care physicians and nurse practitioners at All About Women in Gainesville and Lake City provide compassionate and attentive care for women at all stages of life.