Pelvic imflammatory disease (PID) is an infection of the female reproductive organ. It can affect the fallopian tubes, ovaries, cervix, and the uterus. It can lead to various complications.

Several different types of bacteria can cause PID including the same bacteria that cause the sexually transmitted infection (STIs) gonorrhea and Chlamydia.

What commonly occurs is that bacteria first enter the vagina and cause an infection. As time passes, this infection can move into the pelvic organs.

PID can become extremely dangerous even life threatening if the infection spreads to your blood. If you suspect that you may have an infection see your doctor as soon as possible. Complications include chronic, persistent, pelvic pain, ectopic pregnancy and infertility. 

Causes

Pelvic inflammatory disease (PID) is usually caused by a sexually transmitted infection (STI) like Chlamydia or gonorrhea

• Poor hygiene
• Unsafe sex
• Intrauterine device (IUD) there is a slightly increased risk of PID
• Douching
• Other infections such as bowel infection or ruptured appendix
• Surgical procedures: Some surgical procedures can cause PID
• A vaginal infection
• A disturbed cervical barrier especially during menstruation or after childbirth, miscarriage

Risk factors

You risk of pelvic inflammatory disease increase if you have gonorrhea or Chlamydia or have had an STI before. However you can develop PID without ever having an STI.

• Having multiple sex partners
• Childbirth, abortion or miscarriage
• Douching
• Having sex under the age of 25
• Having sex without a condom
• intrauterine device (IUD) use
• Appendicitis
• Having a history of PID
• An endometrial biopsy
• Having sex without a condom

Symptoms

Many women with PID have no symptoms. If symptoms appear they can vary from mild to severe. However, untreated PID can have serious consequences.

Possible symptoms include:

• Pain during sexual intercourse
• Frequent urination
• Unusual vaginal discharge
• Irregular menstruation
• Bleeding or spotting between periods
• Fever
• Vomiting
• Pain especially in the pelvic area
• Increased or foul smelling vaginal discharge
• Tiredness

Pelvic inflammatory disease can cause mild or moderate pain. However,  some women have severe pain and symptoms such as ;

• Vomiting
• Fainting
• Pain in the abdomen
• A high fever

Diagnosis

The diagnosis of PID generally involves a medical history, gynecologic exam and swabs of the cervix to check for infections.

Test may include:

• Pelvic exam
• Pap smear
• Urine test to check your urine for signs of blood, cancer and other disease
• Cervical culture
• Pelvic ultrasound
• Laparoscopy
• Endometrial biopsy

Treatment

The first kind of treatment is with antibiotic.

Antibiotics for PID include:

• Cefoxintin
• Doxycycline
• Ceftriaxone
• Metronidazole

Hospitalization: If a women with PID is pregnant or has very severe symptoms she may need to remain in the hospital. In the hospital intravenous medication may be given.

Surgery: This is rarely needed but it may be needed if there is scarring on the fallopian tubes or if an abscess needs draining. This may be keyhole surgery or it may involve removal of one or both fallopian tubes.

Complications

• Chronic pelvic pain
• Abscess
• Trouble getting pregnant
• Scaring that can lead to fertility problems
• Ectopic pregnancy
• Recurring PID
• A Tubo-Ovarian Abscess (TOA)
• Severe pelvic pain

Prevention

• Using a condom or cervical cap and practicing safe sex
• Not douching
• Having regular screening, especially for those who have multiple sex partners
• Ensuring sexual partners are tested for infections and STIs